Understanding SAD: Seasonal Affective Disorder
Behavioral Health
December 08, 2020
Understanding SAD: Seasonal Affective Disorder
Woman looking out the window sadly

The holidays bring visions of cheer for many, but for others, the end of the year feels anything but merry. The approach of the holiday season may cause periodic feelings of the winter blues for some people. This is called seasonal affective disorder (SAD). 

While North Texans may not experience long, dark winters like residents in other parts of the country, we’re still capable of experiencing what’s commonly known as the “winter blues.” As the days get shorter and temperatures start to drop, symptoms ranging from mild depression to full-blown seasonal affective disorder may occur.

But this year brings with it a unique twist, with many experiencing pandemic-related depression or anxiety in addition to feelings associated with SAD. 

“The advent of the pandemic has brought about an increase in numbers of reported depressive symptoms, observed by the CDC, and this is in part due to a limit on activities and increased isolation throughout the year caused by COVID,” says Janet Ogbon, a licensed professional counselor on the staff at Texas Health Behavioral Health. “This can be tied to SAD in that with the change in season to colder, winter months with less sun, activities are further limited and isolation can occur much easier as we naturally tend to stay indoors more often during this time of year.”

Ogbon says while SAD may not be well-known, it is a very real mental health disorder that should be taken seriously and discussed with a health care professional. 

What it Is

Seasonal Affective Disorder (SAD) is a type of depression, so it’s not generally thought of as a disorder on its own such as anxiety or post-traumatic stress. SAD occurs when you experience mood and behavior changes similar to depression that correlates with a change in season, most commonly fall and winter, when the days get shorter. That being said, Ogbon notes that SAD can also occur in summer months, but it is less common. 

Between 4% to 6% of people in the United States experience SAD, though it’s thought that 10% to 20% of the population experience a milder version of it. But Ogbon notes, that increased awareness of SAD and its symptoms has also led to an increase in diagnoses. 

Symptoms can include: 

  • A change in appetite, especially craving sweet or starchy foods
  • Weight gain
  • Fatigue or low energy
  • Oversleeping or sleeping more than normal
  • Difficulty concentrating
  • Irritability and anxiety
  • Increased sensitivity to rejection
  • Avoidance of social situations
  • A loss of interest in the activities you used to enjoy
  • Feelings of guilt or hopelessness
  • Physical issues, such as headaches or aches

While the symptoms of SAD can seem vague or related to many other conditions, it’s important to remember that symptoms of SAD tend to come back year after year, and they usually come and go at about the same time every year. 

What Causes SAD?

The most common cause of SAD is directly related to the decrease of sunlight in the fall or winter. Our exposure to light holds an important role in regulating many functions in our body, such as our circadian rhythm (biological clock) which affects our body’s natural wake and sleep cycles, serotonin levels which affect our mood, melatonin levels which helps us fall asleep (more darkness causes the body to produce more melatonin), and vitamin D levels, a natural vitamin our bodies absorb from the sun which plays a role in serotonin levels. 

But Ogbon adds that some people are more at risk for developing SAD than others. 

“A connection has been observed with family history,” she explains. “If you have a relative who suffers from SAD or another form of depression, then there is a higher risk that you will experience SAD. Another risk factor is already having a diagnosis of a depressive disorder or bipolar disorder.”

Being far from the equator, which we are in the U.S., is another risk factor as being far from the equator usually means less sunlight during the winter. SAD is also seen more in younger adults than older adults and can be up to 4 times more common in women than men, Ogbon adds. 

How is it Diagnosed and Treated? 

Diagnosis starts with talking to a trusted health care provider or mental health professional about what you’re feeling. They will ask you about your symptoms, thoughts, feelings, and behavior, and may perform a physical exam. They may also request lab tests to rule out other conditions that cause symptoms similar to SAD. 

“Even if you aren’t entire sure if you’re experiencing SAD, talking to someone could be useful to get a clinical take on what you’re experiencing to address possible symptoms earlier,” Ogbon says. 

Once a diagnosis is made, treatment can begin. There are three common therapies to treat SAD: Light therapy, behavioral therapy and medication. 

Light therapy, also known as phototherapy, is designed to make up for the lack of sunlight during fall and winter. 

“Your doctor may have you come in for treatment, which generally involves sitting next to a light therapy box that mimics natural outdoor light or your doctor may recommend you purchase a light therapy lamp on your own.”

The amount of time you sit in front of the light box depends on the strength of the light. It is usually between 20 and 60 minutes.

There are other types of light therapy. Instead of sitting in front of a box, you can wear a visor that emits light. Another kind is a “dawn simulator.” This light turns on early in the morning in your bedroom. It mimics a natural sunrise and gradually increases in brightness. This allows you to wake up naturally, without using an alarm.

Behavioral therapy, or talk therapy, is what most people think of when they think of traditional therapy. Behavioral therapy can help you identify negative thoughts, then replace them with more positive thoughts. Therapy can also help you learn healthy ways to manage your symptoms of SAD and control manage stress.

Your doctor might recommend you take medicine to help with your symptoms, especially if they are severe. Selective Serotonin Reuptake Inhibitors (SSRIs) are often used to treat depression and some have been approved to treat SAD specifically. If your doctor prescribes medication, it’s important to remember that it can take several weeks before you start feeling the positive effects of the medication. You might also have to try more than one medication to find the one that works best for you. 

Other ways you can help reduce the effects of SAD include:

  • Letting as much natural light as possible into your home or office. Open the blinds, sit close to windows, and keep your environments as bright as possible.
  • Go outside as much as you can. Even if it’s cold or cloudy, the light can still benefit you.
  • Stay physically active. Exercise and activity boost endorphins and relieve stress. Both of these can help you feel better.

If you feel that your SAD symptoms are out of control or negatively affecting your quality of life or work, Ogbon says it’s important to get support immediately. You can start with calling your doctor or speaking to a therapist. You can also get a free assessment at Texas Health Resources by calling (682) 236-6023.

There’s also the option to contact a crisis hotline which is available 24 hours a day, 7 days a week, 365 days a year for support, such as our regional crisis line, North Texas Behavioral Health Authority (NTBHA) at 1-866-260-8000. 

The Takeaway

One of the silver linings of the pandemic has been the focus on health and wellness, including lifting the stigma on mental health. Whether you’re experiencing symptoms of SAD for the first time this year, or it’s something you’ve dealt with for years, it’s important to know that it can be treated and there are support options available to you.  

“I’d like to encourage everyone to take the time to do self-check-ins,” Ogbon says. “Be aware of how you are responding to the change in season, particularly in conjunction with the impact of COVID. It’s easy to want tough it out alone, but don’t hesitate to reach out for support.”

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