What Is Seasonal Affective Disorder?
Seasonal affective disorder (SAD) is far more than the "winter blues." While holiday stress and cold winter months can dampen anyone’s mood, those with SAD experience a more severe form of depression triggered by seasonal changes. Each year, about 5% of the U.S. population is affected by this condition.
Experts believe SAD arises due to shorter daylight hours and reduced sunlight exposure, which disrupt the body’s circadian rhythm and serotonin levels—a neurotransmitter often referred to as the "happy hormone." This disruption can lead to symptoms such as hopelessness, excessive sadness, social withdrawal, and oversleeping. Although winter-pattern SAD is more common, some individuals also experience summer-pattern SAD.
Fortunately, symptoms typically improve as the seasons change. Treatments like therapy and medication can provide relief more quickly for those affected.
Types of Seasonal Affective Disorder
There are two primary types of SAD:
Winter-pattern SAD: This is the most common form, with symptoms typically beginning in December and subsiding by March. The months of January and February typically pose the greatest challenges.
Summer-pattern SAD: Less common, this type starts in June and usually improves by September.
Symptoms
People with SAD may experience the following symptoms, regardless of the season:
Persistent feelings of sadness, emptiness, or hopelessness
Irritability
Loss of interest in activities once enjoyed
Trouble concentrating
Fatigue and slow physical movement
Unexplained physical aches and pains
Season-specific symptoms include:
Sleep disturbances: Oversleeping is common in winter-pattern SAD, while insomnia is more typical of summer-pattern SAD.
Changes in eating habits and weight: Winter-pattern SAD often causes carbohydrate cravings and weight gain, whereas summer-pattern SAD can suppress appetite and lead to weight loss.
Social isolation: Those with winter-pattern SAD may "hibernate," while individuals with summer-pattern SAD often experience heightened social anxiety.
Causes
The causes of SAD remain under investigation, but researchers have identified several contributing factors:
Reduced serotonin: Sunlight influences molecules that regulate serotonin levels, and insufficient exposure can cause mood changes.
Vitamin D deficiency: Sunlight stimulates vitamin D production, which is linked to mental health. Low levels may increase the risk of depression and anxiety.
Melatonin imbalance: Seasonal changes can disrupt melatonin production, which regulates sleep cycles. People with winter-pattern SAD often produce excess melatonin, resulting in fatigue and oversleeping.
These theories primarily explain winter-pattern SAD, while the mechanisms of summer-pattern SAD require further study. However, it’s clear that changes in sunlight and seasonality impact mood, sleep, and overall well-being.
Risk Factors
Certain factors increase the likelihood of experiencing SAD, including:
Being assigned female at birth
Ages 18 to 30 years old
Living farther from the equator
Having pre-existing mental health conditions like depression or bipolar disorder
Diagnosis
If seasonal mood changes disrupt your quality of life, consult a healthcare provider. Diagnosis often involves:
Identifying a seasonal pattern in depressive symptoms
Assessing whether symptoms persist for three to five months
Confirming a history of seasonal mood changes over at least two consecutive years
Providers may also use the Seasonal Pattern Assessment Questionnaire (SPAQ) to evaluate mood, sleep, appetite, energy, and weight changes. They may rule out physical conditions like hypothyroidism or hypoglycemia that can mimic SAD symptoms.
Treatment
Although symptoms often improve as the seasons change, several treatments can help:
Light therapy: Especially effective for winter-pattern SAD, light therapy involves daily exposure to a lamp emitting 10,000 lux of light for 30–45 minutes.
Psychotherapy: Cognitive behavioral therapy (CBT) for SAD helps patients challenge negative thoughts and engage in enjoyable activities.
Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), such as Prozac (fluoxetine) and Zoloft (sertraline), can be effective when therapy alone isn’t sufficient.
Vitamin D supplementation: While studies are inconclusive, some individuals find relief with vitamin D supplements. Consult your provider to determine the best approach.
How to Prevent SAD
For winter-pattern SAD, starting treatment in the fall can prevent symptoms as daylight decreases. This might involve beginning therapy, taking antidepressants, or building habits such as regular exercise. Engaging in joyful activities and maintaining a routine can also help.
For summer-pattern SAD, strategies like meal prepping to prevent weight loss or improving sleep hygiene with blackout curtains or white noise machines may reduce symptoms.
Related Conditions
SAD frequently overlaps with other mental health conditions, including:
Major depressive disorder
Bipolar disorder
Attention-deficit/hyperactivity disorder (ADHD)
Eating disorders
Generalized anxiety disorder (GAD) and panic disorder
Living With Seasonal Affective Disorder
Early treatment and proactive strategies make it possible to manage SAD effectively. Medication, therapy, and lifestyle changes tailored to your specific needs can transform the winter or summer months from a period of struggle to one of growth and resilience. Remember, seasonal depression is temporary. Practicing self-compassion and seeking support from loved ones can provide comfort and hope in challenging times.