What is SAD? Seasonal Affective Disorder Symptoms and Advice

Dr. Anne Metz, clinical counseling faculty member at SNHU, answers a number of important and frequently asked questions about Seasonal Affective Disorder and provides resources for sufferers.

What is Seasonal Affective Disorder? What are the typical symptoms or impacts for the average sufferer?

Seasonal Affective Disorder is a type of depression that is also known as winter or seasonal depression. Those with SAD will often experience mood symptoms that are similar to major depressive disorder (MDD) such as sadness, sleep disturbances, loss of interest in pleasurable activities, agitation, loss of energy, appetite changes, difficulty thinking, feelings of hopelessness, and in some cases suicidal thoughts. These mood symptoms typically emerge in the fall and winter –when there is less sunlight – and improve naturally when spring ushers in longer days and stronger sunlight.

What causes SAD during this time of year? Are there certain risk factors that make some people more susceptible than others?

Like all living organisms, people are more or less solar-powered, and when it comes to SAD, I think the analogy holds true. In the summer, when the sun is out for much of the day, our circadian rhythms are largely in sync and make use of that harmony with energy and a positive mood. However, when fall arrives and suddenly the sun sets at 4:30 p.m., and rises at 9 a.m., our circadian rhythms get a jolt, and with it goes our upbeat mood. The loss of light – particularly, the strong direct daylight that we in the northern hemisphere enjoy during the summer months – can trigger SAD. About 5% of adults in the U.S. experience SAD. On average, symptoms last about 40% of the year, according to the Diagnostic and Statistical Manual of Mental Disorders 5. It is more common among women than men, and more pronounced the farther you are from the equator.

What are some things people can do to help relieve some of the symptoms of SAD? When should someone seek a doctor’s help?

First of all, educating yourself about SAD is one the best ways to relieve the suffering associated with the condition. As a culture, we are quick to judge ourselves for having mental health concerns in the first place, which we shouldn’t do. Remember that whole thing about being solar-powered? Well, if you are noticing that you are feeling blue, and it happens to be wintertime, it is worth asking yourself: Could this be SAD? Think about previous winters when you may have felt blue: did you start to feel better when spring arrived? Or, have your symptoms been more persistent and long-standing? Both SAD and MDD can be serious conditions, and if you are starting to notice that you are experiencing a low mood most days for longer than two weeks, it is worth talking to a healthcare provider to help make an appropriate diagnosis.

There are several treatment options out there for those with SAD. Although SAD typically remits on its own when springtime rolls around, treatment can expedite the process. The simplest way to treat SAD is to get more sunlight. A psychiatrist I know always recommended that his SAD patients get cardiovascular exercise, outside, first thing in the morning. However, if you are not a runner or happen to live in an area with a lot of rain, light therapy can be a great alternative to this solar prescription. There are many light therapy lamps available to consumers, and you don’t need a prescription to buy one. That said, it could be helpful to speak with your doctor first since light therapy does have some potential risk.

On balance, however, light therapy is as effective if not more effective than a course of antidepressants, another option for SAD treatment, according to the Mayo Clinic. If you’re interested in light therapy, there are several points to keep in mind to benefit from this treatment. The first is consistency: first thing in the morning, sit in front of the lamp for 30 minutes every day. The second is proximity: make sure you are within 24 inches of the light source. The third is angle: you’ll want to have the light strike the top of your eye, much as it would if you were outside on a sunny day. Usually, after 1-2 weeks of light therapy, people start to feel better.

If you typically struggle with SAD in the winter months, it can be helpful to start your light therapy early. Even though the days are still long in September and October, it is not a bad idea to start light therapy before fall. Prevention is always easier than treatment.

And, of course, talk therapy with a counselor can also help. Cognitive-behavioral therapy has been identified as an evidence-based treatment for SAD, and combined with any of the other treatments mentioned is an optimal approach.

Are there any resources you recommend to sufferers?

If you feel your depression is severe or if you are experiencing suicidal thoughts, consult a doctor immediately or seek help at the closest emergency room. National Suicide Prevention Lifeline – 800-273-TALK (8255).

If you’re interested in light therapy, here is an article on what to look for when selecting a light box.

Some additional resources include Harvard Health Publishing’s article “Seasonal affective disorder: bring on the light,” and the Mayo Clinic’s article about light therapy.