The Facts Behind Seasonal Affective Disorder (SAD)

Posted by Donna Mae Scheib on July 16, 2019

The Facts Behind Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder (SAD) is a condition that is described as a common mood disorder for those individuals who exhibit depressive symptoms at the same time each year, most commonly during the winter season. Basically, the reduced amount of sunlight during the winter months disrupts the internal clock of those affected by SAD. This disorder is also called seasonal depression as it generally starts in the fall or winter and ends sometime in spring or early summer.

However, there is also a less common form of seasonal depression known as Summer Depression. This article centers around the condition occurring in the winter season which is the predominant time that SAD occurs.

This article looks more closely at the incidence level of SAD, some of the main causes of this syndrome, its diagnosis, various signs and symptoms, and the suggested treatment options available.

Incidence Level

It is reported that SAD impacts between approximately 1.4%-12.5% of the residents in every state. Normally, there is a lower incident level for those individuals who live in sunnier climates like Florida and a higher incident with those living in the northern-most states like New York.

SAD can affect younger adults, but the senior population is especially vulnerable to this form of depression.  One reason for this is that seniors are mostly homebound during the long winter days. In fact, many of them spend quite limited to no time outside in any activity. Women are more prone to SAD than men, although men are known to exhibit more intense symptoms once diagnosed.

Main Causes

Although medical researchers do not know the exact causes of SAD, some think that certain hormones (deep within the brain) trigger attitude-related changes at specific times of the year. They think that this condition might be related to these changes in hormones. One finding is that because of the lack of sunlight during the winter months, the brain then makes less serotonin. This is the chemical linked to brain pathways that regulate moods. When these pathways don’t work normally, a feeling of depression and symptoms of fatigue and weight gain often set in.

Other researchers believe that seasonal depression is linked to the natural hormone melatonin. This then causes drowsiness. Light is known to affect the biological clock in our brains that regulates circadian rhythms. These rhythms are likely to include mood changes when there is less sunlight in the wintertime.   

So, the main reason for SAD seems to be a lack of sunlight mainly because of the colder and darker seasonal winter weather. Being forced to spend the majority of time indoors leads to less fresh air and less overall activity for many people. This, in turn, impacts the symptoms of SAD and results in your natural body-clock falling out of sync.

Diagnosis and Specific Criteria

According to the American Psychiatric Association, those individuals experiencing SAD must meet four specific criteria: 

• depressive episodes at a specific time each year
• remission(s) at a specific time of the year
• these patterns of episodes and remission(s) (mentioned above) must occur two+ years with no nonseasonal major depressive episodes during this same time
• these seasonal depressive episodes outnumber other depressive episodes throughout the patient's lifetime

Signs and Symptoms

There are varying degrees of SAD. And along with the diagnosis, there are varied signs and symptoms depending on the individual. Some people have mild symptoms with limited irritability and depression; others experience extreme depression that interferes with relationships, work, and most daily activities.

Common symptoms include a change in eating habits – eating too much and having weight gain, possessing little or no energy, feeling ill and nauseous, an inability to clearly focus and concentrate on tasks, difficulty with making any decisions, sleeping too much, social withdrawal from friends and routine activities, agitation and irritability, and a very sad or lonely feeling.

Various Treatment Options Available and Recommendations

There are several suggested remedies to SAD. Many of them are no-cost and involve a simple lifestyle change. Others involve seeking medical attention and advice prior to implementation, and in addition, they come with a cost.

• Spend some time outside every day even if it’s not sunny. The daylight and the fresh air will help your mood.
• Eat a well-balanced diet (e.g., protein, fruits, vegetables, limited fats, and carbohydrates) to maintain your energy. Drink enough water.
• Minimize alcohol and caffeine consumption to help with concentration, focus, and sleep.
• Stay involved with your friends and regular activities. To help you continue with routine activities, pair up with a friend for motivation to stay involved.
• Exercise regularly (e.g., 30 minutes/day for 5 times/week is recommended); exercise produces endorphins which will boost your mind and spirit.
• Incorporate light therapy (phototherapy) if recommended by your doctor (e.g., lightboxes can be rented or purchased; they may be covered by health insurance). Routine procedure for lightbox use: The patient sits two feet away from a bright light which is about 20 times brighter than normal room lighting. The therapy sessions start with one 10-15-minute session per week and increase in both the time and frequency each week under the doctor’s direction. The light therapy continues until your symptoms improve or the winter season is over.
• Use normal lamps for your desk and throughout the rooms in your house during the daytime hours (in addition to night hour) to increase the level of light you are exposed to each day.
• Unwind 15-30 minutes before an afternoon nap or your evening bedtime to relax, ensure better sleep, and to feel more refreshed. Try to maintain a normal bedtime and sleep schedule so your sleep cycle is not so sporadic and you don’t fall victim to excessive sleeping.
• Limit screen time (phones, TVs, and computers) especially an hour prior to your normal bedtime.
• Take a daily Vitamin D supplement. This vitamin is needed to help your body absorb calcium and promote bone growth. Scientists suggest the vitamin helps to prevent depression among other medical conditions and diseases.
• Vacation in a sunny destination and get outside to directly benefit from the sun.
• Talk to your doctor about any symptoms and feelings especially if they are seasonal in nature. Follow their recommendations for any lifestyle changes and treatment. Antidepressants are often suggested.

In Summary

Seasonal Affective Disorder is a condition that impacts a high number of individuals, mostly seniors who are more homebound and less active especially during the colder, darker winter season. However, there are many treatment options and recommendations for this condition. It is important to recognize the symptoms and feelings that are seasonal and discuss these with your doctor. With some simple lifestyle changes, and in other cases, more specialized treatment, the symptoms of SAD can be reduced or eliminated.

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