Seasonal Affective Disorder (SAD): How To Beat It This Fall And Winter

Symptoms of seasonal affective disorder

Dr. Desan: “Seasonal affective disorder of the winter type starts in the fall, gets worse through the winter, and gets better in the spring. And if that happens most years as a recurring pattern, someone has seasonal affective disorder.”

Dr. Rosenthal: “At first, it would just look like depression, which could include loss of interest in activities, decreased energy, constant rumination, catastrophizing, and feelings of hopelessness.”

Dr. Mendez: “Some common symptoms include feeling tired and sad most of the day for a period of two or more weeks, having a low energy level and procrastinating or putting off doing necessary tasks or responsibilities, increased appetite and possible weight gain, tendency to isolation and avoid social contacts, and a tendency for oversleeping.”

Dr. Desan: “Technically, to have seasonal affective disorder as a diagnosis, you have to meet [the] criteria for major depression as defined by psychiatrists in the U.S.

There is a somewhat larger group of people who find that their mood, energy, sleep, or their appetite is altered in the winter enough that they seek help, and they may not actually meet the criteria for major depression. We call that ‘subsyndromal seasonal affective disorder,’ but we see plenty of people in our clinic that come in and just don’t have good energy in the winter.”

What causes SAD or seasonal depression?

Dr. Mendez: “Research indicates that seasonal affective low mood may be informed by some people’s response to a decrease in daylight hours. It is less common, although not impossible, for affective seasonal patterns of depression to occur in the summertime.”

Dr. Rosenthal: “Solar insolation is the amount of sunlight one experiences at their location on the surface of the [Earth]. The rate of change of solar insolation triggers changes in SAD.

It is more complicated than you think. Cities at the same latitude can have very different rates of change of solar insolation due to climate, so onset and abatement of symptoms [depend] very much on where you live.”

Dr. Desan: “We know that in lots of mammalian species when you expose the organism to all kinds of winter light, physiology and winter-type behavior start happening. Even though we live in artificial environments, most human brains seem to be aware of the length of the light-dark cycle, and we know that the chemistry in people’s [brains] changes from various kinds of studies across the year.

Now, which chemical in what place is actually linked to human mode? That is not known.

It’s quite likely that it isn’t just simply [chemical] levels because a lot of research has not supported the idea that it’s just simply the amount of serotonin or anything else.

I feel it probably has something to do with turnover and circuit properties. To think that you just have a certain level of some chemical in your brain that goes up and down? We know it’s not that simple.”

SAD and COVID-19 pandemic

Dr. Rosenthal: “The country has seen a spike in anxiety and depression from COVID. When you throw in an underlying condition of SAD, the two effects amplify each other.”

Dr. Mendez: “Individuals diagnosed with mental health conditions, particularly bipolar or depressive disorder, are at greater risk of experiencing seasonal affective disruptions.”

Dr. Desan: “We’re seeing across all of our patient mental health clinics an increase in distress and number of visits.”

Dr. Desan said lifestyle changes brought on by COVID-19 might also be a factor.

“The other thing that we’re noticing is when people are home a lot, they don’t get up in the morning and get exposed to bright light. Consequently, I think seasonal factors are stronger,” he said.

How to prevent SAD or manage symptoms?

Dr. Desan: “Exposure to bright light first thing in the morning is well-validated by multiple research studies because the time that the sun comes out is the most important circadian signal in lots of species.

If you fool the brain into thinking that it’s a bright day early in the morning instead of thinking it’s winter, the brain thinks it’s summer.”

His team has compiled a comprehensive list of specific light boxes that may help combat SAD. They update the list regularly.

Dr. Rosenthal: “Starting August 15, and ending January 15, use the light box for 30 minutes a day. A common recommendation is to use it at noon.” She also noted that many individuals with SAD use antidepressants.

Dr. Rosenthal also offered some perhaps less orthodox ideas:

• When feeling down, consider doing a less overwhelming task that may help boost your mood.
• Spend time playing or talking with your furry friends. If you do not have a pet, consider visiting or volunteering at your local animal shelter or just cuddling with a stuffed animal or furry blanket for a few moments.
• Create special memories, practices, traditions, and rituals. Dr. Rosenthal said this helps you step out of the melodrama and provides an opportunity for interaction that you might otherwise neglect or avoid.
• Embrace making simple and easy-to-manage life changes. For example, change the furniture in the home. This strategy activates creative juices and increases the chances of a greater sense of purpose and value in life through small changes.
• Practice mindfulness, and do not neglect the activities that typically bring you joy, such as gardening, exercising, biking, hiking, and any civic affairs, forums, and programs that may interest you.
• Volunteer time for a cause. These activities help to reduce isolation, increase engagement in purposeful and meaningful activities, and provide the opportunity to positively impact others’ lives.
• Wear your favorite outfit. Dr. Rosenthal said this simple act might lift your spirits and self-esteem.