The cooler weather and less daylight during the winter months can cause many of us to feel less motivated and even disengaged in everyday life. Some of us may experience the winter blues, while others may have seasonal affective disorder (SAD).
Seasonal affective disorder is considered a depressive disorder – a subtype of major depression with seasonal changes. This means that it starts in autumn and lasts through the winter months, improving in the spring.
About 5% of Americans have SAD. Women are four times more likely to experience it. Additionally, people who live in northern states, like the Pacific Northwest, Alaska and New England, tend to experience seasonal affective disorder more.
Seasonal affective disorder can begin at any age. It typically starts between ages 18 and 30.
Symptoms of seasonal affective disorder (SAD)
SAD is different than major depression in that it's specifically tied to the seasons. SAD typically starts in autumn and lasts through the winter, improving in the springtime.
People with seasonal affective disorder experience the cluster of symptoms that may include the following, according to the American Psychiatric Association:
- Feeling sad
- Loss of interest or pleasure in activities you typically enjoy
- Changes in appetite (typically eating more and craving carbohydrates and sugars)
- Change in sleep (usually sleeping too much)
- Loss of energy or feeling more tired despite a good amount of sleep
- Slowed thinking, concentration or decision making
- Increase in activities like pacing, handwringing or inability to sit still, or slowed movements or speech
- Feeling hopeless, worthless or guilty
- Thoughts of death or suicide
Weight gain and too much sleep, known as hypersomnia, are very common with SAD. The more severe symptoms include hopelessness, worthlessness, and thoughts of suicide.
Diagnosis of SAD
The diagnosis of SAD includes:
- meeting criteria for changes in your thinking or daily functions (going to work, going to social events)
- how you feel emotionally and physically
To be diagnosed with SAD, you must meet diagnostic criteria and experience a functional decline in many areas of your life.
When a patient comes for an evaluation, they often say that they're having mood changes, experiencing a decline in function, and not feeling like themselves. Patients are often encouraged to get a medical evaluation first. This is to ensure there are no other underlying conditions that could contribute to weight gain, too much sleep or difficulty thinking, for example. There could be something else going on inside the body that could be causing those symptoms.
Patients are asked about other areas of their life, like what typically causes the onset of SAD. They're also asked about a change in their mood, thinking or functioning at certain times. Most people can pinpoint that, especially with the change in daylight saving time.
If you have any symptoms listed above during the winter months, you should be evaluated by a health care provider.
Treatment and self-care for seasonal affective disorder
If you've been diagnosed with SAD, your treatment plan may include a combination of light therapy, vitamin D supplement, cognitive behavior therapy and possibly medication.
Self-care is key with SAD because it tends to take on a predictable pattern. This means patients can implement prevention strategies in anticipation of severe symptoms. If you have seasonal affective disorder, there are some things you can do to help get ahead of your symptoms:
- Make a habit of getting out for a daily walk. This helps your mood by breathing in fresh air and providing a change in scenery, all while exercising.
- Add vitamin D into your diet and nutritional changes. Consult with a nutritionist or physician on what kinds of things you should target in your diet or what you should increase.
- Plan fun activities and stick to those commitments. Once SAD begins, you're more likely to pull back and cancel plans.
- Get social with friends and family. This helps stimulate your mind and mood by being around others.
- Move your body with physical activity. It doesn't have to be hard exercise, but moving your body will provide physical stimulation. If you can participate in an exercise group or class, that allows you to get physical and social benefits.
- Reach out to your support network. Tell your family and friends how this change of season affects you so they can check in on you. They can also help hold you accountable to your commitments and support you.
What's the difference between the "winter blues" and SAD?
"Winter blues" typically happen every now and then during the colder months. You may feel sad or want to stay home, but you're still able to function. For example, you decide to cancel social plans to stay home but still take interest in your normal activities, like watching TV or crafting. You may just want to hunker down inside more and not be around others. The next day, you may be able to go out and engage with friends or coworkers. You still enjoy life, but you may pull back a little bit. "Winter blues" could also be related to some sort of external stressor, like a death during the holidays.
Seasonal affective disorder is a more prevalent pattern, where a person loses interest in many areas of their life. With SAD, you want to stay home but you don't want to watch the shows you like or eat your favorite foods. You withdraw from life on a global scale.
What's tricky about SAD is it gets better in the spring. People may not seek treatment because they may consider it merely the "winter blues" which is less severe and happens on occasion. But SAD is a major depression with seasonal patterns, which is the official diagnosis – it's more serious than just the "winter blues."
If you experience some of these symptoms, consider talking to your health care provider. SAD can improve with proper treatment.
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Medically reviewed by clinical psychologist Gloria Petruzzelli.