Know the Signs: Seasonal Affective Disorder
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Know the Signs: Seasonal Affective Disorder

If winter weather has you craving carbs and feeling constantly low, it could be SAD.

The choice to stay in bed and hibernate can be tempting for most of us on dark winter mornings. But if you have Seasonal Affective Disorder (SAD), getting out of bed can be an overwhelming challenge. An excessive need for sleep, or hypersomnia is just one symptom people with SAD experience during the winter months.

Seasonal affective disorder is a type of depression that comes and goes along with the changing seasons. Most people start to feel its effects in the fall, with symptoms lasting until about April.

“Exactly how long your symptoms last will depend on whether or not you receive the proper treatment,” says Jacob Manjooran, MD, a psychiatrist and neurologist from Southern Hills Hospital and Medical Center in Las Vegas, Nevada. But most people with SAD—about 60 percent—face bouts of depression each year without any treatment at all.

That’s because symptoms:

  • Can be vague or act like other conditions, such as certain thyroid disorders
  • Don’t last year-round
  • Worsen when people might expect to feel blue, for example, around the holidays

Here’s what you need to know about the symptoms of winter-onset SAD, plus information on how to get help.

What causes SAD?

Scientists aren’t exactly sure what causes this disorder, but many believe the dark mornings and short days confuse your circadian rhythm, or the internal clock that tells you when it’s time to sleep.

“Low winter lighting causes your brain to release more melatonin (the chemical that makes you sleepy), causing you to lack energy,” explains Dr. Manjooran. “Later, during the summer, high levels of light increase your brain’s production of the chemical serotonin, which helps you wake up, energizes you and fights depression.”

What are the symptoms of SAD?

The majority of SAD symptoms also signal clinical depression. These include:

  • Brain fog
  • A persistent sad mood
  • Feeling exhausted all the time
  • A loss of interest in things that once brought you joy
  • Believing you’re worthless or feeling guilty about things that normally wouldn’t bother you
  • Suicidal thoughts: If you have suicidal thoughts, get help right away—call 911, the National Suicide Prevention Lifeline at 1-800-273-8255 or have a loved one take you to the nearest emergency room.

“With SAD, your energy, concentration and motivation all go down,” says Manjooran. “Now, all of these things can occur with major depression, but some additional symptoms stand out as unique for SAD. We’ve found that most people have an increased appetite, especially for carbohydrates.”

It’s also common for people with depression to interact with others less often, but with SAD, isolation is a major symptom, he explains. The need to sleep is especially powerful, as well. People tend to sleep for at least one full hour more per night than they do in warmer months.

“It’s a vicious cycle,” he says. “These symptoms appear and you start feeling worse. You may put on weight, sleep too much and interact less. As a result, that makes you feel even more depressed. You need to do something to break that cycle.”

Get help for SAD symptoms

If you experience some or all of the symptoms of SAD for two weeks or more, reach out to a counselor. SAD is highly treatable and getting the support you need can help prevent future episodes.

“A counselor can help get your days back on track,” says Manjooran. It’s important to keep your routine as regular as possible to improve your symptoms: Eat healthy meals, stick to an exercise program and follow a set sleep schedule.

“It’s not easy to do all of that on your own,” he explains. “A counselor will ask you, ‘are you keeping this routine?’ They can motivate you to do it. On your own, it’s easy to fall behind.”

SAD treatments

In addition to counseling, there are a number of treatments available for SAD. People often see the most improvement with a combination of:

  • Light therapy: A special light box may be used to mimic mood-boosting natural light. “Use light therapy early in the morning, as soon as you wake up,” recommends Manjooran. “Don’t stare at the light, but just sit in the glow, maybe while reading a book, for about an hour.”
  • Negative ion therapy: Consider investing in a negative ion generator. You can order these machines through online stores, but check with your therapist before purchasing to ensure you buy a high-quality product. A number of small studies have found that negative ion therapy reduces depression symptoms for people with SAD. Some experts believe inhaling negative ions causes your brain to release serotonin, although more research is needed to learn exactly how these machines help.
  • Lifestyle changes: “Get out as much as possible, interact with others, stick to your exercises; all of these are essential in treating SAD,” says Manjooran.
  • Medications: Some people need antidepressants along with light therapy and counseling. However, there’s one form of SAD that won’t benefit from antidepressants. “It’s possible to experience a depressed episode of bipolar disorder, which follows a seasonal pattern,” explains Manjooran. “If you have bipolar disorder and you become depressed during the winter, it won’t improve with antidepressants. You’ll need mood stabilizers instead."

Medications typically start working within a few weeks. With light therapy and lifestyle changes, your symptoms may start to improve in just a few days. Don’t put off getting help any longer. If you might have SAD, reach out to a counselor and make a plan to get your routine back.