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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.

For most of us, the choice to stay in bed and hibernate can be tempting on dark winter mornings. But if you have Seasonal Affective Disorder (SAD), getting out of bed can be an overwhelming challenge. That’s because an excessive need to sleep, or hypersomnia is just one symptom that 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 the effects of SAD in the fall, with symptoms lasting until around 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 from year-to-year without any treatment at all. That may be because symptoms:

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

Here are the symptoms of winter-onset SAD explained, plus how to get help if you suspect that you have SAD.

What causes SAD?
Scientists aren’t entirely sure what causes this disorder, but many believe that the dark mornings and short days of winter 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, causes 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 to wake up, energizes you and fights depression.”

What are the symptoms of SAD?
The majority of SAD symptoms are also symptoms of clinical depression. These include:

  • A persistent sad mood
  • Feeling exhausted all the time
  • A loss of interest in the things that once brought you joy
  • Feeling mentally slow or sluggish
  • Believing that you’re worthless or feeling guilty about things that normally wouldn’t bother you
  • Suicidal thoughts: If you’re having suicidal thoughts, get help right away—call 9-11, 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, 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 typical for people with depression to interact less with others, but with SAD, isolation is a major symptom, he explains. The need to sleep is also powerful: 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 adds. “These symptoms appear and you start feeling worse. You’re putting on weight, you're sleeping too much and you’re not interacting. That makes you feel even more depressed as a result. 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, plus getting the help you need can prevent future episodes of seasonal depression.

A counselor can help get your days back on track, says Manjooran. And 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. 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,” he explains.

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

  • Light therapy: A special kind of 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—not all products are created equal. 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 why these machines can improve mood.
  • 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. Build changes into your schedule little-by-little: commit to 30 minutes of exercise a day, then set additional goals when that becomes habit.
  • 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. But 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’re feeling the effects of SAD, reach out to a counselor and make a plan to get your routine back on track.