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Winter Blues - Could you be suffering from Seasonal Affective Disorder?

What is seasonal affective disorder?
Seasonal affective disorder, or SAD, is a type of depression. It happens during certain seasons of the year—most often fall or winter. According to Cletus Carvalho, MD, St. Claire Behavioral Health's Inpatient Medical Director, "It is thought that shorter days and less daylight may trigger a chemical change in the brain leading to symptoms of depression. Light therapy and antidepressants can help treat SAD."


Who is at risk for SAD?
SAD usually starts during adulthood and the risk of SAD increases with age. It’s rare in people under age 20. Women are affected more often than men.


What causes SAD?
Less sunlight and shorter days are thought to be linked to a chemical change in the brain and may be part of the cause of SAD.
Melatonin, a sleep-related hormone, also has been linked to SAD. The body naturally makes more melatonin when it’s dark. So, when the days are shorter and darker, more melatonin is made.


What are the symptoms of SAD?
There are two types of SAD. The most common is fall-onset, or winter depression, with symptoms beginning in the late fall to early winter months and easing during the summer months. Spring-onset, or summer depression, is much less common with symptoms beginning in late spring or early summer. Common symptoms of SAD include:

  • Increased sleep and daytime drowsiness
  • Loss of interest and pleasure in activities formerly enjoyed
  • Social withdrawal and increased sensitivity to rejection
  • Irritability and anxiety
  • Feelings of guilt and hopelessness
  • Fatigue, or low energy level
  • Decreased sex drive
  • Decreased ability to focus or concentrate
  • Trouble thinking clearly
  • Increased appetite, especially for sweets and carbohydrates
  • Weight gain
  • Physical problems, such as headaches

Symptoms tend to come back and then improve at about the same times every year. Symptoms of SAD may look like other mental health conditions.


How is SAD diagnosed?
Depression often happens with other conditions, such as heart disease or cancer. It may also happen with other mood disorders, such as substance abuse or anxiety. For these reasons, early diagnosis and treatment is key to recovery. A diagnosis of SAD may be made after a careful mental health exam and medical history done by a psychiatrist or other mental health professional.

How is SAD treated?

The treatments for "winter depression" and "summer depression" often differ, and may include any, or a combination, of the following:

  • Exposure to sunlight. Spending time outside or near a window can help relieve symptoms.
  • Light therapy. If increasing sunlight is not possible, exposure to a special light for a specific amount of time each day may help
  • Psychotherapy. Cognitive-behavioral or interpersonal therapy helps change distorted views you may have of yourself and the environment around you. It can help you improve interpersonal relationship skills, and identify things that cause you stress and how to manage them.
  • Antidepressants. These prescription medicines can help correct the chemical imbalance that may lead to SAD.

There are also things you can do for yourself to help relieve symptoms:

  • Get help. If you think you may be depressed, see a healthcare provider as soon as possible.
  • Set realistic goals. Don’t take on too much. Break large tasks into small ones, set priorities, and do what you can as you can.
  • Try to be with other people and confide in someone. It is usually better than being alone and secretive.
  • Do things that make you feel better. Going to a movie, gardening, or taking part in religious, social, or other activities may help. Doing something nice for someone else can also help you feel better.
  • Get regular exercise.
  • Don’t expect your mood to get better right away. Feeling better takes time. People rarely “snap out of” a depression. But they can feel a little better day-by-day.
  • Eat healthy, well-balanced meals.
  • Stay away from alcohol and drugs. These can make depression worse.
  • Delay big decisions until the depression has lifted. Before deciding to make a significant transition—change jobs, get married or divorced—discuss it with others who know you well and have a more objective view of your situation.
  • Try to be patient and focus on the positives. This may help replace the negative thinking that is part of the depression. The negative thoughts will disappear as your depression responds to treatment.
  • Let family and friends help you.

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Write down questions you want answered and bring someone with you to help you remember what your provider tells you.
  • Write down the name of a new diagnosis, and any new medicines, treatments, tests, or procedures, as well as any new instructions your provider gives you. Know what to expect if you don’t follow recommendations.
  • Know why a new medicine or treatment is prescribed, how it will help you, and any side effects.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Download a PDF version here.

If you believe you may be suffering from SAD, contact St. Claire Counseling at 606.783.6805 or schedule a visit with your family medicine provider.