Could you have seasonal affective disorder?
About 10 million Americans have winter depression. Here’s how to recognize it — and make it disappear.
If the long winter nights are making you feel tired, crabby and out of sorts, you just might have seasonal affective disorder (also known as SAD). It’s a type of clinical depression that starts in the fall and winter and lasts all the way until spring. And it affects about 5% of adults in the US.
“It has all the same signs and symptoms as regular depression,” explains Kelly Rohan, PhD. She’s a professor of psychological science at the University of Vermont. The only difference? “The seasonal pattern it follows, with the episodes of depression mapping on to certain seasons of the year,” she says. “The average SAD episode lasts about 5 months, and it comes back year after year, with varying intensity. And it takes a serious toll on people who are dealing with it.”
What exactly is SAD?
Lots of people feel a little down during the winter months. Being stuck in the house — or facing icy roads and freezing temperatures — doesn’t help anybody stay cheerful. But for many, a mild case of the winter blues can turn into full-fledged depression. Be on the lookout for these symptoms:
- Low energy
- Loss of interest in favorite activities
- Changes in appetite
- Different sleep patterns
- Fuzzy thinking or poor concentration
- Feelings of worthlessness or guilt
- Thoughts of death or suicide
“Low energy is the universal symptom,” says Rohan, who specializes in researching and treating SAD. “I’ve never met someone with SAD who isn’t tired all the time as part of their seasonal depression.”
Experts say you can blame the shortage of sunshine. “Light seems to be the trigger for SAD,” says Rohan.
Starting around October, shorter days means less sunlight, which affects your circadian rhythm. This is your body’s internal clock that’s tied to your daily cycles of sleeping and waking. It’s even keyed to your body’s production of hormones — the chemical messengers that tell your body what to do and when.
One of those hormones is melatonin, which your body makes to help you feel sleepy at bedtime. Levels rise in the evening to tell you it’s time to go to sleep and drop again in the morning to help you wake up.
But in the winter, when dawn occurs later, the body may still be releasing melatonin when it’s time to wake up, explains Rohan. So your alarm is going off, but your body still thinks it’s nighttime. “There’s a mismatch between your biology and your actual life,” she says.
Research also shows that with less sunlight, your body may produce less serotonin. That’s the feel-good brain chemical that helps regulate your mood. So it’s no wonder that depression is the result.
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Who gets SAD?
Women are about 2 to 4 times as likely to experience SAD as men. It mostly hits people starting between ages 20 and 30 — roughly the same age as the onset of regular depression — though some people have it as kids or teens. But the biggest predictor of SAD is where you live.
Studies show that what part of the country you live in can influence your attitude, according to the Yale School of Medicine. The farther north you are, the more likely you are to get SAD. While only about 1% of Floridians experience winter depression, it happens to more than 6% of Maryland residents and nearly 10% of people who live in New Hampshire.
No matter where you call home, though, be on the lookout for the signs of SAD. “It can take a few years to recognize the pattern of seasonal affective disorder,” Rohan says. Luckily, there are some super effective strategies.
How to conquer SAD
Try these proven tips to help you recognize — and even ward off — SAD.
Look for the cues. It happens every year, like clockwork: The leaves start to change, the days get shorter and the temperatures start to drop. “Pay attention to those things,” Rohan suggests. “They may be telling you to alter your behavior — to retreat and watch Netflix instead of going to the gym.” When you recognize those cues in your environment, you can resist the urge to give in.
Instead, make a plan to do the opposite: If you feel like taking an afternoon nap, wash the kitchen floor or take a wake-up shower instead. Do something that disrupts your original thought pattern and keeps you off the couch.
Stay social. “One of the big signs of SAD is a loss of interest in social activities,” says Rohan. “But getting together with friends is a natural antidepressant. Try to keep up with the activities you’ve always enjoyed — it can really help.”
So resist the urge to hibernate. Go out for a walk with a buddy or join a book club. Bad weather keeping you housebound? No worries. Sign on to a Zoom get-together. Just seeing other people is key.
Feeling stressed or just need an ear? Optum has digital mental health support tools that can help. You can work with someone one-on-one through AbleTo.
Talk to your doctor. SAD can be serious. If you’re experiencing depression symptoms, don’t ignore them. “Talk to your primary care provider or get a referral to a mental health professional — those are good starting points,” says Rohan. Don’t suffer in silence. Let your provider know what you’re experiencing. They may recommend effective treatments for SAD, including:
Bright light therapy (BLT). This involves exposure to a bright light for about 30 minutes, usually first thing in the morning. BLT works by simulating an earlier dawn, Rohan explains. “It gives you the same amount of light that you’d get from the sky at sunrise, which suppresses melatonin production.”
When used properly, under the supervision of a doctor or mental health provider, light therapy is highly effective. One 2019 study showed that BLT helps 67% of patients with mild SAD and 40% of those whose SAD is more severe. Talk to your doctor about buying a light box that’s right for you.
Medication. Since SAD is a kind of depression, medications can help. “Most people who go to their primary care provider will leave with a prescription for an antidepressant drug,” says Rohan. And one medication — buproprion xl (Wellbutrin) — is approved by the FDA for SAD prevention. Be sure to take your medication as directed.
Cognitive behavioral therapy (CBT). CBT is a form of talk therapy. You work with a mental health professional to learn how your thoughts affect your feelings and your actions. “It helps people with SAD see how their negative thoughts about winter may be related to their negative moods and changes their thoughts and behaviors to feel better,” says Rohan.
For example, lots of people with SAD say “I hate winter” — and the more they think about it, the worse they feel. CBT helps them get out of that negative loop.
Bottom line: You don’t have to suffer through the dark months of winter. If you’re feeling down or depressed, see your doctor. There are treatments that can help brighten your mood.
Where you live and SAD: Yale School of Medicine (n.d.). “Winter Depression Research Clinic”
Light therapy study: Frontiers of Psychology (2019). “Bright Light as a Personalized Precision Treatment of Mood Disorders”