Seasonal Affective Disorder (SAD)

Overview 

Seasonal affective disorder (SAD) is a type of depression that is usually triggered by changes in the seasons. SAD starts and ends around the same time every year. 

Individuals with seasonal affective disorder experience energy drain and make a person moody starting in the fall and lasting into the winter. The symptoms settle down by the spring and summer. 

In rare circumstances, SAD brings about depression in the spring or early summer, which then subsides in the fall or winter.

What is seasonal affective disorder? 

SAD is a form of depression brought on by changes in the seasons, usually when autumn starts. Seasonal affective disorder is also referred to as seasonal depression. The seasonal depression peaks in late autumn or early winter before ending in the spring.

The patient can experience the winter blues, a mild SAD form. It is common to feel sad during the cold winter months. The sun sets early and becomes dark, making a person feel trapped inside.

Full SAD is different and goes beyond this. It brings about depression. SAD, as opposed to the winter blues, impacts daily life, including emotions and thoughts. Therapy can assist in getting through this phase. 

Who develops SAD? 

Seasonal affective disorder (SAD) mostly occurs in young adults and women. The risk of SAD is also high in the following individuals.

• People with family members with SAD or other depression types or mental issues like schizophrenia or severe depression.
• Individuals who have another mood disorder, such as bipolar disorder. 
• Living in cloudy areas.
• Living far north or far south of the equator. At these latitudes, the amount of daylight decreases during the winter.

What causes SAD? 

The exact cause of seasonal depression remains unknown. The shorter days and diminished sunlight are thought to trigger a chemical change in the brain, which contributes to the development of SAD.

SAD has also been connected to melatonin; a hormone essential to sleep. When it is dark outside, the body naturally produces more melatonin. As a result, more melatonin is produced during shorter and darker days.

For an individual prone to this illness, inadequate sunlight makes the condition worse. 

The following may be a few possible causes of SAD. 

• Vitamin D deficiency – Vitamin D helps the body produce more serotonin. Since sun rays help in the synthesis of vitamin D, a lack of sunlight during the winter months might result in a vitamin D deficiency. The mood and serotonin levels may be impacted by that change.

• Biological clock – The biological clock adjusts when the amount of sunshine decreases. This internal clock controls the hormones, mood and sleep. One can’t adjust to changes in the length of the day because they are out of sync with the regular daily routine.

• Melatonin boost – Melatonin is a hormone that impacts mood and sleeping patterns. Some people may produce too much melatonin due to a lack of sunlight. The cold months might make a person feel sleepy and tired.

• Negative thoughts – Individuals with SAD frequently experience anxiety, stress and negative thoughts about the winter. The source or effect of these unfavourable thoughts on seasonal depression is unclear to researchers.

Symptoms of seasonal affective disorder 

Seasonal affective disorder (SAD) manifests as fatigue, even with adequate sleep and weight gain related to overeating. 

There are various SAD symptoms that are similar to major depression and can range in severity from mild to severe, including:

• Sleep changes, mostly excessive sleep.
• A sense of worthlessness or guilt
• Appetite changes, usually eating more.
• Experiencing sadness or depression.
• Lack of energy or increase in tiredness.
• Having trouble focusing, thinking or making decisions
• Lack of enjoyment or interest in activities
• Slower speech or movement (these actions must be severe enough to be observable to others)
• Suicidal thoughts

SAD can start at any age, but it usually does so between the ages of 18 and 30.

Season-specific symptoms of SAD 

SAD in autumn and winter 

Winter and autumn depression symptoms that are particular to SAD include,

• Weight gain
• Excessive sleeping
• Appetite changes, particularly for high-carb foods
• Fatigue or lack of energy.

SAD in summer and spring

• Seasonal affective disorder with summer onset, often known as summer depression, may present with the following symptoms.

• Lack of appetite
• Difficulty sleeping (insomnia)
• Weight loss 
• Anxiety 
• Irritation

How is seasonal affective disorder (SAD) diagnosed? 

Speak with a doctor or a mental health professional on experiencing symptoms of SAD. The healthcare professional may ask certain specialised questionnaires to confirm the diagnosis. 

To diagnose SAD in individuals, the person must fulfil the following requirements.

• They must exhibit signs of severe depression or particular signs of SAD.
• Seasonal depression episodes occur for at least 2 years consecutively.
• The episodes must be significantly more frequent than any other depressive episodes the person may have ever had throughout their lifetime.

Risk factors for seasonal affective disorder 

The following characteristics may make a person more susceptible to SAD.

• Being a woman – SAD is 4 times more likely to occur in women than in men. 

• Genetics – Diagnosis of SAD is higher in those with a family history of depression than in those without such a history.

• Living far away from the equator – Those who reside far north or far south of the equator are more likely to have SAD.

• Young age – SAD is more likely to affect younger persons than older adults. SAD cases have been documented even in children.

• Presence of bipolar illness or depression – The presence of any of the disorders could worsen the depression symptoms with the change in the weather. SAD is diagnosed only if seasonal depressions are the most common.

Ways to treat a seasonal affective disorder 

Light treatment, antidepressants, talk therapy or a combination of these can effectively treat SAD. While symptoms typically get better on their own with the changing seasons, they can also improve with treatment.

Light therapy

Light therapy entails sitting in front of a light box that produces a bright light. It normally takes 20 minutes or more a day, usually first thing in the morning during winter.

Within one to two weeks of starting light therapy, most patients experience some benefits. Treatment is continued over the winter to retain the benefits and avoid recurrence. 

Some patients may start light therapy in the early fall to prevent symptoms because they expect their symptoms to return in the late fall.

Medications

When SAD symptoms are severe, antidepressant treatment can help some people.

Those with a history of SAD may benefit from an extended-release form of the antidepressant bupropion. SAD may occasionally be treated with other antidepressants as well.

Antidepressant medication may be started before the symptoms begin to appear on a yearly basis, as per the doctor’s recommendation. Also, the doctor could advise a patient to keep taking the antidepressant after the typical symptom recovery period has passed.

It could take a few weeks before an antidepressant starts to work its full magic. It’s possible that a patient will need to test several medications to find the one that works best for them with fewer adverse effects.

Sun exposure

Getting fresh air or being close to a window can help with symptoms.

Psychotherapy

Interpersonal or cognitive-behavioural therapy can help the patient in developing interpersonal skills, recognise their stress triggers, and learn effective stress management techniques.

Socialise

Engaging in social activities can be extremely beneficial for individuals with SAD.

Research has shown a link between social isolation and sadness. Prolonged periods of solitude can have a negative psychological influence on individuals, leading to signs of depression and post-traumatic stress disorder (PTSD).

It is important to come up with original plans to maintain relationships. There are alternatives to in-person encounters for socialising if wintertime darkness or weather forces a person to spend more time indoors.

Exercise

Exercise can help with SAD as it does with other types of depression. Exercise can also reduce the weight gain associated with SAD.

Due to the exposure to daylight, outdoor exercise is most effective at reducing SAD symptoms. Try using a treadmill, stationary cycle or elliptical equipment placed next to a window at home or at the gym if it’s too cold or snowy to exercise outside.

Conclusion 

SAD, or seasonal affective disorder, is a particular type of depression that usually manifests in the autumn and winter months of the year.

The cause of SAD is not clearly known. Seasonal affective disorder may have its roots in chemical changes in the brain connected to less sunlight and shorter days. SAD may also be related to the hormone melatonin, which is associated with sleep.

A psychiatrist or other mental health practitioner may diagnose SAD following a thorough mental health examination and medical history.

The most common forms of treatment for depression include light therapy, counselling and occasionally medications.

FAQS