Seasonal Affective Disorder, otherwise known as SAD, comprises one of the most common mental health disorders. SAD normally stems from reduced exposure to sunlight and reduced exercise during winter months, leading to lowered Serotonin production. Eventually, this can result in depression, with symptoms including depressive episodes, fatigue, reduced socialization, and inertia or apathy. While Seasonal Affective Disorder normally begins in winter months and fades away in summer, it can be pervasive, eventually leading to full depression.
Today, some 8-10% of the American population experience at least some form of SAD, with an estimated 10 million individuals struggling with major symptoms that greatly affect quality of life. That’s crucial, because SAD poses many of the same health risks as depression. And, with many overlapping with other mental health disorders like substance use disorders, depression, and anxiety, the individuals with SAD are at greater risk of mental and physical harm. While S.A.D. is treatable, much like any other mental health disorder, many people simply don’t seek it out.
Understanding how seasonal affective disorder works, how it’s treated, and how to get a diagnosis may help with getting treatment and moving forward to treatment and a better life.
Symptoms of Seasonal Affective Disorder
Seasonal Affective Disorder is commonly compared to and mistaken for depression and chronic depression. Most symptoms completely overlap, meaning it can be difficult to tell one from the other without a medical investigation into causation, time, and medical history.
Symptoms of SAD include:
Fatigue and lethargy
Reduced interest in activities and hobbies
Mood swings, especially irritability
Hypersomnia (constantly sleeping)
Feelings of guilt and hopelessness
For most people, these symptoms begin gradually. You won’t wake up one day and suddenly be sick like with the flu. Instead, you’ll gradually have more and more worse days, be more and more tired, and for many of us, it just feels normal. This means that many people can become very sick before they ever notice anything is actually wrong. In many cases, it’s also friends and family who notice, because for the individual with the disorder, normal changed so gradually it’s difficult to notice.
Seasonal Affective Disorder heavily overlaps with depression and similar disorders. This means that your doctor will likely take time to diagnose the disorder, and will do so based on factors including:
However, a seasonal affective disorder diagnosis will include a full evaluation:
Physical Exam – Symptoms of depression overlap with symptoms of Vitamin A deficiency, general nutrient deficiency, and some other illnesses. It’s important to have a complete physical exam to ensure you don’t have physical health problems. This will normally include blood tests to check thyroid, complete blood count (CBC), and vitamin A.
Psychological Evaluation – A thorough psychological evaluation includes a review of your symptoms in comparison with the DSM-5. Your doctor may refer you to a psychologist for this. Your psychological evaluation should include an overview of symptoms, their impact on life, their impact on relationships, and frequency and duration of those symptoms. In most cases, it means mapping symptoms to a timeline, figuring out if they’ve worsened over time, and deciding on a starting a point. This helps to determine if you’re suffering from depression or seasonal affective disorder.
The symptoms of Seasonal Affective Disorder mimic those of hyperthyroidism, depression, viral infections, hypoglycemia, and other illnesses. It’s important not to self-diagnose, because you could need medical treatment for your thyroid, you could need insulin treatment, and you might have a nutritional disorder.
If you’re experiencing any of the symptoms listed above, the first step should always be to see your doctor. Here, you can expect to discuss your current health, your medical history, family history of mental health, and your symptoms. Getting a diagnosis can take weeks to ensure that you’re not being treated for the wrong thing.
Treating Seasonal Affective Disorder
SAD Treatment normally involves a multi-stepped approach which might include light therapy, behavioral therapy, and medication. Here, overlapping disorders will heavily impact treatment. For example, if you have bipolar disorder, you likely cannot have many of the Selective serotonin re-uptake inhibitors used to treat SAD.
Light Therapy – Light therapy is normally a first-line treatment for SAD. It involves regular exposure to a full-spectrum lamp, intended to mimic the effects of sunlight. Here, you’ll normally be asked to turn on a lamp during the first 60-90 minutes of your day at least 2-3 days per week. Your progress and symptoms are measured over a few months. If you see improvement, treatment continues.
If you have fall-onset SAD, light therapy is likely the first prescription you’ll receive. Most doctors won’t look further until you’ve had either no success with light therapy or symptoms continue to worsen.
Medication – Medication, including selective serotonin reuptake inhibitors (SSRIs) and bupropion are extremely common for treating SAD. These medications function by preventing your brain from absorbing serotonin at the same rate. This means you use the serotonin for longer, which reduces overall symptoms. Here, medications are normally prescribed for a short period. You can expect 3-6 months on average, followed by a period of tapering usage and seeing if symptoms return.
Therapy – Behavioral therapy including cognitive behavioral therapy is commonly used to treat SAD. This therapy helps you to identify negative behaviors and patterns which reinforce your disorder and help you to create new ones. This can include teaching you coping mechanisms, teaching tools to get out of negative thought patterns, and building healthy habits around food, exercise, and socializing that will help you boost your serotonin production, blood oxygen levels, and energy. Keeping SAD under control often means a combination of good habits and good coping mechanisms, and CBT is one of the most common ways to get there.
Seasonal Affective Disorder affects over 30 million people in the United States. While severity varies, millions of Americans face reduced quality of life. That’s made worse by the fact that individuals with SAD often struggle with cooccurring disorders like anxiety, depression, substance use disorder, and bipolar disorder. Treating it is possible, but it requires a careful and fully customized approach to the individual’s needs.
The Gooden Center offers cognitive behavioral therapy and complimentary therapies designed to help you get back on your feet and back to your life. If you or a loved one has an SAD diagnosis, cognitive behavioral therapy can help you to learn coping mechanisms, build healthy habits, and overcome depression. It’s important to go to your doctor for a diagnosis, to participate in light therapy, and to take medication if it’s diagnosed. However, therapy can help you to build the long-term skills to overcome SAD now and in the future.