Seasonal Affective Disorder (SAD) is a type of depression that typically starts in late fall or early winter and can last through the winter months. SAD affects approximately 15% of Canadians at some point in their lifetime, with 2-3% reporting serious cases1.
In this article, we look at the symptoms, causes and risk factors for SAD and talk about how you can deal with this condition in effective and healthy ways.
Symptoms of SAD
SAD is a form of depression and has the same symptoms with the exception that it is time-limited: the return of warmer weather and longer days typically alleviate the symptoms.
Here are the key symptoms that are typically seen with SAD:
- Low mood for most of the day, nearly every day
- Irritability
- Loss of interest in activities that you normally enjoy
- Lack of energy
- Sleeping too much
- Difficulty concentrating
- Food cravings, especially for carbohydrates and sugars, with attendant weight gain
- Feelings of hopelessness, worthlessness, or guilt
- Suicidal ideation
It is important to note that you may experience some of these symptoms and not others. Talk to your family doctor or mental health care professional for a more complete investigation of your condition.
Risk Factors for SAD
Risk factors for mental health and other medical conditions are things that make you more likely to be diagnosed with an illness. For example, smoking is a risk factor for many illnesses, and gender is a risk factor for some. Here are the things that make you more likely to experience SAD:
- Being female. SAD is diagnosed four times as often in females as it is in males2.
- Living far from the equator, whether north or south of it.
- Having depression or bipolar affective disorder or a family history of either condition.
- Younger age: SAD is more likely in younger adults than older adults and has been reported in children and teens.
Causes of SAD
As is the case with almost all mental health conditions, the precise cause or causes of SAD are still under investigation. It is likely that multiple interacting factors are involved, including genetics and neurotransmitter activity.
Given its relationship with seasonal lack of sunlight, vitamin D deficiency is thought to play a role in SAD. However, the specifics of how vitamin D affects SAD are currently unclear. It is important to recognize that this is common with mental health conditions: often, the relationship between a causal factor and the way it produces an effect takes a long time to pin down2.
People who experience SAD also appear to have trouble regulating the neurotransmitter serotonin. Serotonin is thought to be responsible for evening-out moods and plays a role in other types of depression2.
Overproduction of melatonin may also be responsible for some symptoms of SAD. Melatonin is the hormone that causes sleepiness in dark environments, so people are likely to produce more of it when it is dark outside. However, melatonin on its own cannot account for all the symptoms of SAD, so if it does play a role in this condition, it is in combination with other factors2.
Treatments for SAD
There are several treatments generally recommended for SAD. You can try these treatments out to see if they help, but if your symptoms are disabling or you are having thoughts of suicide or self-harm, talk to a doctor right away. You can visit your family doctor or a walk-in clinic. Go to the emergency department of your nearest hospital if you are in crisis.
Vitamin D Supplements
Lack of exposure to sunlight decreases the production of vitamin D, so taking a supplement can help. Research about the effectiveness of supplemental vitamin D is mixed, and vitamin D can interact with some medications; before you start taking vitamin D supplements, check with your healthcare provider or pharmacist about drug interactions and appropriate dosage.
Light Therapy
Bright light therapy is very commonly recommended as a treatment for SAD. You must purchase a specialized device for this, but they are readily available online or at your local pharmacy. Light boxes for SAD emit light that is much brighter than ordinary indoor light, and they filter out UV light. People using this treatment typically sit in front of a light box every day for 30 – 45 minutes first thing in the morning. Bright light therapy has also been shown to be effective at treating non-seasonal depression and several other conditions3, making a light box a good investment if you experience other mental health issues.
Antidepressant Medication
The antidepressants that are used to treat other types of depression are also effective for SAD. These drugs are often used in combination with counselling and/or bright light therapy. Antidepressants can take up to 8 weeks to be effective, and not all antidepressants work for everybody. Patience is required in finding the right medication and waiting for it to have its full effects. At the same time, the right antidepressant can make an enormous difference in your experience of SAD.
Proactive Measures
For some people, SAD is predictable, recurring every year at about the same time. If this happens to you, you can take steps in advance to minimize the effects of SAD. For example, treatments that have worked for you in the past are likely to be effective again, so you can plan to start those before your symptoms typically begin. You can also plan vacation times to help you manage your symptoms and prepare your loved ones to support you on your most difficult days.
Counselling
As with other types of depression, counselling can be enormously effective in treating SAD. Cognitive behavioural therapy has been found to be particularly effective. This type of therapy focuses on the negative thoughts that depressed people often have. Other types of counselling can also be extremely helpful, and part of this depends on your preferences and the type of therapy that you respond to best. This is different for everyone, so be patient with yourself when you are trying to figure out what is most helpful to you.
Finding the right treatment for your SAD is a process; do not be discouraged when your initial attempts to find relief from your symptoms are not as successful as you hoped they would be. The good news is that once you find a treatment that works for you, it is likely to be effective if you experience SAD again in the future.
If you would like to try counselling for your SAD, Kari Walton Counselling offers a range of treatment options, including cognitive-behavioural therapy, dialectical behaviour therapy, hypnotherapy, group therapy, and family therapy.
Everyone on our skilled, caring team is in your corner: we all understand the challenges of SAD and how severely it can impact your life, your work, and your relationships.
Contact us today to make an appointment. Let’s talk about how we can help you survive the winter and come back stronger than ever in the spring!
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References
1 Canadian Psychological Association “Psychology Works” Fact Sheet: Seasonal Affective Disorder (Depression with Seasonal Pattern) https://cpa.ca/psychology-works-fact-sheet-seasonal-affective-disorder-depressiond-with-seasonal-pattern/
2 Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673349/
3 Effects of Bright Light Therapy on Neuroinflammatory and Neuroplasticity Markers in a Diurnal Rodent Model of Seasonal Affective Disorder https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673349/