Seasonal Affective Disorder

Depressed woman in winter sitting on a park bench

Seasonal Affective Disorder: What You Need to Know

Days are getting even shorter as we journey toward the ending of another year. With the arrival of shorter days that offer less natural light, many people’s moods become adversely affected with increased sluggishness and feelings of depression. This mental health condition is known as seasonal affective disorder (also known as SAD syndrome or seasonal depression.) Symptoms typically rise in the fall and winter, affecting about 1 in 20 people, or 10 million Americans. Even more face less-severe symptoms with another 10-20% experiencing milder forms. Of those experiencing seasonal depressive symptoms, 4 out of 5 afflicted are women.

Your Capital Women’s Care team wants to share vital information about SAD, including its risk factors, symptoms and treatments, plus important tips to lessen its effects should you become diagnosed.

SAD Risk Factors and Women

Women are 4 times more likely prone to experience SAD than men, with the affliction often beginning in their 20s and 30s. Researchers are continuing to investigate why women are so much more likely to be affected. Some suggest reduced sunlight affects serotonin levels, a brain hormone affecting mood. Lowered serotonin levels trigger depression. Fluctuating estrogens, a predominant hormone within females, also affect serotonin levels.

During darker days of winter, our body increases melatonin production, causing us to feel fatigued and sleepiness even during hours we are awake. Increased melatonin production can adversely affect sleep-wake rhythms, upsetting your body’s circadian rhythm, which can be associated with depression.

Of those afflicted with SAD, 13-17% have an immediate family member who is likewise afflicted or afflicted with depression.

According to the National Institutes of Mental Health (NIMH,) additional SAD risk factors beyond sex and age include a person’s mental health history, particularly if you are diagnosed with major depression or bipolar disorder, which can worsen seasonally, and where they live in relation to the equator. Those living in geographical locations furthest from the equator face an increased SAD risk. For example, Florida has a rate of 1.5% of its population afflicted with SAD, while New Hampshire, which is further north from the equator and subsequently gets less natural light during shortened winter months, notes 10% of its population is SAD-afflicted.

SAD Symptoms

In most cases, SAD symptoms begin during onset of late fall or early winter and disappear during spring and summer’s sunnier days each year. A less common disorder affects people with similar symptoms beginning in spring or summer. In either case, symptoms may begin as mild and become progressively more severe as the season continues. To be diagnosed with SAD, symptoms must present seasonally for 2 years.

SAD signs and symptoms may include

  • feeling depressed most of the day, nearly every day
  • losing interest in activities you once enjoyed
  • avoiding socialization with others
  • having low energy
  • having difficulties with sleeping
  • changes in appetite or weight
  • feeling sluggish or agitated
  • having difficulty concentrating
  • feeling hopeless, worthless or guilty
  • and having frequent thoughts of death or suicide.

Symptoms specific to winter-onset SAD, also known as winter depression, may include

  • oversleeping
  • appetite changes, especially craving high-carbohydrate foods
  • weight gain
  • and tiredness, lethargy or low-energy levels.

Symptoms specific to summer-onset seasonal affective disorder, also known as summer depression, may include

  • insomnia or sleep difficulties
  • poor appetite
  • unintentional weight loss
  • and agitation or anxiety.

SAD Treatments

There are many effective treatments for curbing SAD symptoms that may be used singularly or combined as determined by your practitioner, including:

  • antidepressant medications are often recommended, especially for severe SAD symptoms. Antidepressants are prescribed a few weeks before SAD symptoms usually present since these medications become effective with time. Also keep in mind different medications may need to be tested before your practitioner determines the one that best matches your treatment needs and offers minimal side effects.
  • light therapy (phototherapy) uses a special light box which imitates natural outdoor light (10,000 lux) that appears to initiate changes in brain chemicals linked to mood. Phototherapy has been shown to be effective in decreasing symptoms in up to 85% of women with SAD. Since phototherapy may suppress melatonin production, treatment is usually done in the morning hours. Before purchasing a light box, talk with your doctor and become familiar with the features and options available so you buy one that is high-quality, safe and effective. Also ask your doctor about how and when to use it to best alleviate your symptoms.
  • increase vitamin D. Research indicates SAD is prevalent when vitamin D stores within the body are typically low. Your doctor can determine the best way to increase your body’s vitamin D level, either through phototherapy, vitamin supplements or focused diet and nutrition.
  • counseling, particularly cognitive behavioral therapy, may be recommended to identify and change negative thoughts and behaviors that contribute to making you feel worse; learn healthy coping skills, especially with reducing avoidance behavior and scheduling activities; and initiate effective stress management techniques within your daily life throughout shortened days during winter months.

How to Manage SAD

Effective SAD management includes adding the following to your daily routine:

  • Go outside daily for some natural light. Make it a priority to go for a walk at lunchtime outdoors at work or anytime during daylight. Just 20 minutes of natural light exposure can effectively ease SAD symptoms.
  • Make exercise a winter priority. Regular exercise, especially early in the day, has been shown to help regulate circadian rhythms, which can be important in treating SAD. Exercising for 30 to 60 minutes per day also reduces risk of major depression by 26%. Ask a friend to go with you to a favorite spin or fitness class during the day to help squash feelings of SAD while enjoying socialization and companionship.
  • Avoid temptation to load up on carbohydrates. Eliminate sugar swings associated with high-carbohydrate foods and sweets and focus on protein and fresh, whole fruits and veggies. If you aren't getting enough vitamin D in the winter via exposure to sunshine, you can add vitamin D naturally into your diet through fatty fish like salmon and in eggs. Some studies suggest people with SAD have diets low in vitamin D and omega-3 fatty acids. Increasing these food sources is also good for your heart and your brain.
  • Be proactive about your health. If you realize you’re vulnerable to depression and decreased mood during times of diminishing natural light, start early with implementing activities and interventions that help. Don't wait until you feel badly. Institute bright-light therapy and planned diet and exercise changes and strategies early in the season to reap maximum health benefits.
  • Seek a change of scenery. Make the effort to travel and go to different locales during winter months, especially those offering more sunshine. Even a weekend getaway or day trip can provide much-needed relief.
  • Reach out and ask for help. If you find yourself already struggling with depression or anxiety and the increased darkening days are making you feel worse than usual, reach out to family, friends and your doctor for help.

Your Capital Women’s Care team of professional healthcare experts are here to help you with any questions or concerns you may have about your mental and physical health and wellbeing, in addition to any women’s health issue. Our goal is to provide you with optimum care throughout all the seasons of your life, from young adulthood through golden years and beyond, so you may achieve and enjoy quality health and a long life.


Our Mission

The providers of Capital Women's Care seek the highest quality medical and ethical standard in an environment that nurtures the spirit of caring for every woman.


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