What is seasonal affective disorder?

Seasonal affective disorder, or SAD, is a form of depression that results from the change in seasons, most often when fall begins. This seasonal depression worsens in the late fall or early winter before it ends with the brighter days of spring.

It's called the "winter blues," a mild version of SAD. It's normal to feel a little down during the colder months. You may be stuck inside, and it gets dark early.

However, full SAD goes further than this. It is actually a form of depression. Unlike the winter blues, SAD affects your daily life in terms of how you feel and think. Thankfully, treatment can help you through this challenging time.
Seasonal affective disorder can be referred to as seasonal depression by your doctor.

Who is susceptible to SAD?

SAD often begins during adulthood. The risk of SAD increases with age. It's rare in people under the age of 20. It occurs more often in women than in men.

What are the symptoms of seasonal affective disorder (SAD)?

There are 2 types of SAD:

• Fall-onset: This type is also knownas winter depression. Symptoms of depression begin in late fall to early winter. They tend to lessen during summer months.
• Spring-onset: This type is also called summer depression. Symptoms of depression begin in late spring to early summer. This is afar less common form.

Most frequent SAD symptoms include:

• Inappropriateor excessive sleep and daytime sleepiness
• Loss of interest and pleasure in activities onceconsidered enjoyable
• Withdrawal from social interactions and increased sensitivity to criticism or rejection
• Irritabilityand restlessness
• Feelingof helplessness and guilt
• Excessive fatigue(tiredness)
• Lowinterest in sex
• Poorconcentration
• Trouble thinking orconcentrating
• Appetiteincreases, particularly for sweet foods and carbohydrates
• Weight gain
• Headachesor other physical symptoms
• Symptoms appear,then recur, at more or less the same time each

The symptoms of SAD may mimic other mental health conditions. Always see a healthcare provider for a diagnosis.

What causes seasonal affective disorder?

The exact cause of SAD is not known. However, factors include the following:

• Biological clock or circadian rhythm: The minimal intensity of sunlight in fall and winter can trigger winter-onset SAD. This results from the minimal amount of sunshine because the decreased light may break one's internal body clock into melancholy.
• Serotonin levels: Low levels of serotonin, a neurotransmitter affecting mood, could be part of the cause of SAD. Lack of sunlight can contribute to a serotonin drop that could lead to depression.
• Melatonin levels: A change in season can throw off the balance of the body's level of melatonin, which has a role in sleep patterns and mood.

How is seasonal affective disorder diagnosed?

Cases of depression are almost invariably associated with other disorders, such as cardiac illness and oncological problems. So too are mood disorders such as substance-use disorder and anxiety disorder. Therefore, an early diagnosis followed by treatment is central to the recovery process.

Impression regarding SAD diagnosis may be possible after one keen mental health evaluation and health history assessment made by a psychiatrist or other mental health provider.

What are the criteria for a seasonal affective disorder (SAD) diagnosis?

Your provider might consider diagnosing SAD if you exhibit the following:

• Severe symptoms of major depression.
• Two consecutive years with the occurrence of depressive episodes in specific seasons.
• Recurrent depressive episodes that have occurred more frequently during a particular season than at other times of the year.

How is SAD treated?

Your doctor will discuss your treatment choices with you. You might need to take a number of medications or treatments. These could include:

• Light therapy: Bright light therapy involves the use of a special lamp, and can treat SAD.
• Cognitive behavioral therapy (CBT): CBT is one form of talk therapy. Research indicates that it has successfully treated SAD. More people remain well after cognitive-behavioral therapy than with any other treatment.
• Antidepressant medication: Providers sometimes prescribe antidepressant medication alone or in combination with light therapy.
• Spending time outdoors: Increased exposure to sunlight can help your symptoms improve. Get outside during the day as much as possible. Open windows and doors in your home or office to let more sunlight in.
• Vitamin D: A supplement of vitamin D may help improve your symptoms. Discuss this supplement with your provider before taking it.

What are the risk factors of SAD?

Seasonal affective disorder tends to be more common among women than men. And SAD affects younger adults more often than it does older adults.

Risk factors for seasonal affective disorder include:

• Family history: Those with SAD may be more likely to have blood relatives with SAD or another type of depression.
• Having major depression or bipolar disorder: If you have one of these conditions, symptoms of depression may worsen seasonally.
• Place further away from the equator: SAD seems to be more rampant in individuals residing further north or south of the equator. This might be due to the reduced daylight hours for winter months and longer days for summer months.
• Low levels of vitamin D: A small amount of vitamin D is produced in the skin when exposed to sunlight. Vitamin D can contribute to an increase in serotonin activity. The reduced level of sunlight and the insufficient vitamin D from diet and other sources lead to lower levels of vitamin D in the body.

Can I prevent seasonal affective disorder?

Currently, the medical world has nothing concrete on how to prevent the onset of seasonal affective disorder. However, early taking care of the symptoms may prevent further worsening in future. Serious shifts in mood, appetite, and energy may, therefore, be predicted since one can tell the specific time of the year when these symptoms are likely to appear. So, therapy will prevent associated complications, especially when SAD is diagnosed and treated before symptoms worsen.

There are people who find it helpful to start treatment before symptoms would normally begin in the fall or winter and keep going beyond the expected time symptoms would normally go away. Some others, though, need uninterrupted treatment to prevent their symptoms from coming back.

What is the prognosis for people with seasonal affective disorder (SAD)?

If you have SAD, things are looking good. Treatment does exist for SAD. Relief from symptoms can be obtained through the right diagnosis and appropriate combinations of treatments. Consult with your health care provider and determine which treatment would most suit your needs.

When should I talk to my healthcare provider about seasonal affective disorder (SAD)?

If you believe that you are having seasonal depression symptoms or another form of mood disorder, go and consult your healthcare provider. The health provider will want to diagnose some other condition or illness responsible for causing such symptoms.

What do I tell my doctor?

If you have SAD, discuss with your provider:

• Treatment option best suited for me?
• Can I avoid a depressive episodes?
• Is light therapy an alternative for me?
• Should I consider taking an antidepressant?
• When to start medication?
• For how long would my treatment last?
• Should I change my diet?
• Can I change what I do and avoid?

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