Seasonal Affective Disorder is an elusive mental health disorder that affects individuals in many ways. This article will try to provide some background and context to this often misunderstood disorder and offer some tips and tricks to mitigate the effects.

What is Seasonal Affective Disorder (SAD)?

Seasonal Affective Disorder, often referred to as SAD, is a form of depression. SAD usually cycles with the changing seasons and is prominent in the winter months when days are shorter, and the weather forces people to stay indoors. Symptoms of Seasonal Affective Disorder often appear at the onset of winter (or the season) and dissipate when the weather changes.

Like depression, SAD can present a variety of symptoms. Some of the common symptoms folks experience are:

• Fatigue
• Sadness
• Irritability and intolerance with others
• Fighting with loved ones for insignificant reasons
• Lost of interest
• Difficulty sleeping or excessive sleeping
• Changes in eating habits like eating more sweets
• Weight gain
• Feelings of hopelessness and despair
• And in some cases, thought of suicide

Seasonal Affective Disorder is usually associated with the winter months, but SAD can affect people in the summer months. Some common symptoms people experience in the summer months are:

• Difficulty sleeping
• Loss of appetite and weight loss
• Agitation
• Anxiety
• Aggression or violent behavior

Symptoms of Seasonal Affective Disorder usually last between 3-5 months. Patients can be misdiagnosed as having major depression or even bipolar disorder. It’s important to talk with your provider and share as much information as possible to diagnose and treat your symptoms properly. Your healthcare provider may have you complete a questionnaire or ask you some qualifying questions that can help diagnose SAD.

Treatment for Seasonal Affective Disorder (SAD)

There are a few theories as to the cause of SAD. Serotonin and Melatonin are two chemicals in our brains that regulate important functions. Serotonin helps regulate mood, and Melatonin helps regulate sleep. People with SAD often have lower levels of Serotonin and higher levels of Melatonin. Studies also suggest that Vitamin D influences how the body produces Serotonin. Humans get Vitamin D in a couple of ways. We get Vitamin D when we eat Vitamin D-rich foods, and our bodies produce Vitamin D when the sun hits our skin.  

There are four primary therapies to treat Seasonal Affective Disorder (SAD). 

Medication Therapy (psychiatry) 

Selective Serotonin Reuptake Inhibitors (SSRI) address symptoms of depression and work for those with SAD. Research shows that Serotonin levels are lower in people with depression. SSRI medications help regulate Serotonin levels. As with any medication, it’s important to speak with your Psychiatrist, Primary Care physician, or Clinical Pharmacist about any adverse side effects.

Light Therapy

Sunlight hitting the skin promotes Vitamin D production. And Vitamin D helps in the production of Serotonin. Full-spectrum lights can mimic the sun’s rays and create the same effect as natural light. Light Boxes will not cure SAD but may relieve symptoms associated with Seasonal Affective Disorder. We recommend a healthcare provider monitor your use of light therapy as you can overdo it and trigger insomnia, hyperactivity, and ocular issues.

Vitamin Therapy

Ideally, Vitamin D intake should occur naturally through diet and sunshine. Over-the-counter Vitamin D can help supplement your intake; however, looking at your nutrition and making adjustments may be sufficient. Vitamin D supplements are readily available at most drug stores, supermarkets, and online. If you choose to take a supplement, it’s best to begin taking Vitamin D before the decrease in daylight hours. As with any medication or supplement, we always recommend you speak with your Primary Care physician or Clinical Pharmacist first.

Cognitive Behavioral Therapy (psychology)

People who experience Seasonal Affective Disorder (SAD) often experience other emotional and cognitive challenges. Therapy, specifically Cognitive Behavioral Therapy (CBT), can help patients manage their feelings and thoughts while providing tools to help work through bouts of SAD and other emotions. CBT or Talk Therapy used in treating SAD involves several visits with a therapist. Depending on your needs, a therapist may recommend sessions throughout the winter months. In Cognitive Behavioral Therapy, therapists work with patients to explore and identify the negative thoughts and feelings associated with the winter months and replace them (or reframe them) with positive and constructive alternatives. In addition, therapists can help patients identify pleasant indoor and outdoor activities that can jumpstart their engagement with daily living. 

Tips to living with Seasonal Affective Disorder (SAD)

Although there is no cure for SAD, through proper management (either through medications or other therapies), patients can live fulfilling lives. Here are a few tips and recommendations that may help mitigate your symptoms worth implementing.

Socialize
Spend time with family and friends. You’ll find that most people are excited to spend time with you and will make accommodations to see you. Be careful not to pass up invitations because of how you “might feel,” but accept invitations with the caveat that you may need to leave early or may cancel if your SAD symptoms persist. 

Exercise
Physical activity can help jumpstart metabolisms and trigger chemicals in our brains that regulate mood. Vigorous exercise may sound overwhelming, and that is okay. We recommend starting with a walk around the block or riding a stationary bicycle for one 30-minute program. If you are up to it, going to a gym and participating in structured workout programs can greatly improve your management of SAD.

Diet
Some foods have a direct influence on how we physically and emotionally feel. Be conscious of how different foods affect you and make healthy choices. With SAD, people may crave “Comfort Foods,” which, when eaten in moderation, can be a positive experience. Practice caution and restraint as not to overindulge. 

Consuming foods rich in Vitamin D can be beneficial. Some foods to consider are:

• Dairy or fortified foods
• Oily fish such as tuna, salmon, and cod
• Eggs

Final thoughts

Seasonal Affective Disorder may not be curable, but the symptoms are manageable. If you or a loved one experiences SAD, seek professional help. At Think Whole Person Healthcare, we have Primary Care physicians and a Behavioral Health team that can work together to design a treatment program specifically for you. Don’t go another season suffering!

Cabin fever usually impacts families right about now each year. Here are some fun (and familiar) activities the whole family can enjoy.

What is cabin fever?

Did you know there is a medical definition for cabin fever? Cabin fever is the combination of psychological symptoms felt when a person feels restricted indoors.

People tend to experience cabin fever at different intensities based on their age, activity level, and how long they expect to be inside. In the wintertime, people tend to feel cabin fever around January or February. We know winter is almost over, but we also know that snowstorms and winter can drag on into April in the Midwest. Not knowing when the weather will give us a break can heighten our feelings associated with cabin fever. Many people experienced signs of cabin fever during the COVID-19 pandemic.

• Some common symptoms are:
• Anxiety
• Restlessness
• Loneliness
• Depression
• Lack of energy or motivation
• Intolerance or impatience
• I have cabin fever. Now, what do I do?

Here are four ways to help combat cabin fever.

Go outside

Even if it’s cold, taking a brief walk around the block or even stepping outside for a few minutes can help combat cabin fever. If you can, spread your errands out over a couple of days so you can get outdoors a couple of times a week.

Social support

If you aren’t able to go outside, interacting with others can help mitigate cabin fever. A phone call, Facetime, or even a zoom call are great ways to stay in touch with others and get some human interaction.

Stimulate your mind

Making productive use of your time helps make the days go by—getting you closer to Springtime. Choose a book to read with a friend and create a mini-book club. Commit to reading a section of the novel and schedule a call to discuss. Consider learning a second (or third) language. It’s never too late to learn! You may be interested in an artistic outlet like coloring, painting, or knitting. YouTube has hundreds of how-to videos available for free.

Playing games

But the all-time favorite is reliving childhood games with family members. Here are three of the best games for all ages to play indoors or outside (weather permitting).

Hide-n-seek for inside

Everyone in the house can play hide and seek. It’s a simple game. But, it can get a bit rowdy indoors. Everyone is in one room, and the Leader goes out into the house and hides an object. The goal is for the participants to find the identified object and return it to the Leader. The person/team that returns the object to the Leader takes over as the Leader for the next round. If participants have trouble locating the object, the Leader should offer clues to help keep the game progressing. Pair younger children with older adults, and they can work as a team.

Variations can include elements of “I Spy” where the Leader doesn’t disclose the object but provides a clue. The participants have to figure out what the object is and locate it before the others.

Simon Says

This activity can be fun for parents to play with their kids. It creates a wonderful opportunity for children to learn valuable listening skills while getting an opportunity to burn off some energy. If you aren’t familiar with the game, the rules are simple. The participants all stand up in from of the Leader, who we call Simon. The Leader says “Simon says” and includes some action like “touch your nose” or “jump up and down.” After a few Simon says instructions, the Leader omits to say “Simon says” before giving the task. Individuals that do the task sit down—the last person standing wins and takes over as the Leader.

Some timeless instructions are:
Touch your nose

• Do a jumping jack
• Turn around
• Touch your toes
• Take a step forward.
• Clap your hands

Dance Party

This one can be a bit rowdy and awkward for individuals who may be self-conscious, but it can be fun and empowering. Try finding music with an upbeat rhythm. A favorite song the whole family can dance to is Happy by Pharell Williams. Children and older adults must see you having fun with dancing. So be weird. Laugh and exaggerate your movements, so they see it’s okay to look funny. Make the whole dance party exciting. For older adults, sitting in a chair and moving their upper bodies is equally beneficial. Clapping hands and singing along is also a fun way to elevate the activity.

A couple of considerations:

• Make sure sharp edges and breakable items are stored safely away so participants can’t hurt themselves.
• If you have children who tend to overstimulate, you may want to select different music that may be lower energy.
• If you have participants who have mobility issues, more meditative music may be ideal.
• Select music that’s relevant to the group. Ask for suggestions.

If possible, play the music video on your television during your dance party session. Omit if your audience is easily overstimulated.

The most important thing to keep in mind is to have fun! Dance Party is about shedding your self-consciousness and moving around—getting your heart rate up and burning off energy.

A final note about cabin fever.

As with any changes to your routine, check with your Primary Care physician, especially if you have a relatively sedentary lifestyle or health issues. If you don’t have a Primary Care physician, visit our Meet your Doctor page and schedule an appointment today.