Explaining Seasonal Affective Disorder (SAD) 

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!