Seasonal affective disorder: more than winter blues
In short: seasonal affective disorder (SAD) is a type of depression that comes back at the same time each year. It usually starts in late fall or early winter and lifts in spring. It is more than feeling a bit flat in winter, and it can be treated. Talk to a doctor if you've felt low most days for two weeks or more.
What SAD is
SAD is depression that follows a seasonal pattern. Most people with SAD have the winter pattern. A less common summer pattern starts in spring or summer. A doctor or mental health professional looks for episodes that have come back in the same season for at least two years in a row.
Signs to look out for
SAD has the usual signs of depression, most of the day, nearly every day, such as:
- Feeling sad, low or hopeless
- Losing interest in things you usually enjoy
- Feeling tired, with low energy
- Trouble concentrating
Winter-pattern SAD often also brings:
- Sleeping much more than usual
- Eating more, especially craving carbohydrates, and putting on weight
- Pulling away from friends and family, a bit like "hibernating"
Who is most at risk
- Women
- People who live farther north, where winter days are shorter
- People with depression or bipolar disorder
- People with a family history of SAD or other mental health conditions
SAD often starts in young adulthood.
Treatments that help
- Light therapy. Sitting in front of a very bright light box (10,000 lux), usually for 30 to 45 minutes each morning, through fall and winter. Talk to a doctor before you start, about whether it suits you and which kind of box to use.
- Talking therapy. A type of cognitive behavioral therapy adapted for SAD helps you change unhelpful thoughts about the winter and plan activities you enjoy. In a study, it worked about as well as light therapy, and its benefits lasted longer.
- Antidepressant medicines. A doctor may suggest these. They usually take several weeks to work.
- Vitamin D. Some people with SAD have low vitamin D, but studies of supplements have had mixed results. Ask a doctor first, because vitamin D can interact with some medicines.
Everyday habits can help alongside treatment: staying active, keeping a regular sleep schedule and keeping in touch with people. See Looking after your mental health.
When to get help
See a doctor or mental health professional if you've had signs of depression for two weeks or more, or sooner if they're making daily life hard. You don't need to wait for spring.
If you're in crisis or thinking about harming yourself, get help now. In the U.S., call or text 988 (the 988 Suicide & Crisis Lifeline) or chat at 988lifeline.org. Elsewhere, call your local emergency number. If someone is in immediate danger, call 911 or your local emergency number.
Sources
- NIMH (NIH): Seasonal affective disorder
- NIMH (NIH): Caring for your mental health
- 988 Suicide & Crisis Lifeline: 988lifeline.org