By Nina J. Henry, LCPC, CADC, Addiction Specialist & Mental Health Educator
Many of us look forward to “falling back” to Central Standard Time in autumn. “Yay!” we say to that extra hour of sleep, even if it means walking the dog in the darkened afternoon for a couple of months.
There are others of us, however, that get a feeling of foreboding at this time of year. For some, shortened days and fewer hours of sunshine mean less energy, loss of appetite, and feelings of despair or hopelessness. “Seasonal depression, or seasonal affective disorder (SAD), is a type of depression that’s related to a change in seasons. Some people with SAD experience depression in the spring and early summer, but for most, symptoms start in the fall as the weather gets cooler and the sun sets earlier. [Recently], we aren’t just dealing with shorter, colder days - we’re dealing with additional stressors like COVID-19, its variants, and other major disasters. If you experience SAD, you may be feeling it a bit harder this year. (Mental Health America 2021).”
Annually, approximately 5% of the United States population reports experiencing symptoms of SAD, but it is widely believed that SAD is underreported and misdiagnosed (Mayo Clinic 2021). One reason for this may be how difficult it can be to distinguish between a Major Depressive Disorder and Seasonal Affective Disorder. Seventy percent of people with Major Depression feel worse during the winter and better during the summer. What distinguishes the two disorders is that SAD is a major depressive disorder with a seasonal pattern, so that depression is present only at a specific time of year (e.g., in the fall or winter) and full remission occurs at a characteristic time of year (e.g., spring). The people most frequently diagnosed with this disorder include women, people with SAD in their family history, people living north of the equator, and those with pre-existing mental health challenges.
SAD stems from the disruption of three biological functions:
- Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may cause winter-onset SAD. This decrease in sunlight may disrupt your body’s internal clock and lead to feelings of depression.
- Serotonin levels. A drop in serotonin, a brain chemical that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression.
- Melatonin levels. The change in season can disrupt the balance of the body’s level of melatonin, which plays a role in sleep patterns and mood.
There are numerous effective treatments for SAD. These include:
Light Therapy: Since the 1980s, light therapy has been a mainstay for the treatment of SAD. It aims to expose people with SAD to a bright light every day to make up for the diminished natural sunshine in the darker months.
Psychotherapy: Cognitive behavioral therapy (CBT) is a type of talk therapy aimed at helping people learn how to cope with difficult situations. CBT has now been adapted for people with SAD (CBT-SAD).
Medications: Because SAD, like other types of depression, is associated with disturbances in serotonin activity, antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are also used to treat SAD when symptoms occur.
Vitamin D: Since sunlight helps our body produce vitamin D, many people with SAD often have vitamin D deficiency. Nutritional supplements of this vitamin may help improve symptoms.
There are also many self-help avenues to explore, including exercise, relaxation, meditation, peer support groups and social networks, and many books on the topic: https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder
If you notice symptoms of depression as Fall turns to Winter, consider the possibility that you may be experiencing SAD. Reach out to a mental health provider if you are struggling with daily routines, work/school responsibilities, and emotions. Call JCFS Chicago at 855.275.5237 for information about counseling and other JCFS programs and services.