Is your mood and energy so low this time of year that you think you could have “winter blues” or seasonal affective disorder? Read on to learn about the difference between the two, the symptoms, and coping strategies.
What is SAD?
Seasonal Affective Disorder (SAD) is a term that was coined by Norman Rosenthal in the 1980s to describe annually recurring depression that typically starts during autumn or winter and subsides in spring or summer. The acronym stands out, capturing a hallmark feature of the condition itself. However, SAD is something a little different from the more commonly experienced winter blues.
With winter blues, you feel a natural and more temporary dip in energy and mood with the changing of the seasons, but it doesn’t cause impairment in important areas of functioning. Similar to how most headaches can’t be classified as migraines, instances of the winter blues do not necessarily suggest SAD, which is more formally classified as Major Depressive Disorder with Seasonal Pattern.
In order to be diagnosed with SAD, a mental health professional must assess for a certain combination of symptoms and also rule out alternate causes of them:
Most notably, they must identify a seasonal pattern to the onset and remission of major depressive episodes over a period of at least two years.
Within that period, the seasonal depressive episodes must substantially outnumber non-seasonal ones, and they must persist for most of the day, every day, for at least two weeks.
As well, the depressive episodes cannot be better explained by seasonally-related psychosocial stressors (e.g. an absence of work during winter months, returning to school in the autumn), substance use, a general medical condition, or bereavement.
Increased cravings for high-calorie comfort foods, excessive sleeping, social withdrawal, and resultant weight gain (in combination with the aforementioned criteria) are also characteristic of SAD.
Persistent feelings of sadness, stress, guilt, confusion, distractibility, and hopelessness are likely. Tasks that were once simple may suddenly become overwhelming.
What causes SAD?
The exact cause of SAD is still being debated. A commonly accepted theory is that people with SAD may generally struggle to regulate serotonin (a mood-balancing brain chemical) or overproduce melatonin (a hormone that signals “bedtime!” to the body). Decreased sunlight may further reduce the body’s production of serotonin and increase its production of melatonin. Because the body’s internal clock naturally thrives on routine, such a disruption to it can be quite distressing (just ask shift workers!).
The absence of sunlight is not the only potential cause of SAD. Researchers have found that genetic factors may play a role. Most people who develop SAD have at least one close family member with a history of depression.
As well, women are significantly more likely to develop the condition than men. Of course, being a woman and having a family member who struggles with depression does not mean that a person will develop SAD; these factors could be better thought of as connections rather than causes.
Of note, some professionals believe the cause of SAD could be more simply explained by the idea that seasonal changes impede people from engaging in the usual outdoor activities that bring them joy.
What helps SAD?
Resisting cravings and making healthy food choices, engaging in physical activity (even when the desire to do so isn’t there), and maintaining contact with social supports are common (and evidence-based) strategies for managing many mental health concerns. Some other, perhaps less familiar options are:
Self-compassion: People with SAD have a lower threshold for stress during the autumn/winter months, so looking for ways to reduce demands during this time of year is important. Remember, our best inevitably changes from moment to moment: What you are capable of on a day during which you are healthy compared to a day during which you have the flu is going to be different. Similarly, what you can offer or do for others is going to look different on a day during which you ’re experiencing relationship bliss or booked a vacation, compared to a day during which you’ve been fighting with your partner or had to take your injured pet to the vet. Context matters. Just because you can handle certain demands at one point in the year, doesn’t mean you “should” be able to handle those same demands at another. Practice self-compassion, restructure your work if possible (e.g. start later in the day, work shorter hours, decline extra projects), and ask others for more help during the darker months.
CBT: Of the many styles of therapy out there, cognitive-behavioural therapy (CBT) is the most widely researched and recommended approach for treating SAD. CBT helps clients better understand and manage the reciprocal relationships between their thoughts, feelings, and behaviours. Challenging our negative thoughts and behaviours to bring about more positive emotions can seem easy in principle, but requires effort to put into practice. A therapist who practices CBT may be a valuable companion to invite into one’s support network when working to cope with SAD.
Light therapy: Light therapy is another effective way to manage SAD symptoms at home or work. It involves the regular use of a specially designed light therapy box that mimics the natural light of the sun’s rays. The most effective light therapy boxes emit 10,000 lux (a measurement of light intensity), and require about 15 minutes to one hour of exposure per day. It is best used within one hour of waking up, and can also be beneficial when used mid-day. Light therapy boxes can be placed within your peripheral vision (up to 2 ft. away), meaning you can engage in your usual daily tasks (e.g. reading, writing, drinking your morning coffee) with minimal disruption. The cost of such boxes has decreased in recent years, making them more affordable to those in need. However, light therapy boxes may not be suitable for everyone. Negative side effects of light therapy can include eye strain, headaches, agitation, and nausea. Insomnia may result from late night exposure, and hypomania has been found in rare cases. It is important to do research and consult with your treating physician before making the investment into a light therapy box.
Medication and supplements: Physicians may also be able to provide some valuable insights about whether or not prescription medication could be a potentially helpful option for you. They, or your pharmacist, may also be able to determine if you’d benefit from over-the-counter supplements such as vitamin D or 5-HTP. Always consult with your team of healthcare professionals before trying something new to address physical or mental health concerns.
If you would like to talk to a mental health therapist about seasonal affective disorder or something else, connect with your EFAP for support. We're here to help.