Is it seasonal affective disorder (SAD)? How to know and what you can do about it

Pacific Northwest winters spell shorter days, dreary skies and plunging temperatures, yet for many the changes that accompany “The Big Dark” go beyond the weather.

Millions of Americans, or approximately 5 percent of the U.S. population, live with seasonal affective disorder (SAD), a type of clinical depression related to the change of seasons.

“Unfortunately, some people with SAD can have symptoms up to five months of the year,” says Jeff Eisen, MD, MBA, chief medical officer of the MultiCare Behavioral Health Network. “This condition can affect all aspects of someone’s life, including their ability to work productively or socialize with their loved ones.”

If you find yourself experiencing the winter doldrums from year to year, it could be SAD. Whether you just feel a little down or your symptoms are more serious, there are treatments available and lifestyle changes you can make to stabilize your mood and support your mental health year-round.

What causes SAD

For most people, SAD starts in the fall and peaks in winter, though there is also a rare form that affects people from spring to summer. The exact causes of SAD aren’t known, but there are three factors that likely contribute to the development of this condition.

One is related to circadian rhythm — our bodies’ internal clock, which helps direct everything from our body temperature to our mood to our sleep patterns.

“Seasonal shifts bring with them changes in the amount of sunlight we get, and those changes can disrupt our circadian rhythm, among other processes in the body, perhaps triggering symptoms of SAD,” Dr. Eisen says.

Changes in sunlight quantity can also influence the production of two very important hormones: serotonin and melatonin, which also regulate sleep and mood.

While anyone can experience SAD, even children, it often affects those living in northern areas — such as New England, Alaska and the Pacific Northwest, where there is a significant amount of darkness during the winter months. There are also other risk factors that can make some people more prone to developing SAD than others, such as a family history of depression or a current diagnosis of bipolar disorder.

Symptoms of SAD

SAD is similar to other types of depression except that the symptoms follow a predictable pattern, waxing and waning during certain months of the year. Those symptoms, which can range from mild to severe, include:

• Sleep problems — insomnia or sleeping too much
• Lack of interest in activities you typically enjoy
• Persistent sluggishness
• Difficulty concentrating
• Weight gain or shifts in appetite
• Feelings of guilt, hopelessness or worthlessness
• Frequent thoughts of suicide or that life is not worth living*

* If you or someone you know is thinking about harming themselves, call the National Suicide & Crisis Lifeline at 988, available 24 hours a day, seven days a week.

How to cope with SAD

SAD can’t be prevented, but that doesn’t mean you have to suffer through symptoms that are life-threatening or disruptive. A good first step is to contact your primary care physician about what you are experiencing. They can assess your symptoms and refer you to a mental health specialist, if needed. Connecting with family or friends can also be helpful.

“One of the most important things people can do is talk about their concerns and feelings with someone they trust,” says Dr. Eisen. “Sometimes people who experience SAD or other forms of depression may be hesitant to reach out. If we could talk about mental health concerns as openly as we talk about diabetes or high blood pressure, then we could erase some of that stigma and create more opportunities for people to get the help they need.”

Treatments for SAD include psychotherapy as well as the use of antidepressant medication.

Another common treatment is light therapy, which can be done at home. This form of treatment involves sitting near a small portable box that emits very bright light for about 30-45 minutes a day, often in the morning. Light therapy helps make up for the lack of natural sunlight during fall and winter.

Many people who undergo light therapy experience relief from their symptoms and an improved sense of well-being. Your provider can help you determine if light therapy or other treatments might be a good option for you.

In addition to treatments, there are other steps you can take to alleviate symptoms of SAD.

“One thing that can be really helpful is sticking to a daily routine, even when you just want to crawl back under the covers,” Dr. Eisen says. “Having a routine helps provide a sense of meaning and purpose that can carry you through the day.”

Other tips for alleviating SAD symptoms:

• Avoiding long naps during the day, which can further disrupt sleep
• Traveling to a sunny destination during the winter season to help your body and mind recharge
• Incorporating as much physical activity as possible into your day, particularly during daylight hours, even if it’s just a walk through the neighborhood
• Limiting your exposure to electronic devices like phones and computers at nighttime, since the type of light they emit can interfere with sleep

Even if SAD doesn’t affect you, keep in mind that it can have a significant impact on the lives of others.

“If you have a friend, family member or colleague who seems different during the winter season, it’s OK to check in with them and offer your support,” Dr. Eisen says. “That sense of community is what gets us through tough times — and it may be just what a person needs to feel comfortable asking for help.”