Are you SAD?
Seasonal Affective Disorder (SAD): Symptoms, Causes, and Treatment Options
Meta Description: Seasonal Affective Disorder (SAD) is a type of depression linked to changes in seasons. Learn symptoms, causes, and evidence-based treatments from a mental health nurse practitioner.
As we move into January and the post-holiday letdown sets in, many people notice a shift in their mood and energy. Searches for seasonal depression, winter blues, and Seasonal Affective Disorder (SAD) peak this time of year for a reason. This time of year can be especially challenging for those of us living in colder, darker climates. It’s common to feel more tired or less motivated—but for some, these changes are more intense and persistent.
Seasonal Affective Disorder (SAD) is a form of depression with a seasonal pattern, most often beginning in the fall or winter when daylight hours decrease and lasting for several months. People who live with year-round depression or bipolar disorder often notice that their symptoms worsen during the winter months. SAD is different from the “holiday blues,” which are typically related to stress, grief, or changes in routine around the holidays and tend to resolve more quickly.
While most people associate SAD with winter, a smaller number experience summer-pattern SAD, which presents differently.
Seasonal Affective Disorder Symptoms
SAD can feel very similar to major depression. Symptoms may include:
Persistent low mood or feeling “down” most of the day, nearly every day, for at least two weeks
Feelings of hopelessness, pessimism, or emotional numbness
Irritability, frustration, or restlessness
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in activities you usually enjoy
Low energy, fatigue, or feeling slowed down
Difficulty concentrating, remembering, or making decisions
Changes in sleep or appetite, or unplanned weight changes
Physical symptoms such as headaches, body aches, or digestive problems without a clear medical cause
Thoughts of death or suicide
Winter-Pattern Seasonal Affective Disorder
Winter SAD often looks like a form of “hibernation,” including:
Oversleeping or difficulty waking
Increased appetite, especially for carbohydrates
Weight gain
Social withdrawal or isolation
Summer-Pattern Seasonal Affective Disorder
Summer SAD may include:
Difficulty sleeping or insomnia
Decreased appetite or weight loss
Restlessness or agitation
Increased anxiety or irritability
Causes of Seasonal Affective Disorder
Research suggests that seasonal changes in light exposure play a significant role in SAD.
Serotonin: Sunlight helps regulate serotonin, a brain chemical involved in mood. Reduced daylight during winter months may contribute to lower serotonin levels.
Vitamin D: Sunlight exposure is also important for vitamin D production, which has been linked to mood regulation. Levels often drop in the winter.
Melatonin: Some studies suggest that people with winter-pattern SAD may produce higher levels of melatonin, a hormone that regulates sleep. This can contribute to increased sleepiness and low energy.
Treatment Options for Seasonal Affective Disorder
The most important first step is reaching out for help. SAD is a real, treatable condition, and you do not have to manage it alone.
Therapy
Cognitive Behavioral Therapy (CBT), particularly CBT tailored for SAD, has strong evidence for effectiveness. While symptom relief may not be immediate, CBT has been shown to provide longer-lasting benefits by helping people develop coping strategies and healthier thought patterns.
Light Therapy
Light therapy can be very effective, especially for winter-pattern SAD. This typically involves sitting near a specially designed light therapy box for about 30 minutes each morning.
When considering light therapy:
Look for a lamp that provides 10,000 lux of UV-free light
Follow the manufacturer’s recommended distance from the lamp
Do your research, as quality and price vary widely
Always talk with your healthcare provider before starting, especially if you have eye conditions or bipolar disorder
Some people experience side effects such as headaches or eye strain, and in rare cases, light therapy may trigger manic symptoms.
Red Light Therapy / Infrared Saunas
Red and near-infrared light therapy, often delivered through dry heat saunas, has some emerging evidence for mood improvement. These treatments are best used in combination with other therapies and should also be discussed with your medical provider before starting.
Medication and Supplements
Vitamin D supplementation may be helpful for some individuals, though research shows mixed results when used alone.
Antidepressant medications can be effective for SAD, but they typically take 4–6 weeks to reach full benefit.
When to Seek Help for Seasonal Affective Disorder
If symptoms interfere with your daily functioning, relationships, or work—or if you experience thoughts of self-harm—it’s important to seek professional care promptly.
Research suggests that many people see improvement with light therapy, while the benefits of CBT tend to be longer lasting. For most individuals, a combination of treatments is often the most effective approach.
If you’re struggling, please know this: you are not alone, and you are not “just being lazy” or “overreacting.” Seasonal Affective Disorder is a legitimate medical condition, and effective treatments are available.
If these symptoms sound familiar, reach out to your medical or mental health provider. Support is available, and help can make a meaningful difference.
💙Marie Smith, PMHNP
If you are experiencing a medical or psychiatric emergency, or need immediate support, please do not wait for a response.
Instead, contact emergency services:
Call 911 for immediate assistance
National Suicide & Crisis Lifeline: Dial 988
Substance Abuse and Mental Health Services Administration (SAMHSA)
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