Understanding Seasonal Affective Disorder and Depression

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Unhappy woman indoors

Seasonal affective disorder (SAD) is a form of depression primarily in winter. SAD is most common in the southern United States, Europe (particularly Scandinavia), Japan, and Australia. SAD is genetic, and people in the northern hemisphere have evolved to be more susceptible to SAD than people from the southern hemisphere. The shorter days of autumn and winter trigger genes that make us feel unhappy. SAD is also known by the following names: seasonal depression, winter blues, summer blues, and autumnal depression.

A Biopsychosocial model suggests that SAD is caused by the interaction of biological, psychological and social factors because an evolutionary approach suggests that SAD may be a consequence of environmental mismatch with our current environment.

A typical day during the SAD period is when a person with seasonal affective disorder might feel lethargic, depressed, and experience low energy. It takes about two weeks to recover from about of seasonal affective disorder, even if they have been treated using light therapy.

Symptoms

For a diagnosis of seasonal affective disorder, the symptoms should be limited to depressive episodes that occur during the autumn and winter months. Once spring arrives, there should not be any depressive symptoms anymore. Other emotional changes may include:

A feeling of being unable to concentrate or not feel like concentrating on things. Not remembering details that you would normally remember. Feeling sluggish and low energy levels, doing simple tasks like getting dressed or washing the dishes takes longer. A sense of worthlessness, self-blame for mistakes made during the day, and hopelessness. A change in appetite: having cravings for sugary foods and an increased desire for carbohydrates like pasta, bread or pizza. The symptoms of SAD can also make people antisocial and withdrawn because they feel depressed so often.

Individuals feel guilty for hiding inside and not enjoying the natural world. They have a belief that they are “less” than other people that do not suffer from SAD, that they can’t enjoy the things in life that other people take for granted. A person with a healthy emotional state does not have the same feelings of dread, guilt or worthlessness.

While your career does not cause seasonal affective disorder, it can make managing your work life more difficult. The symptoms of SAD can also make people antisocial and withdrawn because they feel depressed so often. People who have other depressive or anxiety disorders, particularly agoraphobia, may have been afraid to leave home due to the weather conditions and so they become depressed as it gets colder. People with SAD may also lack vitamin D. This is a hormone that’s important for the absorption of calcium and phosphorus, which both are necessary to form healthy bones in children and adults.

Relationship Between Depression and SAD

The first step to diagnosing SAD is ruling out other diagnoses such as dysthymia, depression due to a general medical condition or drug use, chronic major depressive disorder, bipolar disorder, cyclothymia, psychotic depression, premenstrual dysphoric disorder (PMDD), adjustment disorder, schizoaffective disorder, and hypomania.  Patients who are diagnosed with adjustment disorders have mild depressive symptoms caused by a stressful event but they do not meet the criteria for major depression disorder. Taking antidepressants is a common way to treat SAD, but this can only help for mild cases of SAD mental health issues.

People who suffer from SAD will often be diagnosed with clinical depression. This mental health condition can interfere with your ability to work, sleep, study and eat. It also takes over your life by making you too exhausted or hopeless to want to live it fully. It affects more than 350 million people worldwide and is the leading cause of disability.

The following are key characteristics of depression:

  • Depression often means a sense that you have less energy than usual. Interest in activities that used to be enjoyable may be lessened.
  • A sense of worthlessness and guilt may be present after the mistakes you have made during the day.
  • Difficulty paying attention to your normal daily activities, including work-related tasks. Having trouble making decisions about simple things.
  • Suicidal thoughts or wishes, but not having any intention to harm yourself.

While a person with seasonal affective disorder may have some symptoms of depression, they will also exhibit other symptoms relating specifically to the arrival of winter months: A sense of dread in the weeks leading up to winter. Unnecessary worry about minor things like losing your job, or getting sick in the winter. Fears related to health, aging, and death are common during this time of year. A feeling like you are doing something wrong by not being outside enjoying nature is common.

Depression is more common in women than it is in men. There are many different reasons for this, some of the reasons are:  Women may not want to be vulnerable or show any sign that something is wrong, which can lead them to stay silent. Women are more connected to their emotions because they are hormonal beings, which means they will be more reactive to changes in moods. The hormone estrogen has been linked to mood regulation and depression.

SAD is most common in the southern United States, Northern Europe, Japan, and Australia 

SAD isn’t just an American problem, it also occurs in Northern Europe. People with SAD often have a shorter winter than those without the disorder.

Research has proven that people living above 52 degrees north (Scandinavia) or 30 degrees north (Scotland and Canada) are diagnosed with SAD during the winter months. People who live closer to the equator don’t develop SAD because they have more daylight hours. The disorder is also found in people living under because they have nearly 2 weeks of winter starting in April and lasts until October/November.

SAD is genetic

People in the Northern Hemisphere have evolved to be more susceptible to SAD than people from the Southern Hemisphere. SAD is genetic. People in the northern hemisphere have evolved to be more susceptible to SAD than people from the southern hemisphere. The shorter days of autumn and winter trigger genes that make us unhappy.  Similar disorders like post-pregnancy depression and Schizophrenia are genetic as well.  The symptoms of Schizoaffective disorder are usually milder than some forms of bipolar disorder, but more severe than unipolar depression. A small number of individuals may also experience periods with psychotic symptoms without any mood swings.

Light Therapy

Light therapy has been proven effective at helping SAD sufferers who are willing to give it a try. It can also help with mood regulation and sleep patterns, which reduces the severity of symptoms of depression.

Light therapy is useful for SAD because it helps to regulate mood and circadian rhythm. It’s also used to treat mild depression, age-related mood changes, and sleep problems in blind people.

This can be done through natural sunlight or with artificial lights such as those found on lamps, light boxes, and TV screens.  Artificial light sources can produce the same positive effects of light therapy.  Natural and artificial lights have been found to change the amount of melatonin and serotonin in our brains. This helps with mood regulation, as well as sleep patterns.

Some people may also benefit from spending some time in front of a lightbox, which is a device that emits artificial sunlight.  You may get the same benefit of light therapy from a phototherapy device that you can purchase.

Light therapy is also beneficial to people who suffer from Seasonal Affective Disorder. This usually includes 20 or 30 minutes of light exposure, five days a week.

Even though sunlight can help improve one’s mood, it’s still very important to protect yourself from too much UV rays and heat.

Light therapy has been proven effective at helping SAD sufferers who are willing to give it a try.  Studies have shown that 10,000 lux of white fluorescent light significantly improved moods. 

SAD patients who have a hard time going outside during the winter months can use artificial lights that don’t require bright lights pointed at their eyes. The lamps are usually less expensive than SAD lamps and is just as effective in treating symptoms of depression and regulating moods.  People can also watch TV to get a similar effect, or even go to an arcade that has bright lights (video games, rides). These are forms of phototherapy light therapy.

Another much more expensive but also a beneficial treatment option for people suffering from SAD is a multi-day vacation at a high-altitude resort. These resorts are found in mountainous regions like Mexico and Colorado, where the sun can be intense in winter. The high altitude will produce more serotonin in the brain without using artificial light sources. 

However, a more extreme method involves injecting the patient with radioactive isotopes through an IV several times per day. As harmful as it sounds, the small doses of radiation have been proven effective at lessening the effects of SAD. Another form of light therapy is called “Sub-Zero Therapy”. This type of treatment involves exposing yourself to temperatures as low as negative 50 degrees Celsius for six minutes at a time. The therapy works by having subzero gas come out of the nose and mouth, which makes your body release nerve growth factor, a hormone that can cause happiness and warmth. Although there isn’t a lot of research that shows the Sub-Zero therapy works, it is one of the only ways to get this type of effect.

Other potential treatments

Artificial light is often a last recourse.  Natural light is always better, but finding it is difficult for many people. Here are other ways to alleviate or fully treat SAD:

  • Self-monitor daily activities and emotional states.
  • SAD and its symptoms can also affect the brain, including restlessness and tiredness. This is because of an imbalance between two neurotransmitters: serotonin and norepinephrine. One of the most commonly used antidepressant medications to treat SAD is selective serotonin reuptake inhibitors  (SSRI). SSRIs balance neurotransmitter levels and are prescribed by psychiatrists.
  • Counseling is a helpful option for gaining insight into the root of the depression.
  • The benefits of ORMUS and other emerging natural treatments like CBD may help control the causes and symptoms of SAD
  • Cognitive Behavioral Therapy (CBT) helps patients identify negative thinking patterns that lead to depression. It also teaches them how to change their thoughts and behaviors in order to improve mood.
  • Interpersonal Therapy (IPT) is similar to CBT, but it focuses more on relationships and social situations that may have been a factor in the onset of SAD symptoms.

Coping with Season Affective Disorder

If winter is long and you can’t find an ongoing treatment to keep your blues at bay, consider these:

  • Spending time outside every day will naturally improve moods.
  • Going out for walks or hikes during the winter months helps.
  • Exercising and practicing yoga or meditation can also help reduce symptoms of SAD.
  • Having a “sunny” outlook on life can also keep your spirits high when it’s cold outside. Look for any light at all, even if it doesn’t come from an artificial source, and find something positive about the situation.
  • Try to schedule activities and have a plan for the day so that you don’t sit around all day doing anything.
  • Some people find it useful to keep a mood chart, where they can write down their daily feelings and emotions. This way they can see if there is a pattern of depression coming on in certain seasons.
  • People suffering from SAD should limit or avoid alcohol because it can exacerbate symptoms of depression and lack of energy, making them feel worse.
  • Frequent visits with family, light exercise, and socializing can all help the patient feel better.
  • Be sure to keep your doctor informed about any changes in mood, appetite, or sleep patterns that may be related to SAD. Symptoms of depression may also mean other problems are present. A diagnosis from a medical professional is important for beginning treatment, as well as support for loved ones.
  • Taking a trip to the mountains on a multi-day vacation or being at an arcade with bright lights can help reduce SAD symptoms.

 

Eric Van Buskirk
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