You know the feeling — it’s late afternoon and the sky is already darkening. You might be driving to and from work in the dark, and then spend most of the day stuck indoors.
When the days get shorter, you may begin to feel less enthusiastic and active. You may find yourself going to bed earlier, sleeping longer, and even eating more. Many people notice slight fluctuations in their routine and mood during winter months.
Some people feel more than just the winter blues and may have periods when they have difficulty functioning. These symptoms may be seasonal affective disorder (SAD), a type of depression that can cause a range of emotions depending on the seasonal type.
When Does SAD Affect People?
SAD usually begins and ends at the same time each year. Winter depression occurs in the fall/winter, starting around October or November, and lasts through March or April. Spring/summer onset can begin in April and last until October. If left untreated, SAD can recur on an annual basis.
Shorter days and a lack of sunlight during the winter months may cause symptoms of SAD, including:
- Tiredness and decreased activity level
- Crying spells and mood swings
- Trouble concentrating
- Body aches
- Loss of sex drive
- Trouble sleeping or a desire to hibernate
- Cravings for carbohydrates and/or overeating
- Loss of interest in doing routine things
Spring/summer onset symptoms are less common, but include:
- Weight loss
- Decreased or poor appetite
- Energy increase
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How Common is SAD?
In general, SAD affects 3% of the population. A majority of the patients are seen in the primary care office setting. Nearly 15% of these patients also have major depressive disorder.
Who Is at Risk of Developing Sad?
SAD is more commonly seen in women, but it affects all genders. Younger adults are more commonly diagnosed than older individuals, and those with a family history of some form of depression may also be at a higher risk. Having major depressive disorder, or even bipolar disorder, may cause these seasonal types to be worse overall.
Some ongoing studies suggest that living in regions with less sunlight exposure, or living farther from the equator, may increase risk. Genetic links are being studied as well.
Researchers are also studying individuals with circadian rhythm sleep disorders. This includes people who work “swing shifts” or “third shifts.” Studies are looking to see if there is a link to the serotonin levels in the brains of certain people which may make them more susceptible to SAD without any other known genetic risk factors.
Other links have been reported regarding melatonin levels. Darkness overall may increase the production of melatonin, causing increased fatigue and circadian rhythm — or “sleep-wake” cycle — disturbances.
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Ways to Deal With Seasonal Affective Disorder
Make a plan to get outside during daylight hours, particularly in the morning. Consider taking a short walk during your lunch break or a 10-minute stroll in the afternoon. If you do eat inside, search for a spot near a window.
Consider trying a winter sport or activity. Make plans to go ice skating on the weekend, or buy some snowshoes and go for a hike. Snowshoeing can be a fun, relaxing way to enjoy the outdoors. It can also lead to a lot of belly laughs as you try to figure out how to walk in your new gear.
Try Light Therapy
Light therapy is good for coping with SAD because it replaces missing sunlight with artificial bright light. It involves sitting in front of a specially designed light box for 30 to 45 minutes each day, typically in the morning.
Light therapy is affordable, but talk with your doctor before trying it. UPMC’s Behavioral and Mental Health Services also can help you find the right therapy.
Make Plans With Friends and Family
When you’re feeling down, it can be hard to make time to see people. Try to schedule some fun activities with family and friends, which can help boost your mood. Make a list of things you love to do, whether it’s going to the movies or browsing a bookstore with a friend.
Let loved ones know how SAD is affecting you so they can encourage you to get out of the house and have some fun even when you’re not up for it.
Take up a Hobby
Winter is a good time to try out a new hobby. If you don’t know what you want to do, consider things you liked to do as a kid.
Did you love to visit the library or throw a ball around? Dust off that library card, or gather your kids or nieces and nephews for a game of catch in the backyard. If you want to try something brand new, like knitting or meditation, look for classes or groups in your area and online.
Keep a Regular Schedule and Eat a Balanced Diet
Try to get up at the same time every day, even on weekends. Shorter daylight hours during the winter months can disturb your body clock.
Keeping a regular schedule also can help improve your mood and energy level. The same is true for meals, so eat at regular times and follow a balanced diet. Avoid sugary beverages and drink plenty of water. Avoid caffeine in the evenings and be mindful of your alcohol use. Drinking alcohol can have a negative effect on your natural sleep stages.
Get Treated for SAD
It’s normal to feel a bit more tired and down during the winter months. If these feelings interfere with your ability to function and enjoy life, talk to your doctor. Seasonal affective disorder is a type of depression that is treatable with psychotherapy and antidepressant medicine.
How Is SAD Diagnosed, and What Should I Tell My PCP?
Symptoms may affect your overall quality of life, thus it is important to tell your doctor when you are experiencing any of the symptoms noted above. Typically, in the primary care office, you will be asked to complete a questionnaire. This is called a PHQ 9 form and it helps identify patients with depression; it also can help identify SAD. There are other screening forms used by your PCP as well. The forms generally ask you how you are feeling, what your symptoms are, how often are you experiencing them (typically over a two-week period of time).
Testing may be needed to ensure there are no other medical problems creating the onset of these symptoms. Your PCP will want to rule out thyroid disease, anemia, vitamin D deficiency, and other issues.
Additionally, to properly diagnose SAD, reviewing and optimizing medication is important. Some medications may have side effects that contribute to the feelings you are experiencing. Your PCP will ask you about your other health issues to ensure there is no underlying alcohol abuse, attention deficit disorder, or other mental health condition that has similar symptoms to SAD.
Your health care provider will develop a follow-up plan to best suit your needs. Recent data suggests that office visits every four to eight weeks are useful in monitoring symptoms and severity. Discuss treatment and long-term care with your provider as well.
If you currently have any of the symptoms of SAD, talk to your PCP or a mental health professional.
UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. UPMC Western Psychiatric is the hub of UPMC Western Behavioral Health, a network of nearly 60 community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors throughout western Pennsylvania.