Seasonal Affective Disorder (SAD)

As the colder gray months drag on, it’s not uncommon for feelings of sadness or mild depression to creep in. Being cooped up inside without exposure to sunlight can trigger chemical changes in the brain that can result in a depressive state known as Seasonal Affective Disorder or SAD. SAD in women is 4x more common than in men, so we’re shining a light on this condition and how to find help if you need it.

What is Seasonal Affective Disorder (SAD)?

For most people, periods of sadness or mild depression aren’t uncommon, sometimes referred to as the “winter blues.” But, for those suffering from SAD, these overwhelming feelings are a regular part of life throughout the winter months, year after year. Sometimes called Seasonal Depression, this condition describes a serious depressive disorder that experts believe is triggered by reduced sunlight and vitamin D levels. This causes a disturbance in the normal production of serotonin, a neurotransmitter responsible for stabilizing our mood and feelings of well-being, and melatonin, the hormone that regulates sleep.

This condition affects roughly 5% of the U.S., or over 15 million people each year and tends to first appear in young adulthood. According to the National Institute of Mental Health, SAD is diagnosed four times more often in women than in men. The reasons for this are still being studied, though some have cited a connection to hormonal changes in women surrounding puberty, following pregnancy, and during perimenopause, or menopausal transition.

With so many affected, and so much still unknown, it is important to know the signs and symptoms, so you can recognize a need for help as early as possible.

What are the Signs of SAD?

Similar to other forms of depression, each individual’s case will vary from that of others in both the severity and number of symptoms. However, years of studies and research show there are some commonalities when it comes to symptoms, including:

• Strong feelings of depression, misery, apathy, hopelessness, low self-esteem, or despair throughout the day, nearly every day
• Severe mood swings/changes from one extreme to the other, often with more manic periods in the brighter months of the year
• Overwhelming or paralyzing anxiety, coupled with a lack of any ability to tolerate even the smallest stressors
• Sudden, inexplicable overeating and changes in appetite during winter months, often leading to weight gain
• Finding it difficult to concentrate, even on things you enjoy
• Constantly feeling lethargic or sluggish
• Dramatic changes in sleep habits—both a need for extra/oversleep, as well as frequently disturbed sleep or insomnia
• Severely reduced libido or interest in physical or social contact
• In severe cases, frequent thoughts of morbidity and suicide
  If you are ever having suicidal thoughts or feelings, please know that there are many people who want to support you! Please reach out for help. Call 1-800-273-TALK in the U.S. or visit IASP or Suicide.org to find a helpline in your area. You are not alone. It can get better.

As the name of the condition implies, these symptoms tend to begin in mild, almost unnoticeable ways in the early fall months, and proceed to worsen through the shorter, darker winter months. The brighter days of spring alleviate these symptoms until the cycle repeats, if left unaddressed.  That’s why it is important to examine what can be done to lessen or prevent this condition from becoming a problem and recognize that treatment and relief are available.

Getting Help & Treatment

Knowing what the condition looks like and how it can affect you is a great start! We encourage you to read more from trustworthy, helpful sources like Mental Health America, the DHHS Office on Women’s Health, or the National Institute of Mental Health to give you and those you care for the best chance at recognizing this condition and how it could be affecting you. This self-education and support from loved ones, combined with open, ongoing dialogue with your provider, improves the awareness needed to recognize and address this debilitating condition.

The good news is that those affected can find relief both in simple ways, as well as with help from your provider. A common and accessible first step is taking a vitamin D supplement, combined with the use of light therapy, where a person relaxes for 30-45 minutes in front of a specialty bright-light box to mimic the intense afternoon sun. These are commercially available and relatively inexpensive, but always check with your provider whether there are any watchouts, especially if you have existing conditions involving eyesight.

Another accessible and common approach is talk therapy, or CBT related to the condition. Long-term studies comparing reports from those using either light therapy or talk therapy show that both were effective in bringing relief from SAD symptoms. The research also showed that light-therapy provided a more immediate source of help, whereas talk therapy provided more effective long-term support.

Finally, it is possible that your provider may supplement these other approaches by prescribing the use of antidepressants or selective serotonin reuptake inhibitors (SSRIs) to treat the condition by regulating serotonin levels. This group of medications is commonly prescribed for conditions surrounding depression and have a proven record of helping millions lead happier lives. Make sure that you fully and openly discuss your questions and concerns about any medications and their possible side-effects with your provider. Resources like the Mental Health Medications page from the National Institute of Mental Health, or the U.S. National Library of Medicine’s MedlinePlus program also provide plain-language, trustworthy FAQ style information on these medications.

And as always, remember that Axia Women’s Health and our family of providers are always here for you to be an open, compassionate ear for your questions and concerns. We are your partner in helping you get the support you may need. Please know that it is not only okay to ask for help, it’s essential, no matter how hard that first step may seem. Help is available, and treatment works. If you think seasonal affective disorder may be a reality for you or those you care for, don’t suffer in silence.