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Seasonal Affective Disorder: A Guide to SAD and How to Deal With It

We (human beings) tend to enjoy summer and dislike winter. There’s just something about the colder weather and shorter days that has a real impact on us. Some of us can handle it, but others really struggle as the chilly season takes its toll on their mental health. Then spring arrives and they feel better again… until autumn rolls around and that slump in mood and motivation starts to return. 

Does this sound familiar? If you really struggle with your mood during the winter season, you could be suffering from seasonal affective disorder (SAD). This disorder is more commonly known as the ‘winter blues’.

Surely you must have heard of SAD, but if not, this is your guide to the disorder and what you can do to treat it and cope with it.

What is SAD exactly?

Seasonal affective disorder is a period of depression that recurs around the same time each year. Normally, the symptom materialises around autumn and ebbing away in spring, hence the nickname of the ‘winter blues’. 

As you can imagine, SAD is the type of mood disorder that makes you struggle to get out of bed as since it’s more of a ‘winter thing’. However, it’s possible (and less common) to experience it in summer, too, in which case the disorder would manifest itself in the spring and slowly diminish in the autumn. 

To receive a diagnosis of SAD, you must meet the criteria for major depression that coincides with specific seasons for at least two years. You also have to experience seasonal depression more than non-seasonal.

Who is at risk of SAD?

Unfortunately, you could be at risk of SAD if any of the following apply to you:

  • You’re a woman. SAD is diagnosed four times more often in women than it is in men.
  • You live far from the equator. People who live far north or live far south of the equator get SAD more frequently.
  • There’s a family history of depression. If any type of history of depression runs in your family, you’re more likely to suffer from SAD than someone in whose family this isn’t the case.
  • You already get depression or suffer from bipolar disorder. The bad news is that if you suffer from either of these, the symptoms may become more acute in the SAD seasons.
  • You’re young. Younger adults are at a higher risk of experiencing SAD than older adults, who are at less risk as they get older. It’s not unknown for children and teenagers to suffer from the disorder.

These are some of the main reasons you could be at risk of SAD. If you happen to experience some form of mental or physical trauma during winter, this may also affect you in the future because you may start to recall the event and become depressed every winter.

boy looking out of window

What causes SAD?

We’d love to be able to tell you the exact reasons for this mood disorder, but the truth is no one has a definitive, proven answer. Many attribute the disorder to the shorter autumn and winter days, in which there’s less sunlight. The theory is that the lack of sunlight stops the hypothalamus region of the brain from working properly, which interferes with: 

The circadian rhythm

The circadian rhythm is the body’s internal clock. The human body uses sunlight to help regulate sleep, mood and appetite. The time we wake up is one of the elements the body uses sunlight to regulate, which means that the lower levels of light we endure during the winter can disrupt our internal clock and leave us groggy, sleepy and disoriented. It’s for this reason that there are less cases of SAD in countries that have lots of sunlight the whole year round.

Melatonin production

When it’s dark, the body produces melatonin to help us sleep. When it’s light again, the body receives the signal to the body to stop producing it so that we can stay awake and alert during the day. Due to the longer nights of autumn and winter, the body can produce too much melatonin, making us drowsy and causing our energy levels to fall. 

Serotonin production

Serotonin is a chemical linked to brain pathways that regulate our mood. The lesser exposure to sunlight in winter can prevent the body from making as much serotonin as it would on the longer days of spring and summer. When mood-regulating, nerve-cell pathways in the brain don’t operate as well as they normally do, the results can be depression, weight gain and fatigue. The serotonin deficit can also diminish sex drive and appetite. 

Symptoms of seasonal affective disorder

How can you tell if you’re in the grip of SAD? 

The disorder announces itself with a number of symptoms. Watch out for the following:

  • Constant low mood.
  • Little or no pleasure or interest in everyday activities that you enjoy normally.
  • Feelings of guilt, despair and/or worthlessness.
  • Sleepy and lacking energy during the day.
  • Finding it harder to get out of bed in the morning and sleeping for longer than you do normally.
  • Craving foods that contain carbohydrates and putting on weight.

You may also be suffering from SAD if you experience:

  • Lower sex drive.
  • Difficulty concentrating.
  • Pains and aching that you can’t explain.
  • Recourse to drugs or alcohol for comfort.
bowl of fruit

How can you prepare for these winter blues?

Of course, seasonal affective disorder, as its name suggests, is seasonal. It stays with you, you get over it and you live to fight another day until the next bout of SAD is back upon you the following autumn and winter. You know it’s coming, so you can prepare for it. Here are a few ways to preempt the SAD:

Start exercising

It’s no secret that exercising is good for depression because of the wellbeing it induces. You should exercise the whole year around anyway, but if you tend to suffer from SAD, you should make sure you’re already well into the habit of exercising before autumn arrives. If you can exercise outdoors and get some sunlight, so much the better. Building exercise into your daily lifestyle will help you weather the SAD storm much easier.

Speak to your doctor before autumn or winter

It’s a good idea to visit your doctor before the SAD period strikes so that you can form a depression management plan. Then when the darker days come, you can spring into action and implement the plan. Your doctor may also want to prescribe you some medication to help you cope with the change in season.

Start observing good sleep hygiene

Before the SAD season arrives, you should start observing good sleep hygiene and learn to control your sleep cycle. Start by getting up early with the sun, going to bed at the same time every night and making sure you sleep for eight hours each night. When the clocks go back, keep one clock set to the summertime and use this to set your sleep cycle.

Observe a healthy diet

Observing good nutrition and eating all the right foods is always going to be beneficial, whether you suffer from SAD or otherwise. Research has found that there is a link between a high intake of fruit, vegetables, wholegrain, fish, olive oil, low-fat dairy foods and antioxidants, lesser consumption of animal foods, and a decreased level of depression. This is much different compared to fried foods, processed foods and foods packed with refined grains, fat or added sugars, which can all make us feel worse, no matter how tasty we might find them. A good diet is as important for our emotional wellbeing as for our physical one.

woman looking annoyed

How do you treat SAD?

There are various SAD treatments you can try, but the first thing you should do is consult a doctor. This doesn’t necessarily mean they’ll rush straight in with medication to treat your SAD. They’ll ask you questions about your lifestyle, moods and sleeping habits before they decide which is the best form of treatment for you. 

Here are some treatments they may suggest:

Cognitive behavioural therapy

The way we think and behave affects the way we feel. That’s the idea behind cognitive behavioural therapy (CBT). It’s a psychosocial form of therapy and it’s all about changing the way we think about situations and how we take action so that we can feel better about them. 

When you go down the CBT route, you’ll have several sessions with a CBT therapist across several weeks or months. The sessions could be:

  • One to one.
  • With a partner, if the SAD is damaging your relationship.
  • A group programme.
  • A computer-CBT programme, supported by work with a trained therapist.

Counselling and psychodynamic therapy

Counselling is a straightforward form of therapy in which you talk to a professional counsellor about your thoughts and worries. It’s slightly different to psychodynamic therapy, in which you discuss how you feel about yourself and others and also talk about events in the past. The objective of psychodynamic therapy is to identify whether anything from your past is having an impact on you in the present. 

Are these forms of therapy effective for treating SAD? It’s hard to say.

Light therapy

Light therapy involves sitting beside a special lamp for around 30 minutes each morning to improve your mood. This lamp is called a ‘light box’. Whether it’s an effective form of treatment is the subject of much discussion, but some studies have concluded that it is. Light therapy appears to have good short-term results, so although the light box will help you treat your SAD one winter, you can still expect the mood disorder to return the following winter.

Most people can use the light boxes without any problems. If you’re taking a medication that increases your sensitivity to light or if you have an eye condition or eye damage that makes your eyes more sensitive to light, you should avoid this form of treatment. Otherwise, you should be okay. Light boxes have filters that remove the harmful ultraviolet (UV) rays, cutting out the chance of skin or eye damage.

Although light therapy rarely produces side effects, it can sometimes produce the following:

  • Blurred vision.
  • Irritability.
  • Eye strain.
  • Headaches.
  • Tired.
  • Sleeping problems.

If any of these problems persist, you should speak to a doctor.

Note that light boxes aren’t available on the NHS. When you’re buying a light box, check the box is suitable for treating SAD, including any medical approval of this; that you’re using the right intensity of light; and that you’re sitting by the light for the right amount of time. You can look for all these things on the instructions from the manufacturer. 

Antidepressants

Sometimes doctors will prescribe antidepressants for severe cases of SAD. If you think you’ll need antidepressants, visit your doctor in autumn. The belief is that antidepressants work best at the start of the winter, so you need to see your doctor before SAD starts. 

Selective serotonin reuptake inhibitors (SSRIs) are the antidepressants of choice for SAD because they increase serotonin levels to lift your mood. Note that the antidepressants may take 4 to 6 weeks to have a notable impact. You should keep taking them as prescribed until your doctor tells you to gradually stop.

woman looking quizzical

How to cope with SAD

Unfortunately, you can’t stop winter arriving and although you can preempt the SAD with some of the suggestions above — and still employ tactics such as taking exercise and observing a healthy diet when it does strike — you may still feel the disorder working on your mood and body. You don’t have to roll over and let it, however. 

Here are a few things you can do to lift your spirits and not let the disorder have it all its own way:

Get some natural sunlight

The temperatures might be a little crisp, but that doesn’t mean you have to hibernate the whole winter. Get outside, enjoy the fresh air and, in doing so, get some natural sunlight on your skin. Do this as much as possible to boost your mood. Incorporating a daily walk into your routine can help you get more sunlight regularly.

If you’re struggling to get yourself outside for whatever reason, make your home as bright as possible, by keeping the curtains as wide open as possible, and sit by the window. Basically, avoid darkness when you can during the day.

Have things to look forward to

If you’re feeling in despair and have no plans ahead of you, life can feel pretty miserable, so give yourself something to which you can look forward. It could be a holiday, an evening with friends or even just the thought of taking part in a seasonal celebration. There’s plenty to celebrate in winter and you have no need to feel trapped in the house. 

Making plans can see you through and help you to be more positive about the situation. If you just can’t muster up the good spirits, remember that it won’t be long before spring and you’ll be feeling better again.

group of women laughing

Connect with others

Reach out to friends and family, whether it’s by text, email or phone and grab the opportunity to visit them or let them come to see you. Winter can cause feelings of isolation, but this doesn’t have to be the case when you have a good support network around you. It’s also a good way to chat to others about how you’re feeling and exchange tips on how to cope with the season. You never know — they might be feeling just as bad as you are and be glad of the companionship.

Get cosy

Okay, we’re going to contradict ourselves here ever so slightly. So, you don’t need to feel trapped in the house and you should get out — but you can stay indoors if you want as long as you make yourself as cosy as possible. After all, it’s not a prison! Part of this could be keeping your mind busy with your favourite hobbies or interests. You can also cook yourself some hearty soups, stews and other comfort foods. 

You can handle SAD

Winter comes and there’s nothing we can do about it. SAD comes, too, and if you suffer from it, you might not be able to stop it dead in its tracks, but there are definitely measures you can take to cope more comfortably throughout the season. Putting yourself in the right frame of mind with lifestyle changes that can preempt SAD will help, as well as pursuing activities and making concerted efforts to feel better when it arrives. The strategies can make the days feel worth getting out of bed for, rather than letting the disorder have all the fun and force you to just stay under the covers all day. That won’t do you any good, even if it is all nice and warm under there!