Seasonal Affective Disorder, also known as Major Depressive Disorder with Seasonal Pattern, is a form of depression that consistently occurs during certain months of the year. It can present during either winter or summer, but it more commonly occurs in the colder months when there are fewer daylight hours. While distance from the equator is a major risk factor, even those in sunny California are at risk. Females are more commonly affected, and the typical onset is in adolescence or early adulthood. The disorder is attributed to a disruption in circadian rhythm due to reduced sunlight. Alterations in serotonin, melatonin, and vitamin D have also been implicated.
The symptoms of Seasonal Affective Disorder are more severe than those of “Winter Blues” and include persistently depressed or irritable mood, loss of interest in activities, feelings of excessive guilt or worthlessness, fatigue, poor focus, restlessness or slowed movements, and suicidal thoughts. Additionally, increased appetite, carbohydrate cravings, and hypersomnolence are common in the winter-pattern type. In children and adolescents, parents can look out for signs like significant changes in their child’s mood or behavior during certain months of the year. Symptoms typically last 4-5 months of the year.
While Seasonal Affective Disorder may naturally improve with the changing seasons, one should consider seeking professional help if symptoms are severe or impair daily functioning. Treatment options include light therapy, medications, and psychotherapy. Light therapy involves sitting in front of a box that emits a very bright light (e.g., 10,000 lux) for at least 20 minutes per day in the morning. Antidepressant medications that can be considered include serotonin reuptake inhibitors and bupropion XL, which is FDA approved for the prevention of Seasonal Affective Disorder in adults. Vitamin D supplementation may also be helpful in those with vitamin D deficiency.
Additionally, psychotherapy can encourage individuals to replace negative thoughts with positive ones and increase engagement in uplifting activities. Cognitive Behavioral Therapy for Seasonal Affective Disorder (CBT-SAD), in particular, is a type of psychotherapy that was designed specifically to target this condition and entails participation in two weekly group sessions for six weeks.
Behavioral strategies can also be instrumental in preventing and treating the symptoms of Seasonal Affective Disorder. For example, increasing exposure to sunlight by spending more time outdoors or opening the shades in one’s room can help. Sticking to a regular routine can also support one’s mental health.
Finally, maintaining healthy habits, such as exercising regularly, eating nutritious foods, maintaining sleep hygiene, and connecting with loved ones are ways to combat this disorder.
References:
Seasonal affective disorder (SAD). American Psychiatric Association. March 2024. Accessed September 25, 2024. https://www.psychiatry.org/patients-families/seasonal-affective-disorder
Seasonal affective disorder. National Institute of Mental Health. 2023. Accessed September 25, 2024. https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder
H Sheldon-Dean. What is seasonal affective disorder? How it can affect kids, and how parents can help. Child Mind Institute. August 19, 2024. Accessed September 25, 2024. https://childmind.org/article/seasonal-affective-disorder/
AUTHOR:
Dr. Kristen Kim, MD, Psychiatrist
Vista Hill Foundation