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Seasonal Affective Disorder: How Mood Can Change with the Seasons




What is seasonal affective disorder?


For those of us in the Northern Hemisphere, the fall season is here. Days are shorter, the weather is cooler, and, for the most part, the seasonal changes are welcome and often celebrated. But the drastic decrease in sunlight can affect one’s mood. Seasonal affective disorder, also known as SAD, is a mental health disorder characterized by depression that occurs during the same time of year. About 5% of adults in the United States have SAD, of which most are women. Symptoms of SAD tend to appear during the fall and winter months due to lack of sunlight and will often improve during springtime. However, though uncommon, depression during the spring and summer months can occur and is known as summer-pattern SAD.


What are common signs and symptoms of seasonal affective disorder?


The signs and symptoms of seasonal affective disorder include:

  • Changes in sleep, such as sleeping too much

  • Feeling sad or depressed every day

  • Feeling fatigued or low energy

  • No longer interested in activities once enjoyed

  • Inability to focus or concentrate

  • Feeling irritable or agitated

  • Changes in appetite, especially overindulging in carbohydrates and sweets

  • Withdrawal from social interaction

  • Feeling worthless or hopeless

  • Frequent suicidal thoughts


What causes seasonal affective disorder?


There is no clear answer for what causes SAD. Research shows that people with SAD may have a biochemical imbalance, which can cause mood changes. Sunlight boosts a neurotransmitter called serotonin in the brain, but for those with SAD, the lack of sunlight during fall and winter months may cause a decrease in serotonin levels leading to depression. People with SAD may also produce too much melatonin, a hormone that regulates the sleep-wake cycle, which can cause excessive sleepiness. SAD can develop at any age, but it is often diagnosed in the 18 to 30 age group.


How is seasonal affective disorder diagnosed and treated?


Anyone with symptoms of SAD should talk to a mental health professional. To receive a diagnosis of SAD, a person must meet the following criteria:

  • Experience major depression or most of the symptoms described above.

  • Depressive episodes should follow a seasonal pattern (i.e., during the fall/winter months or during the spring/summer months) for a minimum of 2 consecutive years. However, some people with SAD may not experience symptoms annually.

  • The depressive episodes should occur more frequently than other depressive episodes the person may have experienced at different times of the year in the past.


There are several effective treatment options for SAD, such as:


  • Light therapy. Sitting by a window during sunlight hours can help ease symptoms. During winter months, a light box can be used first thing in the morning for approximately 30 minutes a day. Most individuals start to notice an improvement within the first two weeks of treatment.

  • Psychotherapy. Cognitive behavioral therapy (CBT), a form of talk therapy, is used to teach people how to deal with difficult situations. Negative thoughts involving aspects of the winter season are replaced with positive thoughts. CBT also uses behavioral activation, a process which helps individuals find and create enjoyable new indoor or outdoor activities to fight off winter blues.

  • Medications. Because SAD can cause disturbances in serotonin levels, antidepressants called selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medication for treating SAD. Some commonly used SSRIs are sertraline, fluoxetine, citalopram, escitalopram, and paroxetine.


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