As the days get shorter, darker and colder, many of us experience a shift in mood that you might hear called “the winter blues.” You can start to feel like you’ve lost your energy and have a hard time getting excited about things, or you may feel down in general. In most scenarios, a case of the winter blues won’t have a severe effect on your life. But if you find wintertime leads to far-reaching consequences that lower your quality of life, you may be dealing with seasonal affective disorder, or SAD.
SAD has all the features of winter blues, but it’s more than just waiting for the first signs of spring or being irritated by another winter storm. It’s a condition that can be more serious than people realize, and deserves effective treatment.
What Is Seasonal Depression?
Seasonal affective disorder is a form of depression usually marked by its appearance during the colder months. People who have SAD display changes in mood and other symptoms that mirror depression quite closely. SAD is unique in that its symptoms appear at the turn of the seasons, typically fall and winter. However, some people can experience SAD during the summer.
Many people feel distressed and overwhelmed at the unexpected severity of this condition, which can affect them for almost half the year. SAD sufferers often don’t realize how severely their condition can affect their day-to-day duties and relationships, so only a small percentage of people ever seek treatment.
How Common Is This Type of Depression?
Approximately 5% of the adult population experiences full-fledged SAD. An additional 10 to 20% of people suffer from a milder form of winter blues that does not necessarily interfere with life and require treatment. Women disproportionately have it, with three out of four SAD sufferers being women. Although the onset of SAD usually occurs around age 20 to 30, it can appear in younger children as well as teens. As people get older, they usually become less susceptible to SAD, with seniors displaying the lowest prevalence rates.
Geographical location also heavily influences someone’s chances of developing SAD. The farther you are away from the equator, the more likely you will be to experience the condition. For example, people who live in Oslo, Norway, reported rates of SAD at 14%, in contrast to 4.7% in New York City. Lower levels of sunlight during the winter are most extreme further away from the equator, a significant factor in the high prevalence of SAD in places like Alaska.
Symptoms of Winter Depression
With so few people understanding how common SAD is, it’s essential to understand the symptoms to help identify if you or someone you care about is struggling with the condition. As summer fades and days become shorter, a predictable set of symptoms begins to appear. You may feel tired and lethargic and start reaching more often for sweet and starchy food, leading you to pack on the pounds. It may feel difficult to concentrate, and you may feel an inexplicable need to avoid friends and family for more alone time. These symptoms adversely affect relationships as well as work, making winter feel bleak and burdensome.
People with SAD often display marked sleep changes, usually to the tune of oversleeping. People with SAD self-report sleeping an average of 2.5 hours more in winter than in the summer, while people with the winter blues only sleep an average of 1.7 hours more. Compared to the general population, which sleeps about 0.7 hours longer in the winter, people with SAD lose a significant amount of time due to their symptoms.
SAD symptoms usually last four to five months, until the days start to get longer again. Because of the influence of sunlight levels on the condition, people with it may unexpectedly experience symptoms when cloudy weather strikes at any point in the year. Spending extended periods indoors without exposure to natural light may also adversely affect people who are susceptible to SAD.
As with any condition, SAD has a variety of symptoms that may or may not manifest for everyone. It’s common to cycle through several of the following symptoms with varying predictability:
- Feeling sad and hopeless
- Suicidal ideation
- Hypersomnia, or oversleeping
- Changes in appetite, especially cravings for sweet and starch-laden food
- Weight gain
- Feelings of heaviness in arms or legs
- Reduced energy level
- Reduced physical activity
- Fatigue and tiredness
- Impaired concentration
- Increased sensitivity to social rejection
- Avoidance of social situations
Notably, the symptoms of summertime SAD are significantly more limited, including:
- Loss of appetite
- Weight loss
- Anxiety and agitation
Both types of SAD frequently include symptoms found in major depression. Someone with SAD may experience feelings of guilt, loss of interest in the activities they usually enjoy and persistent feelings of hopelessness or helplessness. Some people even experience unexplained psychosomatic issues like headaches or stomachaches.
To receive a diagnosis of SAD, a person’s changes in mood should not be due to predictable seasonal stressors. For instance, if your job involves a pattern of unemployment during the winter months, like work in the Alaskan fishing industry, your depression may relate to being out of work, rather than having SAD. A more common example involves the stress and tension many people feel around the winter holidays. Harboring negative anticipation for family gatherings or events can also lead to depressive symptoms not caused by SAD.
SAD can worsen the effects of predictable seasonal stressors, and symptoms from both sides are not mutually exclusive. The only way to be sure you’re struggling with SAD is to enlist the help of a mental health professional for a diagnosis.
SAD in Kids and Teens
Although SAD usually affects adults, it can also affect children and teens. It also frequently goes untreated because the symptoms are reminiscent of normal teen moodiness or the onset of puberty. If you think a child or teen is struggling with SAD, look for these three indicators that occur seasonally.
1. Unusual Fatigue
It’s normal for teens to want to sleep in, but when they seem to have trouble getting out of bed, there may be another problem at work. If a child seems lethargic and unable to participate in their typical activities only during winter, it could be an indication of SAD.
2. Difficulty in School
Kids with SAD are usually too tired and unable to focus to do well in school during winter months. Their grades might consistently slip during this time, often in all subjects at once. You may also see them having trouble concentrating at home, and find it challenging to engage them.
3. Social Withdrawal
Rejection sensitivity is a state in which any perceived judgment or rejection, whether real or imagined, causes the affected person emotional pain. If a child appears to be overly sensitive and avoiding socialization during the winter, SAD may be the culprit.
Risk Factors: What Causes SAD?
Experts are still trying to pinpoint the exact cause of SAD, but the research so far indicates three potential sources for this condition. All three possible causes link back to the reduced exposure to light that occurs during winter.
1. Reduced Serotonin
Serotonin is a critical neurotransmitter that’s necessary for moderating mood. Serotonin production often declines during the winter as a mechanism that helps protect people against environmental stress during this time. However, one study revealed people with SAD don’t have that decrease in serotonin production, making them more vulnerable to the fluctuating symptoms of the affective disorder.
2. Disrupted Melatonin
Melatonin is a hormone produced in the brain’s pineal gland. It helps regulate our sleep cycles, and many people take melatonin supplements to help facilitate sleep. Your body produces melatonin in the dark, so people make more of it during short winter days. The excess production contributes to hypersomnia and some of the changes in mood associated with SAD.
3. Reduced Vitamin D
With less sunlight, we get less vitamin D. This essential nutrient links with serotonin in ways that may explain the development of depression. People with depression of all types have lower levels of vitamin D.
Treating Winter Depression
As SAD shares several core symptoms with major depression, some of the treatment options are the same as a depressed person would receive, and others are specific to SAD. There are four major types of treatment for SAD:
- Light therapy
- Vitamin D
If you have SAD, you might use these methods alone or in combination, according to the treatment course recommended by a therapist.
Doctors frequently prescribe drugs called selective serotonin reuptake inhibitors (SSRIs), a common category of antidepressant, to treat SAD. SSRIs do have side effects, so it’s essential to discuss the potential risks of using one with your doctor. Many people find they need to try more than one antidepressant before finding one that alleviates symptoms without intrusive side effects.
2. Light Therapy
Light therapy has been helping SAD sufferers relieve their symptoms for many years. It came about from the idea that if SAD results from a lack of exposure to light, getting more light can reverse the effects. Bright light stimulates retinal cells that connect to the hypothalamus, a part of the brain that influences our circadian rhythm. By activating the hypothalamus at the same time every day, people can regulate their circadian rhythm and minimize the effect of SAD symptoms.
Typically, people sit in front of a lightbox for 20 to 60 minutes in the morning. The box puts out 10,000 lux of fluorescent light and filters out ultraviolet rays.
Cognitive behavioral therapy (CBT) is a form of psychotherapy that is effective for many disorders, including SAD. Some professionals have training in a branch of CBT specifically for treating people with seasonal affective disorder, CBT-SAD. This method uses techniques like identifying unhelpful and negative thoughts to replace them with healthier ones.
Children and teens with SAD can benefit significantly from dialectical behavioral therapy (DBT). DBT is a form of CBT that encourages participants to live in the moment and cope with stress in healthy ways. The desired outcomes are to improve emotional regulation, as well as the ability to participate in healthy relationships.
For kids and teens, a specific, modified form of DBT called DBT-C is available. DBT-C can best address the developmental levels of children and suit their treatment needs. It teaches coping skills in a series of stages that match up to a child’s current developmental situation. In many cases, this approach can produce better outcomes for children who haven’t responded to other forms of therapy.
4. Vitamin D
Vitamin D supplementation is not an effective treatment for SAD on its own, but it does help address the lack of vitamin D found in people with the disorder. There is no current consensus on how effective vitamin D supplementation is as compared to psychotherapy or light therapy. However, as it is inexpensive and generally considered safe, many professionals recommend it as part of a treatment regimen.
Work Through It Together
If you’re worried your child is experiencing SAD or another type of depression, it’s essential to become actively involved in their treatment and recovery. While the behavioral health professional works on the clinical side of treatment, you can help at home. For instance, treatment usually requires people to complete some form of “homework” outside of sessions. When a child is tired and groggy from SAD, they may need some extra pushing and encouragement to get it done on top of the homework they get from school.
Spending quality time with people who have SAD is also critical, as social isolation is so common. You probably won’t convince them to hit the arcade, but reading a book together or playing board games can provide social stimulation without tiring a child out. When possible, encourage exercise. If you live somewhere where weather prohibits outdoor fitness, you may need to get creative and look for alternatives to keep your child moving.
When you notice symptoms of SAD in your child or yourself, remember that it’s essential to take it seriously and seek appropriate support and treatment. If left unaddressed, SAD can be a severe, year-round hindrance to health and happiness.
Depression Treatment Options at Hillside
If you are seeing symptoms of seasonal depression in your child, consider depression treatment at Hillside. We offer one of the premier residential treatment centers in Georgia, as well as DBT day programs that help children curb self-destructive behaviors that can arise as a result of SAD or other types of depression. With Hillside’s help, your child can learn to manage their symptoms in the healthiest and most effective ways possible. When kids have the tools to help themselves, their outcomes improve at school and at home.
Additionally, the Conant School at Hillside is ideal for children with behavioral health issues who may be struggling in a traditional school setting due to their symptoms. Contact Hillside today to learn more about how our treatment center, day programs and Conant School can help kids overcome SAD and other types of depression.