People who experience serious mood changes that occur regularly with the change of seasons may have a disorder, previously known as seasonal affective disorder, or SAD. Also known as the "winter blues," SAD is a type of depression related to the change of seasons. Most prevalent in areas far north or south of the equator, SAD typically occurs when the seasons change, and most symptoms begin in the autumn and continue into the winter months. It is now officially known as major depressive disorder with seasonal pattern.
If you are experiencing symptoms of seasonal depression, it is best to see your GP or a counsellor or therapist. In recent years, mental health professionals have developed a host of simple and effective treatments. The first step to feeling better is to acknowledge the problem and to seek help for an accurate clinical diagnosis and recommendations.
Understanding seasonal depression
Seasonal depression is commonly associated with the arrival of winter and shorter periods of daylight. This is sometimes referred to as winter-pattern depression. However, some individuals experience this condition during spring and summer – known as summer-pattern depression—but this is not nearly as common. The key distinction in this form of depression is the seasonal component involved in the change in mood.
While it's common to feel a little blue during the winter, for some individuals the arrival of winter leads to a high level of emotional distress not associated with calendar events, such as Christmas. If you have difficulty engaging in normal work and social activities each winter, you may be suffering from a seasonal form of depression.
According to the Diagnostic and Statistical Manual of Mental Illnesses, to receive a diagnosis of seasonal depression a person has to have had episodes of depression, that begin and then subside during the same time each year, typically winter, for at least two consecutive years. The core symptoms are lethargy, sleepiness, overeating and weight gain, and sadness. People with the disorder often tend to avoid social interaction. The most difficult months for people with seasonal depression are January and February, although in some cases, symptoms worsen in the spring.
Seasonal mood changes can also occur with bipolar disorder. This is known as bipolar “with seasonal pattern” where a person experiences depression, mania, or hypomania at the same time of year.
Signs of seasonal depression
The signs and symptoms of seasonal depression are much like those of depression but with a seasonal component. People with seasonal depression usually experience several of the following symptoms each winter:
Because some doctors are unfamiliar with seasonal depression, it is not uncommon for someone with the disorder to be misdiagnosed as suffering from hypothyroidism, hypoglycaemia, or a viral infection.
See your GP if you think you may have depression
If you think you may have depression, you can first arrange to see your GP to make sure that you don't have any underlying medical problems. Your visit may include a physical exam and tests. You can also see a mental health professional (such as a psychiatrist or psychologist) for a mental health evaluation and to rule out another kind of depression. You may receive recommendations for mind-body support such as yoga, acupuncture, massage, and meditation.
Treatment and tips
Most treatments for seasonal depression, are the same as those prescribed for depression. However, some people respond to treatment aimed at compensating for the reduction of daylight in winter. Before you begin a course of treatment, you should always check with a medical or mental health professional.
Seek professional help. Your health care provider may prescribe psychotherapy (such as cognitive behavioural therapy), vitamin D, light therapy, or an antidepressant. For many people, a combination of treatments is effective.
Light therapy (phototherapy) may help. Studies show that light therapy is effective in providing symptom relief. Treatment typically involves 20 to 30 minutes of exposure to a specialised bright artificial light, up to 100 times brighter than normal indoor lighting, soon after waking up each morning. Specially designed light-therapy boxes mimic outdoor light via a set of high-luminosity fluorescent bulbs. Another option reported to help some people is a dawn simulator, an alarm clock-like device that wakes you up using gradually increasing light instead of abrupt sound.
Note: Ultraviolet and full spectrum light, heat lamps, or tanning lamps should not be used. It's important to check with your doctor before undertaking light therapy. Doctors advise against light therapy for people with bipolar disorder. You should also consult with your doctor if you've had eye problems such as cataracts, glaucoma, or diabetic eye damage.
Spend time outdoors. Experts also recommend that people with depression get as much daylight as possible each day. Outdoor light on a sunny day is at least five times as intense as the light provided by a light box. Even sitting or walking outside during winter on grey, overcast days will provide you with more light exposure than when you are inside in a well-lit room.
Get regular exercise. Exercising outdoors during the winter months can be very helpful too. It has been shown for many to be helpful in reducing symptoms of depression at any time of year.
Stay active. Don't let short days and cold weather keep you cooped up inside. Keep your mind and body active with wintertime activities in your community and social groups. If you know you're likely to experience seasonal depression, schedule activities ahead of time so you'll have reasons to get out and about.
Keep to a regular schedule. This improves sleep and gives you exposure to light at the same times each day.
Spend time with family and friends. Avoid social isolation by spending time with friends and family whose company you enjoy. Normal social activities can lift your spirits, as can talking to someone about your seasonal blues.
Focus on healthy nutrition. Eat balanced, nutritious meals at regular intervals. Drink enough water and other healthy fluids to stay hydrated. As less exposure to sunlight can reduce your vitamin D production, you could ask your doctor to check your levels and consider supplements.
Anticipate the onset each year. Recognising that it is likely you will deal with SAD each year may help you to adopt routines in advance to avoid feeling low during its onset. This may include a regular exercise routine and spending time outdoors, paying attention to your sleep routine, tweaking your diet to eat healthier food, and planning ahead for regular dates with friends to keep you out and about. The more you have in place before the seasons start to change, the better you will deal with the onset of SAD.