Introduction to Seasonal Affective Disorder (SAD)
Seasonal affective disorder (SAD), also referred to as winter depression, seasonal depression, or depressive disorder with seasonal pattern, is a subtype of major depressive disorder characterized by the onset and remission of symptoms during specific seasons. Most commonly, symptoms arise in the late fall and winter months when daylight hours and natural light intensity decline, leading to disturbances in circadian rhythm. Many people experience improvements in mood as daylight increases in the spring and summer months. Risk factors include living at higher latitudes (such as New York City), having a history of other mental disorders (such as depression, anxiety disorders, or bipolar disorder), and being female, with prevalence markedly higher among women.
Estimates suggest that about 5% of U.S. adults experience SAD annually. Individuals with SAD often experience symptoms consistent with major depression, such as low mood, fatigue, trouble sleeping or sleeping too much, and social withdrawal, which are triggered by reduced sunlight exposure. These seasonal changes can disrupt the body’s internal clock and lead to alterations in serotonin and melatonin levels, which in turn affect mood and energy regulation. Such seasonal disruptions in circadian rhythm are considered a key mechanism in SAD.
To learn more about diagnosing and treating SAD, please contact a compassionate psychotherapist at Balanced Mind of New York for a complimentary 15-minute consultation.
Signs and Symptoms of SAD
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), a diagnostic manual from the American Psychiatric Association, classifies SAD (also called seasonal depression) as a form of major depressive disorder. SAD occurs when there are shorter daylight hours, leading to a disruption in melatonin and serotonin activity.
Symptoms of seasonal affective disorder (SAD) overlap with those of major depressive disorder, and these symptoms affect daily functioning. Symptoms can range from mild to severe and often start in young adulthood. These symptoms include feeling sad most of the time, carbohydrate cravings (which may lead to weight gain), feeling irritable, difficulty concentrating, negative thoughts, disruptions in sleep patterns, and fatigue, even when getting enough sleep. In severe depressive episodes of SAD, symptoms may also include suicidal thoughts and being unable to function properly, such as attending to hygiene or managing work, educational, social, and/or family commitments. Early recognition of SAD symptoms is important for timely treatment and management.
Diagnosis and Related Conditions
Accurate diagnosis of seasonal affective disorder (SAD) requires thorough evaluation of mental health and symptom patterns by a licensed mental health professional. Since SAD and several other mental health conditions share similar symptoms, the diagnosing clinician will ask you about your current mental health symptoms, any history of psychiatric conditions in you or in your family, your medical history, and any current stressors that may be impacting your mental health. A blood test may be ordered to check Vitamin D or thyroid levels and to rule out any medical conditions that may be contributing to your mood changes before diagnosing seasonal affective disorder.
Preparing for Your Appointment
Start by seeing a health care provider or mental health professional, like a psychiatrist or psychologist. Prepare information about your symptoms and mental health history before the appointment. Being ready helps your mental health professional diagnose and treat seasonal affective disorder. Clear communication improves the effectiveness of your mental health care, so be sure to ask your provider for clarification about terminology or treatment instructions if needed.
Treating Seasonal Affective Disorder
Treatment for seasonal affective disorder includes light therapy, psychotherapy, and medications. Be sure to inform your mental health professional if you have bipolar disorder before starting treatment. Light therapy and antidepressant medications, including some selective serotonin reuptake inhibitors (SSRIs), can trigger manic episodes in bipolar disorder patients. Mental health professionals tailor treatment plans based on individual affective disorder needs.
How Does Light Therapy Work?
Light therapy exposes you to bright light from a special light box within the first hour of waking for 20-30 minutes daily. Light therapy is also sometimes referred to as bright light therapy. The bright light emitted from the light box mimics natural outdoor light and alters brain chemicals linked to mood improvement. Light therapy is a first-line treatment for fall-onset seasonal affective disorder and works within weeks.
Consult your health care provider before purchasing a light box to ensure safety and effectiveness. While it can be an effective tool used to treat depression symptoms of SAD, it may also trigger other mood disorders, such as a manic episode in bipolar patients.
Psychotherapy
Psychotherapy, also called talk therapy, is an effective treatment option for seasonal affective disorder. It is often used in tandem with light therapy to treat SAD. Cognitive behavioral therapy (CBT) is a type of therapy used to improve symptoms of SAD and to help individuals learn how to prevent symptoms from recurring. CBT helps address mood and motivation issues related to seasonal affective disorder.
Outpatient therapy sessions typically last about an hour and are commonly conducted in a one-on-one setting. They may be offered virtually or in person. You may meet with your therapist more frequently at the beginning of therapy or during the late fall and early winter months, and as symptoms improve, move toward a less frequent therapy schedule.
Antidepressant Medication
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can help treat severe symptoms of seasonal affective disorder. Extended-release bupropion may prevent depressive episodes in people with a history of seasonal depression. Starting antidepressants before symptoms of SAD begin each year is often recommended. It may take a few weeks to see benefits, and different medications might be tried for the best results. Be sure to let your prescribing provider know if you are taking any additional medications, including dietary supplements or alternative treatments, to avoid potential medication reactions.
Self-Care and Lifestyle Changes
Follow your personalized treatment plan for seasonal affective disorder (SAD). Incorporate lifestyle habits that support mental health and mood stability. This may include journaling, art therapy, meditation, and exercising regularly. Self-care complements professional treatment for affective disorder management, so don’t be afraid to make time and space for yourself to heal. Consistency in self-care helps maintain motivation throughout seasonal changes.
How Do I Pay for Therapy for SAD?
Balanced Mind of New York is a private pay practice and does not accept insurance. We believe in providing individualized, high-quality care without the restrictions or limitations often associated with insurance-based treatment.
If you have out-of-network benefits, we’re happy to provide a superbill upon request, which you can submit directly to your insurance provider for potential reimbursement. Please consult your provider to understand your coverage and eligibility for out-of-network mental health services.
To Learn More About Seasonal Affective Disorder (SAD)
Please contact Balanced Mind of New York to schedule an appointment and take the first steps toward healing.