Don’t ignore the winter blues: Seasonal affective disorder is a serious form of depression

MORGANTOWN, W.Va. — As the days grow shorter and sunlight becomes scarce, a West Virginia University clinical psychologist is reminding people not to dismiss the “winter blues.”

Seasonal affective disorder, or “SAD,” affects millions of Americans each year and is a form of depression that deserves serious attention.

Stephanie Cox, professor in the Department of Behavioral Medicine and Psychiatry—part of the Rockefeller Neuroscience Institute at the WVU School of Medicine in Morgantown, West Virginia—says the disorder typically occurs at certain times of the year, most often during winter and especially in northern latitudes.

“Symptoms are thought to be related to reduced exposure to natural sunlight,” Cox explained. “This decrease in light can affect neurotransmitters in the brain, such as melatonin and serotonin, and disrupt the body’s circadian rhythm.”

While many people feel a mild dip in mood or energy during darker months, Cox emphasized that seasonal affective disorder is more than a case of the “winter doldrums.”

“SAD involves a cluster of symptoms that persist and significantly interfere with daily life,” she said. “People may experience increased or disrupted sleep, loss of interest in activities, difficulty concentrating, feelings of hopelessness, and changes in appetite or food cravings.”

Cox noted that because seasonal affective disorder is a type of depressive disorder, its symptoms can mirror those of major depression. The condition is more common among younger individuals, women, those with a family history of the disorder, and people with existing mood or mental health concerns.

“In winter-pattern SAD, symptoms usually begin in the fall, last through the winter months, and improve with the arrival of spring and longer daylight hours,” Cox said. “People who recognize this predictable pattern may benefit from starting treatment or preventive strategies early in the fall.”

What are the signs and symptoms of SAD?

According to the National Institute of Mental Health, seasonal affective disorder is characterized by a recurrent seasonal pattern, with symptoms lasting about 4−5 months out of the year.

The signs and symptoms include those associated with depression as well as disorder-specific symptoms that differ for winter-pattern versus summer-pattern seasonal affective disorder.

Not every person with seasonal disorders experiences all the symptoms listed below. Learn about the signs and symptoms of depression. Symptoms can include:

• Persistent sad, anxious, or “empty” mood most of the day, nearly every day, for at least 2 weeks
• Feelings of hopelessness or pessimism
• Feelings of irritability, frustration, or restlessness
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy, fatigue, or feeling slowed down
• Difficulty concentrating, remembering, or making decisions
• Changes in sleep or appetite, or unplanned weight changes
• Physical aches or pains, headaches, cramps, or digestive problems that do not have a clear physical cause and do not go away with treatment
• Thoughts of death or suicide, or suicide attempts

For winter-pattern SAD, additional symptoms can include:

• Oversleeping (hypersomnia)
• Overeating, particularly with a craving for carbohydrates, can lead to weight gain
• Social withdrawal (feeling like “hibernating”)

Seasonal affective disorder can also appear in summer

According to the Mayo Clinic, in most cases, symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. Less commonly, people with the opposite pattern have symptoms that begin in spring or summer. In either case, symptoms may start out mild and become more severe as the season progresses.

Spring and summer SAD

Symptoms specific to summer-onset seasonal affective disorder, sometimes called summer depression, may include:

• Trouble sleeping (insomnia)
• Poor appetite
• Weight loss
• Agitation or anxiety
• Increased irritability

Seasonal changes and bipolar disorder

People who have bipolar disorder are at increased risk of seasonal affective disorder. In some people with bipolar disorder, episodes of mania may be linked to a specific season. Spring and summer can bring on symptoms of mania or a less intense form of mania (hypomania), anxiety, agitation, and irritability. They may also experience depression during the fall and winter months.

Treatment for seasonal affective disorder

Cox says treatment options for seasonal affective disorder range from light therapy—using a special light box that emits 10,000 lux of white light for 30 to 60 minutes daily—to medication, cognitive-behavioral therapy, and lifestyle adjustments such as regular exercise and consistent sleep schedules.

“Talking with a health care provider can help identify the best treatment options and timing for your specific situation,” Cox advised.