Although the science behind Blue Monday is a bit questionable, this time of year is notoriously bleak, particularly for those living farther north of the equator where there are less daylight hours in the winter. This winter, especially, has brought us a double depression whammy with COVID-19—and the sadness, worry, and isolation that goes along with it—so there are more people than ever struggling with SAD. The good news is that there are many things you can do to help manage and alleviate the symptoms that this seasonal depression brings. But first, let’s learn a little more about Seasonal Affective Disorder.
Seasonal Affective Disorder, sometimes referred to as ‘winter blues’, is not a separate disorder but, rather, a type of depression characterized by its recurrent seasonal pattern, with symptoms lasting about 4 to 5 months per year. The most difficult months for people feeling depressed with SAD in the United States tend to be January and February.
The causes of SAD are not fully understood, but has been linked to a biochemical imbalance in the brain exacerbated by shorter daylight hours and less sunlight in winter. During this time, people experience a shift in their biological internal clock or circadian rhythm that can cause them to be out of sync with their usual schedule.
Research suggests that the lack of sunlight reduces our serotonin (the “feel good” hormone) levels while increasing our melatonin (the “sleep” hormone) levels. In people with SAD, the changes in serotonin and melatonin levels disrupt the normal daily rhythms. As a result, some people can no longer adjust to the seasonal changes in day length, leading to sleep, mood, and behavior changes.
People with SAD experience mood changes and symptoms similar to depression such as sadness, loss of interest, low energy, hopelessness, agitation, and difficulty concentrating. In addition, common symptoms of seasonal depression, which may range from mild to severe, may also include:
SAD can affect anyone, but is more common in people with major depressive disorder or bipolar disorder, especially bipolar II disorder, which is associated with recurrent depressive and hypomanic episodes. People with other mental disorders—or who have relatives diagnosed with them—such as attention-deficit/hyperactivity disorder, or an eating, anxiety, or panic disorder are at higher risk than those who do not have them.
As mentioned, people who live in areas of the world that have reduced daylight hours in winter are at increased risk as compared to those living in areas with more sunlight.
Yes! Just like anyone with depression, talk therapy, particularly cognitive behavior therapy (CBT), can effectively treat SAD.
“If you know (or suspect) that you struggle with SAD, be proactive. Start working with your provider(s) to prepare a treatment plan prior to the darkest days of the year,” advises Michelle Coco, MSW, LCSW, a psychotherapist in private practice in Pittsburgh, PA.
“If you don't have a therapist, it’s an ideal time to seek one out. We're living in an era where it's easier than ever to find, and even meet with, a qualified provider completely online. Weekly telehealth sessions with a trusted professional provide a dedicated space to process emotions, monitor symptoms, and cultivate healthy coping skills. Having this type of outside support has been conclusively shown to reduce symptoms and improve overall quality of life.”
If you know this time of year is when you tend to struggle most, Autumn is probably not the best season to discontinue or reduce existing anti-depressant medication.
Michelle—who is no stranger to treating patients with SAD since Pittsburgh is the 11th least sunny city in the US—suggests collaborating with your prescriber to preemptively modify your treatment plan to better support your needs during these difficult months. As your symptoms begin to ease in the springtime, you and your provider can discuss any appropriate adjustments.
“While therapy and medication may be essential for some people with SAD, anyone can employ simple strategies to help self-manage symptoms throughout the season,” says Michelle, who advises to: