The Winter Blues Disguised in SADness: Seasonal Affective Disorder


As we make our way into the cold and dark winter season, it is fairly common to see a change in people’s mood and experience a form of the ‘winter blues’. Winter can be a difficult season to experience as the days become shorter, colder, and limited in the amount of sunlight available. One is more likely to spend time indoors and may not participate in the same activities one was able to in the warmer months. It is quite common to see many feeling lethargic and down more than often. Can someone experience a more serious form of the winter blues? Can the winter months get you down more than you think? Yes. It’s called seasonal affective disorder, also known as SAD.

SAD is more than just the winter blues. Seasonal affective disorder (SAD) is known as a mood disorder characterized by the predictable depressive onset in the colder fall and winter months and hypomanic or manic episodes during the spring and summer months. A distinct feature that stems from this kind of mood disorder is that the symptoms tend to appear during the same months when seasons change. For example, an individual who tends to experience feelings of SAD during the colder months, can start to see symptoms emerge late fall to the early days of December. SAD has been studied to be linked to a biochemical imbalance in the brain produced by less daylight hours and sunlight in the winter. It may be rare, but SAD can be experienced in the summer months. 

Symptoms of SAD vary among seasons. Typical symptoms of SAD in the cold winter months consist of hypersomnia and increased appetite (specifically additional cravings of carbohydrates) (Ghaemi, 2020). When a study was conducted to see correlations between seasonal affective disorder and bipolar disorder, a 24 year-old woman shared her symptoms of SAD. “She craves bread, pasta, and sweets and reports increased appetite in winter compared with summer. Fatigue and difficulty concentrating are causing her problems at work and school.” (Roecklein, Rohan, & Postolache, 2010). The study concludes how different symptoms appear in the colder months compared to the warmer months. Several describe their symptoms of SAD during the winter months to be a period of hibernation where they rather be trapped away in their homes. Other symptoms can include feelings of no motivation, loss of interest, and decreased levels of energy (Team, 2020). 

A striking difference between experiencing this mood disorder between the colder and warmer months is people who are struggling with SAD during the spring and summer months tend to have a loss of appetite and insomnia. It is common between these warmer months where an individual will tend to have hypomanic or manic episodes. However, a similarity between the seasons is that an individual will experience a typical form of depressive symptoms. A dive into typical depressive symptoms are feelings of worthlessness and hopelessness, withdrawal from family and friends, agitation, and a sluggish mood (Borenstein, 2019). SAD depressive symptoms can lead to suicidal thoughts which are distinctive of major depression. 

One may ask what exactly causes SAD? There are three major causes to this condition. The first apparent cause is a disruption in the body’s circadian rhythm which is referred to as the body’s biological clock. Due to the reduced amount of sunlight in the fall and winter months, the body recognizes this disruption in its internal clock that may lead to the winter onset of SAD and introduction to depressive symptoms. This shift in the body’s internal clock is what can lead an individual to step outside of their daily schedule (Torres, 2020). The neurotransmitter called serotonin, responsible for mood regulation and stabilizing feelings of happiness and well-being, is noticeably reduced in individuals diagnosed with SAD. Another probable cause of SAD onset would be the over-production of the hormone melatonin in the body, which contributes to an individual feeling more tired and having lower levels of energy. 

Because SAD is categorized as a mood disorder and demonstrates cyclic seasonal patterns of depressive or manic symptoms, it exhibits commonalities with bipolar disorder. According to the National Institute of Mental Health (NIMH), initial studies were conducted on 29 patients which revealed that 93% of them had bipolar illness. Through many experimental studies, it has been discovered seasons affect mood even more for individuals with bipolar disorder compared to individuals with depression (Shin, 2005). The rebirth of spring and longer days can contribute to symptoms of mania in individuals with bipolar disorder. The relationship between seasons and mood can play a major impact on bipolar disorder and have the potential for triggering symptomatic behavior. 

If you feel that you are experiencing symptoms of SAD and these symptoms are invading other parts of your life, it is important to seek out professional help, especially if you feel down for more than a couple of days at a time. There are many types of treatment options for SAD, consisting of light therapy, psychotherapy, and medication. Light therapy is considered a form of phototherapy where an individual will sit in front of a light therapy box emitting a very bright light for approximately 20-60 minutes. Many people will tend to see improvements within the first two weeks of light therapy. The concept behind light therapy is to replenish the amount of sunlight that gets diminished from the fall and winter months. It is recommended that light therapy be used in the early fall to prevent symptoms from occurring.   

Cognitive behavioral therapy (CBT) is a type of psychotherapy that has been effective for individuals combating SAD. CBT is recognized as a talk therapy where individuals can improve and develop coping skills for the seasons (Rohan, 2013). As the name suggests, there are two components to this form of therapy, cognitive and behavioral, that individuals work on equally. The cognitive component is composed of learning to access and deal with the negative emotions and thoughts when experiencing SAD symptoms.The behavioral aspect consists of identifying and scheduling pleasurable everyday activities during the winter months to offset the lethargic feelings developed in SAD. To counteract the decreased levels of serotonin in the body, the most common type of medication used for SAD are selective serotonin reuptake inhibitors (SSRIs), which are a type of antidepressant. 

The most integral part of dealing with SAD is to take care of your general health. This can consist of eating a proper diet, getting enough sleep, and spending time with friends and loved ones. One of the key aspects to offset SAD is to embrace the joys of winter and enjoy the season in order to get through the difficult months of the year. The winter season is a time of the holidays and bringing others together. The winter months may not share the same activities one may enjoy in the summer months. However, you can pick up a pair of skates with a friend and go ice skating. You can bring loved ones closer together by making a comforting and cozy meal. One should not feel the cold of the winter alone, so it is important to try to be as occupied as you can. It is very possible to stay active, healthy and happy and combat the grueling symptoms of SAD one can face.  

 

References

Borenstein, J. (2019, December 31). The Winter Blues or Seasonal Affective Disorder. Brain & Behavior. https://www.bbrfoundation.org/blog/winter-blues-or-seasonal-affective-disorder

Ghaemi, S. N. (2020, January 28). Seasonal Affective Disorder (SAD) : Facts and Misconceptions. https://reference.medscape.com/slideshow/seasonal-affective-disorder-6007256

Levitan, D. (2007, September 1). The chronobiology and neurobiology of winter seasonal affective disorder. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202491/

Roecklein, K., Rohan, K., & Postolache, T. (2010, February). Is seasonal affective disorder a bipolar variant? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874241/

Rohan, K. (2013). Pardon Our Interruption. American Psychological Association. https://www.apa.org/news/press/releases/2013/02/seasonal-disorder

Shin, K. (2005, May 1). Seasonality in a community sample of bipolar, unipolar and control subjects. ScienceDirect. https://www.sciencedirect.com/science/article/abs/pii/S0165032704004380

Team, B. A. S. (2020, September 30). What’s the Difference Between the ‘Winter Blues’ and Seasonal Affective Disorder (or SAD)? Health Essentials from Cleveland Clinic. https://health.clevelandclinic.org/whats-the-difference-between-the-winter-blues-and-seasonal-affective-disorder-or-sad/

Torres, F. (2020, October). What is Seasonal Affective Disorder?  https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder

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