We all get a little down at times during the winter months. Who can blame us? It’s cold. It’s dark by 5 p.m. It’s too icy to walk or run outside so we bury ourselves in quilts and watch TV or lose ourselves in a good book instead. We cope. We get out of bed, go to work, and engage with our friends and family. We make it to the gym now and then. We’ve simply got a case of the wintertime blues that waxes and wanes but doesn’t really keep us down.

That’s not true for folks experiencing seasonal affective disorder, or SAD.

“SAD is a reoccurring major depressive disorder with a seasonal pattern. It’s not just getting the blues when the sun goes in for a few days,” said Craig McFadden, a licensed behavioral health specialist with UCHealth’s Mountain Crest Behavioral Health Center in Fort Collins.
Winter months can bring on the wintertime blues, but for people with seasonal affective disorder, feelings can be less temporary and more serious.
SAD is more common in women, younger adults and in those living far from the equator. And get this — it isn’t exclusive to winter.

“SAD usually occurs in winter, but not always. It can set in with the coming of any season,” he said.

SAD is not the same as depression that gets triggered by a life event such as an anniversary of a death or trauma that happened during a particular season. Such depression tends to be more specific and shorter term.

When SAD sets in

SAD symptoms mimic those of major depression, with a few twists. People with SAD might feel more irritable, tired, and hypersensitive. They also feel more anxious with the signs of a changing season.

“They can get upset just thinking about the season turning. Leaves falling might make them anxious and irritable as they anticipate what’s to come,” McFadden said.

“As fall sets in, they might notice they are crying more often over little things like commercials, eating more comfort food or oversleeping. They’ll experience other signs of major depression as well. It’s never about one symptom; it’s about the whole picture,” McFadden added.

Approximately, 10 to 20 percent of people with major depression experience a seasonal pattern. In the United States, only about 7 percent of the population copes with major depression in the first place, so overall numbers for SAD are low. It takes at least two seasons of depression before it can be labeled SAD. Relief comes with the signs of spring, or the changing of seasons.

Solutions to SAD

SAD can be effectively treated the same way as major depression, with psychotherapy and medications, plus one addition: light therapy to help regulate seratonin.

With wintertime SAD, reduced sunlight lowers our serotonin levels and changes our melatonin rhythms, which can disrupt our biological clocks. “Serotonin is a key player in balancing our moods, and melatonin helps regulate our circadian rhythm and therefore our sleep,” McFadden said. Light therapy is thought to change these brain chemicals by mimicking natural light. It’s often the first line of treatment for SAD, and people can experience positive results within a few weeks.

“Light boxes work for some but not for others. Besides light boxes, people suffering from SAD should get up and open the shades. Seeing light upon waking stops the flow of melatonin and signals our brains that it’s time to get up and get moving,” McFadden adds.

McFadden perceives that in general, people with depression get a little worse over the winter. He also notes that there are more hospital admissions during late fall and winter than other times of the year. Whether you cope with SAD or the occasional case of wintertime blues, it’s important to stay active and get outside in the sunlight to help balance your moods and feel more positive, he noted.

“The winter is dark and cold and people tend to socialize less and be less active — which can contribute to feeling more down. I have found that mental health symptoms get worse across the board, from anxiety disorders and psychosis to personality disorders and depression during winter months,” he concluded.

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SYMPTOMS OF SAD

Seasonal Affective Disorder is a subset of reoccurring major depressive disorder, with a seasonal pattern. Symptoms include:

• Sadness, depression, hopelessness. “Noticing a significant change in mood with the change in seasons is a major sign of SAD,” McFadden said.
• Irritable, frustrated, angry, hypersensitive to rejection.
• Tired, low energy, heavy feeling in arms and legs.
• Oversleeping or insomnia, weight gain or loss, changes in appetite including craving for high-carb foods.
• Trouble concentrating, thinking and making decisions.
• Thoughts of dying or suicide.
• Feelings of worthlessness or guilt, self-blame. “Thoughts like, ‘I‘m a failure, ‘I’m a burden to others,’ and experiencing all-or-nothing thinking or catastrophizing about the future are common with major depression and SAD,” McFadden added.
• Anxious, agitated, restless.
• No interest in activities you used to enjoy.
• Isolating from friends and family.