Seasonal Depression

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Seasonal Depression (SAD) is a type of depression classified as Major Depressive Disorder with a Seasonal Pattern, and individuals affected by SAD undergo symptoms similar to those with depression. Symptoms occur in the fall and winter months in the United States. Moods greatly improve once spring and summer roll around, though there are rare cases that occur in the warmer months. According to the American Psychiatric Association, the condition is found to be connected to a biochemical imbalance in the brain from the decrease in sunlight, though this is simply a theory. While some may claim the condition is a simple case of the “winter blues,” seasonal depression is a serious disorder that can disrupt everyday functions in individuals.

The precise cause of seasonal depression is not yet known, but scientists have found that it is possibly connected to the releasing of hormones in the brain. The brain produces less serotonin, a chemical that aids in managing mood, in the winter due to the decreased amount of sunlight. When the chemical is produced in small quantities, the brain pathways it regulates are unable to function properly, causing mood swings and symptoms of depression (WebMD). SAD can occur in people of all ages, however, it often arises in people aged 18-30 years old and is more common in women than men.

Typically, those with winter-pattern SAD will find that symptoms emerge in the late fall or early winter and continue until the bright days of spring. Those who experience summer-pattern SAD will encounter a reversed pattern: symptoms will begin in the spring or summer, and continue until the early winter. Regardless of the season in which SAD begins, symptoms generally become more severe as the season continues. Effects of SAD include losing interest in once-enjoyed activities, reduced energy, abnormal sleeping patterns, suicidal thoughts, anxiety, agitation, and sluggishness. For those who specifically experience winter-pattern SAD, hypersomnia (oversleeping), overeating, weight gain, and social withdrawal may occur. As for summer-pattern SAD, insomnia (trouble sleeping), a lessened appetite, weight loss, restlessness, anxiety, and periods of violent behavior are common symptoms.

SAD can be treated comparably to depression, since it is not a separate mental disorder, but a type of depression characterized by the season in which it happens. For those experiencing suicidal thoughts, or those know someone with an intention to harm themselves, the National Suicide Prevention Lifeline can be contacted toll-free at 1-800-273-TALK (8255) or the TTY number at 1-800-799-4TTY (4889). If one prefers the option of texting, the Crisis Text Line is available and can be reached by texting “HELLO” to 741741. There are additional treatments that do not necessarily include talking to a volunteer, and they fall into four categories: light therapy, psychotherapy, antidepressants, and Vitamin D.

Light therapy has been the main form of treatment for winter-pattern SAD, because the purpose of it is to make up for the lack of sunlight. In this form of therapy, patients sit in front of a bright light box (10,000 lux) for 30 to 45 minutes in the morning to increase exposure to light. Those with eye diseases and those whose specific medications warn against direct exposure to sunlight should check with a medical professional before deciding to undergo this form of therapy, as it can be damaging to a particularly sensitive eye.

Psychotherapy, on the other hand, is a form of talk therapy commonly used for depression, but modifiable for seasonal depression. In this therapy, patients usually meet in groups to focus on “replacing the negative thoughts related to the winter season with more positive thoughts” (NIMH). The group setting has proven more efficient compared to a therapy in a one-on-one setting, since it gives individuals the opportunity to formulate self-awareness, though both forms are accessible and beneficial. Light therapy and psychotherapy have been equally effective in lessening the symptoms of SAD.

Antidepressants, or any form of medication, can be used to increase the levels of serotonin in the brain. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, citalopram, sertraline, paroxetine, and escitalopram, can improve patients’ moods by preventing reuptake, a process to recycle neurotransmitters. Therefore, more serotonin will be available when neurotransmitters are communicating messages between brain cells. Vitamin D supplements are also readily accessible; since many diagnosed with SAD suffer from vitamin D deficiency, supplements may help alleviate symptoms. However, increased vitamin D intake is a very contingent form of treatment. In some cases, its potency can be greater than that of light therapy, but in others, it may not be a functional form of treatment at all.

There are two types of seasonal depression: winter-pattern SAD and summer-pattern SAD, both identified by their seasonal pattern. While there are a wide range of symptoms shared, there are symptoms unique to each type of seasonal depression. Those affected can access treatments such as light therapy, psychotherapy or talk therapy, medications, or increase their intake of Vitamin D. These treatments are constructive since they deal with tricking the brain into thinking that it’s a different time of year. Because seasonal depression is a serious mental disorder, those suffering from it should seek assistance in alleviating symptoms in order to function as they would during the rest of the year.

References

American Psychiatric Association. (2020, October). Seasonal affective disorder (SAD). Home │ psychiatry.org. https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder

Bruce, D. F. (2008, June 12). Seasonal depression (Seasonal affective disorder). WebMD. https://www.webmd.com/depression/guide/seasonal-affective-disorder#1

Mayo Clinic. (2017, October 25). Seasonal affective disorder (SAD) - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651

National Institute of Mental Health. (n.d.). NIMH » seasonal affective disorder. NIMH » Home. https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder/index.shtml

United Kingdom National Health Service. (2017, October 23). Selective serotonin reuptake inhibitors (SSRIs). nhs.uk. https://www.nhs.uk/conditions/ssri-antidepressants/