By Carissa Weber, MA, LPC, CSAC
If you live in the northern hemisphere, you know what time of year it is. That’s right, it’s winter! Cold temperatures, snow, and the lack of sunlight are all Hallmarks of this time of year. Along with fabulous road conditions, cold and flu season, and arguing who’s turn it is to shovel the driveway, the season brings something even more sinister: Seasonal Affective Disorder.
This post is all about this seasonal condition that impacts 3% of the world’s population (and 30% of people diagnosed with major depressive disorder). It is my hope (by the end of this post), that you have a good understanding of what Seasonal Affective Disorder (better known as SAD) is and how to combat it during these long winter days.
First things first, what in the world is Seasonal Affective Disorder (SAD)? Great question! SAD is a sub-type of depression that is impacted by the changes of the season. Some of the criteria of the diagnosis of season affect disorder include:
- Feeling sad or depressed at the onset of a seasonal change
- Loss of interest in hobbies or activities
- Changes in appetite (either eating more or eating less)
- Changes in how you sleep (either too much or not enough)
- Increase in isolating yourself from others
- Increase in irritability and/or tearfulness
- Changes in how we move (either we are a “caged tiger” or you are sluggish)
- Feeling worthless or guilty for no apparent reason
- Difficulty focusing or concentrating
- Thoughts of death or suicide
- Unexpected weight gain/loss
If you have been struggling with two (that’s right, two) or more of the above symptoms since the change of a season, you may be struggling with SAD.
Now, some of you may be thinking “Carissa, these are the same symptoms of depression.” If you read my post, Depression and All That Jazz, you wouldn’t be able to miss the similar diagnostic criteria. The symptoms are similar, but the onset of symptoms is very different. For depression, the onset of symptoms can happen anytime of the year. Depression also is diagnosed when you hit five of the above criteria for a period two week’s long.
Seasonal Affective Disorder (SAD) happens during specific times of the year. The majority of people with SAD will experience it in the colder, winter months, however, there are some people who feel it in the spring and summer months. SAD’s duration is typically four-five months long, spanning those dark and cold months (or warmer months).
Now, can you have depression and Seasonal Affective Disorder? Absolutely! In fact, people who are diagnosed with depression or bipolar disorder are 30% more likely to develop SAD. Can you have Seasonal Affective Disorder and not have a diagnosis of depression? Absolutely! About 10% of the general population report at least two of the above listed criteria, with 15% of that demographic stating these changes happen in the warmer months of the year.
So, why does Seasonal Affective Disorder happen? Yet another great question! This is where SAD differs from depression. If you recall from Depression and All That Jazz, depression occurs when we don’t have enough free serotonin floating around in our brain. Seasonal Affective Disorder, on the other hand, has a couple of different factors that “typical” depression does not.
The first thing science noted about seasonal affective disorder is directly related to sunlight. That’s right, the changes in the amount of sunlight we are exposed to (or not in the case of winter-onset SAD) dictates the production levels of melatonin. Melatonin is a powerful neurotransmitter that helps us fall (and stay) asleep. During months where there isn’t a lot of sun (like right now), a small gland in our brain, called the pineal gland, increases the production of melatonin and changes our natural sleep cycle.
Why is this important? Well, think about it. When it is cold and dark outside, are you a go-getter, or would you prefer to stay home and take a nap? Most likely the latter as the pineal gland has produced a lot of melatonin. Now, if you notices SAD during the warmer and brighter months, the pineal gland is still responsible for that inability to fall asleep. Why? The increase in sunlight tells the pineal gland that it is time to be awake. That is why black-out curtains are my favorite in the summer.
Another way the body changes is it decreases is production of serotonin. An interesting fact about the body: we get the majority of our vitamin D intake from natural sunlight. Vitamin D is needed to help our body break down the amino acid, tryptophan. Without breaking down tryptophan, you cannot produce serotonin. Without serotonin, your brain struggles with feeling happy, motivated, and hopeful.
The lack of light doesn’t just mess with serotonin and melatonin, it also impacts coritsol levels. But now how you think.
As you recall, cortisol is a stress hormone released by our body during the triple F response. This hormone is responsible for helping our vital organs survive and prepares us to stay alive. Interesting enough, with the increase melatonin production, cortisol production shuts down to allow our bodies to sleep and rest. I bet you didn’t see that one coming! (honestly, I didn’t see that one coming either).
All of these things can play havoc on us. So, how do we cope with this incontrollable situation?
Coping Skills Alert
There are a lot of things within our power to help treat Seasonal Affective Disorder. First, let’s look at how we can control our environment to help get those neurotransmitters functioning like they should be.
Whether it is in my office or at home, I use a sun lamp. Why? Because it mimics the UV-A rays in the sun that triggers the production of vitamin D. Sitting by or under a sun lamp for 30 minutes a day can help:
- Decrease the production on melatonin
- Improve the production of serotonin
- Increase the function of your pineal gland
- Produce natural Vitamin D within your body
- Regulate your sleep cycles and get you ready to work different shifts
Before you go to your local tanning bed, you need to hear this. Light therapy from a sun lamp and the light from a tanning bed are two different types of light. A sun lamp (like the one below) will have filters in it to filter out UV rays that can cause headaches and skin cancer. Tanning bed lights do not have this same filter.
I mentioned earlier in this post about my love for black-out curtains. For those of you who struggle with Seasonal Affective Disorder during those warmer and sunny months, black-out curtains are a must. They help with your pineal gland producing melatonin, so you can sleep better. They also help your body get back in a normal sleep cycle, which is pretty handy of you are trying to manage working and kids home on summer break.
The next thing we should talk about are dietary changes. Like I mentioned above, there are some studies out there that show vitamin D deficiency may be a trigger for Seasonal Affective Disorder. by increasing our vitamin D levels, we can help break down that tryptophan and make some much-needed serotonin. There are several foods rich in vitamin D, including:
- Salmon and fatty fish (like tuna, sardines, and other tasty treats)
- Cod Liver Oil (disgusting, but it works)
- Eggs, specifically, egg yolks
- Milk (especially if it is labeled it has been fortified with vitamin D)
- Soy milk (yup, vitamin D is there, too)
- Oatmeal and fortified cereals
- Oranges (and orange juice!)
Many people have asked me about the use of vitamin D supplements for assisting in their Seasonal Affective Disorder. I always say this: “I am not a doctor and it is outside of my scope of practice to give you medicinal advice on supplements.” Why do I say this? Because vitamin D is a vitamin that can cause some pretty nasty side effects if you over do it. It is okay to talk to your doctor about adding a vitamin D supplement to your diet. They will be able to guide you on the safe use and monitoring of side effects.
While you are talking to your doctor, you can also ask them about starting on a medication to assist with symptoms. Like we talked about in my post, To medicate or not to medicate, that is the question, sometimes our brains need help with regulating the neurotransmitters responsible for anxiety and depression. Many people use common anti-depressants and/or anti-anxiety medications during these tough months of SAD.
Now that we’ve talked about what we can control in our environment, let’s go back to some good ol’ fashion coping skills! Did you really think I wouldn’t talk about them? Seriously, coping skills are fundamental when things outside of our control impact us. When it comes to Seasonal Affective Disorder, my favorite skill to discuss is routine building.
Yup, building a routine you can count on does a couple of things. First, it helps that darn amygdala know what it can expect from the day, which reduced anxiety and that edgy feeling we feel. Second, building a routine also helps the prefrontal cortex know what you should be doing, which can help improve motivation. Third, having a routine can help you check in with how your mental health is really doing Remember that post about mooring lines? Yup, those are part of a healthy routine.
The next crucial coping skill that helps with Seasonal Affective Disorder would be setting SMART goals. They have been talked about in a few different posts, but it this is something that is really important to releasing dopamine and serotonin, as well as setting realistic expectations for yourself and build motivation.
SMART is an acronym that helps us remember to set goal that are :
- S – Specific
- M – Measurable
- A- Attainable
- R- Realistic
- T – Trackable
These steps are crucial for setting goals that not only release feel good neurotransmitters but building motivation as we can see progress being made.
Talk about a lot of information! I want to thank you for taking time to really dive into seasonal affective disorder and help keep your brain healthy during this (physically) darker time of year. Remember, SAD is out of your control, but how you respond to it is in your control
Are you looking for a way to have the skills mentioned above with you? Do you like having coping skills in a place you can find (and your hippocampus doesn’t have to remember it in stressful times)? The worksheet bundle is full of (and helpful) handouts. These handouts are designed for your personal use and to help you remember the facts and coping skills of each post. This week’s handouts (that’s right, handouts!) goes over setting up a routine, SMART goals, and Seasonal Affective Disorder. Enjoy!
Want all the worksheets in one, easy to download, file?
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- American Psychiatric Association (2020). Seasonal Affective Disorder. Retrieved from Seasonal Affective Disorder (SAD) (psychiatry.org)
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596. Reviewed 12/13/2021
- Aulinas A. Physiology of the Pineal Gland and Melatonin. [Updated 2019 Dec 10]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK550972/
- Basil, Lisa , Rodriguiz, Jessica (2020). 6 Tips on How To Deal With Seasonal Affective Disorder. Retrieved from https://www.endocrineweb.com/news/how-cope-seasonal-affective-disorder
- Harvard Health Publishing (2019). Shining a light on winter depression. Retrieved from https://www.health.harvard.edu/mind-and-mood/shining-a-light-on-winter-depression