Seasonal Affective Disorder

Overview

What is seasonal affective disorder?

Seasonal affective disorder (also called SAD) is a type of depression that is triggered by the seasons of the year. The most common type of SAD is called winter-onset depression. Symptoms usually begin in late fall or early winter and go away by summer. A much less common type of SAD, known as summer-onset depression, usually begins in the late spring or early summer and goes away by winter. SAD may be related to changes in the amount of daylight during different times of the year.

How common is SAD?

Between 4% and 6% of people in the United States suffer from SAD. Another 10% to 20% may experience a mild form of winter-onset SAD. SAD is more common in women than in men. Although some children and teenagers get SAD, it usually doesn’t start in people younger than 20 years of age. For adults, the risk of SAD decreases as they get older. Winter-onset SAD is more common in northern regions, where the winter season is typically longer and more harsh.

Symptoms

What are the symptoms of SAD?

Although your symptoms are clues to the diagnosis, not everyone who has SAD experiences the same symptoms. Common symptoms of winter-onset SAD (90% of people who have SAD) include the following:

Symptoms of summer-onset SAD (10% of people who have SAD) include:

Symptoms of SAD tend to come back year after year. They also usually come and go at about the same time every year. The changes in mood are not necessarily related to obvious things that would make a certain season stressful (like regularly being unemployed during the winter, for example).

  • A change in appetite, especially a craving for sweet or starchy foods

  • Weight gain

  • A drop in energy level

  • Fatigue

  • A tendency to oversleep

  • Difficulty concentrating

  • Irritability and anxiety

  • Increased sensitivity to social rejection

  • Avoidance of social situations and a loss of interest in the activities you used to enjoy

  • Feelings of guilt

  • Feelings of hopelessnes

  • Physical problems, such as headaches

  • A loss of appetite

  • Weight loss

  • Insomnia

  • Irritability and anxiety

  • Agitation

Treatment

Is there a treatment for SAD?

SAD can be treated in a number of ways, including light therapy, medicine, or behavior therapy. Your doctor may want to combine therapies if using one does not work for you.

If you have winter-onset SAD and your doctor suggests you try light therapy, you may use a specially made light box, or a light visor that you wear on your head like a cap. You will sit in front of the light box or wear the light visor for a certain length of time each day. Generally, light therapy takes about 30 minutes each day throughout the fall and winter, when you’re most likely to be depressed. Another kind of light therapy involves a "dawn simulator" which is a light that is activated by a timer. It is set up in your bedroom to mimic a natural sunrise. The light turns on early in the morning and gradually increases in brightness and allows your body to wake up naturally, without using an alarm. If light therapy helps, you’ll continue it until enough sunlight is available, typically in the springtime. Stopping light therapy too soon can result in a return of symptoms.

When used properly, light therapy seems to have very few side effects. However, some side effects include eyestrain, headache, fatigue, irritability and inability to sleep (if light therapy is used too late in the day). Light therapy should be used carefully in people who have manic depressive disorders, skin that is sensitive to sunlight and/or medical conditions that make their eyes vulnerable to sunlight damage.

Tanning beds should not be used to treat SAD. The light sources in tanning beds are high in ultraviolet (UV) rays, which harm both your eyes and your skin.

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Questions to Ask Your Doctor

  • What treatment is best for me?

  • Should I use light therapy?

  • Can you give me instructions on how to use a light lamp?

  • What changes can I make at home to help myself?

  • What is causing my SAD?

  • Should I take medicine?

  • How long will I have to continue treatment?

  • Should I talk with a counselor?

  • Should I make any changes to my diet?

  • Could exercise help me deal with SAD?