- What causes seasonal affective disorder?
- What are the symptoms of SAD during winter?
- What are the signs of SAD during summer?
- How is seasonal affective disorder diagnosed?
- How is seasonal depression treated?
- What is light therapy for SAD?
- Does light therapy work for seasonal depression?
- Can seasonal affective disorder be prevented?
- When should people call their doctor about seasonal depression?
Do the bleak winter months get you down more than you think they should? Maybe you have seasonal depression, also known as seasonal affective disorder or SAD. Seasonal depression is a mood disorder that happens every year at the same time. A rare form of seasonal depression, known as "summer depression," begins in late spring or early summer and ends in fall. But in general, seasonal affective disorder starts in fall or winter and ends in spring or early summer.
What Causes Seasonal Affective Disorder?
There are two seasonal patterns with SAD. One starts in the fall and continues through the winter, and the other starts in late spring or early summer. The fall-onset type of SAD, often referred to as "winter depression," is better known and easier to recognize -- and we know more about it than we know about its counterpart.
Hormones manufactured deep in the brain automatically trigger attitudinal changes at certain times of year. Experts believe that SAD is related to these hormonal changes. One theory is that reduced sunlight during fall and winter leads to reduced production of serotonin in the the brain. Serotonin is a neurotransmitter that has a soothing, calming effect. The result of there not being enough serotonin is feelings of depression along with symptoms of fatigue, carbohydrate craving, and weight gain.
Because foods high in carbohydrates (chips, pretzels, cookies) boost serotonin, it is thought that they have a calming, soothing affect on the body and mind.
SAD usually starts in young adulthood and is more common in females than in males. Some people with SAD experience very mild symptoms and feel out of sorts or irritable. Others have debilitating symptoms that interfere with relationships and productivity.
Because the lack of enough daylight during wintertime is related to SAD, it is seldom found in countries within 30 degrees of the equator, where there is plenty of sunshine year round.
What Are the Symptoms of SAD During Winter?
People with SAD have many of the normal signs of depression, including:
- Decreased levels of energy
- Difficulty concentrating
- Increase in appetite
- Increased desire to be alone
- Increased need for sleep
- Weight gain
What Are the Signs of SAD During Summer?
Symptoms of summer SAD include:
How Is Seasonal Affective Disorder Diagnosed?
It is very important that you do not diagnose yourself with seasonal affective disorder. If you have symptoms of depression, see your doctor for a thorough assessment. Sometimes, physical problems can cause depression. But other times, symptoms of seasonal depression are part of a more complex psychiatric problem. A health professional should be the one to determine your level of depression and recommend the right form of treatment.
How Is Seasonal Depression Treated?
There are different treatments for seasonal depression, depending on the severity of the symptoms. Also, if you have another type of depression or bipolar disorder, the treatment may be different. Many doctors recommend that patients with SAD try to get outside early in the morning to increase their exposure to natural light. If this is impossible because of the dark winter months, antidepressant medications and/or light therapy (phototherapy) may help.
What Is Light Therapy for SAD?
Light therapy for SAD uses a full-spectrum bright light that is shined indirectly into your eyes. When you use light therapy, you sit about 2 feet away from a bright light -- about 20 times brighter than normal room lighting. The therapy starts with one 10- to 15-minute session per day. Then the times increase to 30 to 45 minutes a day, depending on your response. It is important not to look directly at the light source of any light box for extended periods in order to minimize the risk of damage to your eyes.
Some people with SAD recover within days using light therapy. Others take much longer. If the SAD symptoms are not resolved, the prescribing doctor may increase the light therapy sessions to twice daily. Those who respond to light therapy are encouraged to continue until they can be out in the sunshine again in the springtime.
Does Light Therapy Work for Seasonal Depression?
Some researchers link seasonal depression to the natural hormone melatonin, which causes drowsiness. When light strikes the human retina, a process in the body decreases the secretion of melatonin. Light modifies the amount of melatonin in the human nervous system and boosts serotonin in the brain. So light therapy has an antidepressant effect.
Experts now believe that light therapy may be an effective treatment for people who have eating disorders, insomnia, and major depression (unrelated to SAD). Researchers have found that when depressed patients without SAD take antidepressants and use light therapy, there is an added benefit of increased energy and improved mood.
Can I Prevent Seasonal Affective Disorder?
If you have been diagnosed with seasonal affective disorder, here are some things you can do to help prevent it from coming back:
- Try to spend some amount of time outside every day, even when it's very cloudy. The effects of daylight are still beneficial.
- Begin using a light box when fall starts, even before you feel the effects of winter SAD.
- Eat a well-balanced diet, including sufficient amounts of vitamins and minerals as recommended by the FDA. This will help you have more energy even if your body is craving starchy and sweet foods.
- Try exercising for 30 minutes a day, three times a week.
- Stay involved with your social circle and regular activities. Social support is extremely important for those with mood disorders, especially during winter months.
When Should I Call my Doctor About Seasonal Depression?
If you experience feelings of depression, fatigue, and irritability that come at the same time each year and appear to be seasonal in nature, you may have a form of SAD. Talk openly with your doctor about your feelings. Follow the doctor's recommendations for lifestyle changes and/or treatment if you have SAD.
If your doctor recommends light therapy, ask if the practice provides light boxes for patients with SAD. You can also rent or purchase a light box, but they are expensive and health insurance companies do not usually cover them. While side effects are minimal with light therapy, be cautious if you have sensitive skin or a history of bipolar disorder.
WebMD Medical Reference
Health Solutions From Our Sponsors
American Academy of Family Physicians: "Seasonal Affective Disorder."
National Institute of Mental Health: "What Is Depression?"
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, American Psychiatric Pub, 2000.
Fieve, R, MD. Bipolar II, Rodale Books, 2006.
National Institute of Mental Health: Science Update: "Properly Timed Light, Melatonin Lift Winter Depression by Syncing Rhythms."
Reviewed by Joseph Goldberg, MD on July 22, 2012
© 2012 WebMD, LLC. All rights reserved.
Top Seasonal Affective Disorder (SAD) Related Articles
AcupunctureAcupuncture is the practice of inserting needles into the body to reduce pain or induce anesthesia. More broadly, acupuncture is a family of procedures involving the stimulation of anatomical locations on or in the skin by a variety of techniques.
Bipolar Disorder in Children, Teen, and AdultsBipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood-stabilizer medications, antidepressants, and psychotherapy.
Wellbutrin (bupropion)Bupropion (Wellbutrin, Zyban, Aplenzin, Forfivo XL) is an antidepressant medication prescribed for the treatment of depressive disorders and smoking cessation. Off-label uses for Wellbutrin include posttraumatic stress disorder (PTSD), anxiety, attention deficit hyperactivity disorder (ADHD), and neuropathic pain (nerve pain). Side effects, drug interactions, warnings and precautions, pregnancy information, and dosage should be reviewed prior to taking any medication.
What Are the Causes of Seasonal Affective Disorder (SAD) and How Do You Fight It?Seasonal affective disorder is a type of depression linked to the seasons. You fight seasonal affective disorder by using light therapy, talk therapy and medication.
CitalopramCitalopram is an antidepressant drug used to treat: depression, obsessive compulsive disorder (OCD), panic disorder, premenstrual dysphoric syndrome (PMDD), anxiety disorder, and posttraumatic stress disorder. Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking any medication.
Cymbalta vs. Wellbutrin Comparison
Cymbalta (duloxetine) is an antidepressant that belongs to the drug class called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). Cymbalta affects the chemicals that nerves within the brain make and release in order to communicate with each other. Wellbutrin (bupropion) also is an antidepressant, however, it works differently than any other antidepressant because it also affects the chemical dopamine.
Cymbalta is used to treat depression, general anxiety disorder (GAD), pain associated with diabetic neuropathy, fibromyalgia, and musculoskeletal pain. Wellbutrin is used to manage major depression and seasonal affective disorder. Off-label uses for Wellbutrin include attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), social phobias, and nerve pain.
Cymbalta and Wellbutrin have similar side effects like nausea, dry mouth, and constipation. Side effects unique to Cymbalta include diarrhea, fatigue, increased blood pressure, and sexual dysfunction. Side effects unique to Wellbutrin include weight loss, sweating, tinnitus, stomach pain, muscle pan, and a fast heart beat. Serious side effects of Wellbutrin include suicidal thoughts and seizures.
Dosage depends upon the patient, any other medical issue he or she has, and the condition being treated. Both Cymbalta and Wellbutrin interact with other drugs. Neither drug is recommended during pregnancy or while breastfeeding.
DepressionDepression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Depression QuizMany people do not recognize the symptoms and warning signs of depression and depressive disorders in children and adults. With proper diagnosis, treatments and medications are available. Take this quiz to learn more about recovery from depression.
Depression: Seasonal Affective Disorder (SAD)Do you find yourself getting depressed as winter approaches each year? Or when you don't see the sun for a while? You may have seasonal affective disorder, or SAD. Learn all the symptoms and how to manage them.
fluoxetine (Prozac, Sarafem, Prozac Weekly)Fluoxetine (Prozac, Sarafem, Prozac Weekly) is a drug prescribed for the treatemnt of depression, bulimia, obsessive-compulsive disorder (OCD), panic disorder, and premenstrual dysphoric disorder (PMDD). It is also prescribed in combination with olanzapine (Zyprexa) to treat resistant depression and depression associated with bipolar disorder. Side effects, multiple drug interactions, dosage, and pregnancy safety should be reviewed prior to taking this medication.
Holiday Depression, Anxiety, and StressThough the holidays are a fun time for most, for others, they're a sad, lonely and anxiety-filled time. Get tips on how to avoid depression and stress during the holiday season.
Holiday Depression Triggers10 holiday depression and stress triggers, and ways to cope. From anxiety over bills to social commitments and travel, WebMD shows you how to manage stress.
InsomniaInsomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Mental HealthMental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under the umbrella of mental illness. Depression, anxiety, and substance-abuse disorders are common types of mental illness. Symptoms and signs of mental illness include irritability, moodiness, insomnia, headaches, and sadness. Treatment may involve psychotherapy and medication.
PsychotherapyPsychoteraphy is often the first form of treatment recommended for depression. Psychotherapy helps depression by helping people understand the behaviors, emotions and ideas that contribute to their depression, regain a sense of control and pleasure in life, and learn coping techniques as well as problem solving skills.
Zoloft (sertraline)Zoloft (sertraline) is a medication prescribed for the treatment of depression, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder and premenstrual dysphoric disorder (PMDD). Side effects include skin rash, constipation, upset stomach, loss of appetite, headache, diarrhea, abnormal ejaculation, decreased interest in sexual activity, and dry mouth. Drug interactions, dosage, and a pregnancy and breastfeeding safety information should be reviewed prior to taking this medication.
Sleep Disorders (How to Get a Good Night's Sleep)A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep; 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement). The side effects of lack of sleep or insomnia include:
- Feeling sleepy during the day
- Concentration or memory problems
Lack of sleep and insomnia can be caused by medical conditions or diseases, medications, stress, or pain. The treatment for lack of sleep and insomnia depends upon the cause.
SuicideSuicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.