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Seasonal Affective Disorder (SAD): Symptoms, Causes & Treatment

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What is Seasonal Affective Disorder?

Seasonal affective disorder (SAD) is a type of depression triggered by seasonal changes and researchers believe it relates to disturbances to normal circadian rhythms (x). Symptoms of SAD usually begin to appear in the late fall or early winter and end by the spring or early summer. But because SAD can occur during any seasonal change, it is also possible to experience symptoms in the spring and summer (x). The symptoms are similar to depression (x, x):

  • Hopelessness, guilt, helplessness
  • Low energy
  • Difficulty sleeping
  • Appetite and weight changes
  • Difficulty concentrating or making decisions
  • Thinking about death or suicide
  • Losing interest in everyday activities
  • Restlessness 
  • Sluggishness

Anyone can feel sad or purposeless at some point. However, if a patient experiences the symptoms for more than two weeks, it may be a sign of depression. Without treatment, depression and its complications — weight gain, heart disease, substance abuse, social isolation, self-destructive behaviors, etc. — can intensify (x).

Classifying Depression

There are two classifications for depression. Major depression means the patient exhibits at least five symptoms for at least two weeks every day or almost every day. Minor depression means the patient only shows two to four symptoms. The main symptom for each classification is a prolonged feeling of sadness or decreased mood. SAD is a type of major depressive disorder (x).

Symptoms of SAD

SAD has similar symptoms to other types of depression, except they appear with seasonal changes. The patient must experience the symptoms with specific seasons for at least two years. Usually they appear as fall and winter approach and then resolve in the spring and summer. But patients can experience seasonal affective disorder in the spring or summer as well. Patients with another depressive disorder may experience mood changes with the seasons as well, but physicians will only diagnose SAD specifically if seasonal depressive symptoms are the main symptom (x, x).

Loss of Enthusiasm

Patients may feel a lack of enthusiasm for everyday life or routine activities — no longer caring to shower or get out of bed. It may also refer specifically to a lack of enthusiasm for activities that once brought them joy — favorite hobbies, movies or sports. In seasonal affective disorder, the patient loses interest or enthusiasm as the seasons change.

Negative Feelings or Suicidal Thoughts

Feeling guilty, hopeless or worthless are common symptoms of depression, including SAD.

Suicidal ideation (suicidal thoughts) and fixating on death is also common. If patients experience suicidal thoughts, there is free and anonymous help available. For example, there are several online resources for suicide prevention and support hotlines around the world (x).

Disrupted Sleep Patterns

There is a strong but complicated relationship between depression and sleep. Depression may trigger sleep problems, but sleep disorders can also trigger depression. Patients with depression or seasonal affective disorder may develop insomnia (difficulty falling or staying asleep), sleep apnea (difficulty breathing during sleep), narcolepsy (excessive sleepiness) or restless leg syndrome (discomfort in the legs during sleep) (x).

Difficulty Concentrating and Brain Fog

Brain fog is also a symptom of depression and seasonal affective disorder, in which the patient has difficulty thinking, understanding and remembering information (x). Depression causes hormonal changes in the brain, which affect memory and concentration. Researchers note that depressive thoughts are related to memory and concentration on a day to day basis (x).

Appetite Changes

Patients may experience a loss of appetite or their appetite may increase and cause certain cravings. The areas in the brain that regulate responses to food also relate to depression. This may lead to sudden weight gain or weight loss, which can cause negative side effects of their own (x).

Anxiety

It is not unusual to worry from time to time about work, family, school or finances, but it does not automatically indicate depression. Anxiety or anxiety disorders are often an accompanying symptom of depression. They are different conditions, but they often have similar symptoms. In addition, patients with depression may also have a history of anxiety that may contribute (x).

Physical Symptoms

Depression is a psychological condition that also has somatic symptoms that physically affect the body, including headaches, back pain, stomach pain and general muscle pain (x).

Winter vs. Summer SAD

The symptoms may also differ depending on the season that triggers them. For example, the winter pattern is more likely to cause the patient to overeat, crave carbs and withdraw from society, similar to hibernating. On the other hand, the summer pattern is more likely to cause agitated, restless and sometimes violent behavior (x).

Symptoms of Seasonal Affective Disorder

Risk Factors for SAD

Depressive disorders are complex. Researchers have not identified a specific cause for seasonal affective disorder. However, there are several factors that may increase the risk. It may be triggered by a specific stressful event, such as loss of a job, loss of a loved one or divorce. There are also biological and non-biological risk factors.

Biological Gender

According to research, women are statistically four times as likely to experience SAD than men (x).

Age

Anyone can develop seasonal affective disorder, but most diagnoses are in young adults rather than older adults. It may even affect teenagers and children (x).

Location

People who live very far north or south of the equator are more likely to experience SAD. Research states that nine percent of people in colder, northern areas like New England and Alaska experience seasonal depression, compared to one percent in Florida (x, x).

Biological Factors

Serotonin

According to research, patients suffering from depression often have a hormonal imbalance or difficulty regulating certain hormones and neurotransmitters. This relationship is the same in people with seasonal depression. For example, serotonin is a neurotransmitter that regulates mood. According to one study, patients with SAD showed increased serotonin transporters in the winter than the summer, meaning the body has less serotonin available because it cannot recycle it (x).

Melatonin

This chemical helps regulate sleep patterns and the body activates it in darkness. In the winter, the days are shorter and the body produces more melatonin, which affects the circadian rhythm and may cause people to feel more tired and lethargic (x). Although the body produces it naturally, melatonin supplements may help balance the circadian rhythm and regulate sleep patterns.

Treatment for SAD

Some of the treatment methods for seasonal affective disorder may be similar to treating depression. However, because it is seasonal, some of the treatment options are different.

Medication

Physicians can prescribe medications, such as antidepressants like selective serotonin reuptake inhibitors (SSRIs) or bupropion (x).

Cognitive Behavioral Therapy (CBT)

Patients may find relief with cognitive behavioral therapy (CBT) by trying to identify negative thoughts that contribute to their depression and replacing them with more positive and productive ones. The therapy aims to help patients cope with winter and associate it with more enjoyable activities and thoughts, instead of negative ones (x).

Light Therapy

Because patients experience seasonal depression often because of a lack of sunlight, light therapy may help. Patients expose themselves to bright, artificial light from a light box during the winter months when there is limited natural light. The light box is significantly greater than natural indoor light, so practicing light therapy in the morning for 20 minutes to an hour can help (x).

Natural Remedies for SAD

Many patients search for natural remedies to complement prescribed therapies, but it is important to note that natural therapies may not be completely effective on their own. Rather, they may provide some relief in conjunction with medical treatment, such as therapy or medication. Always consult with a doctor about natural remedies and do not stop taking any prescribed medication unless a doctor orders it.

Aromatherapy

First, aromatherapy may help boost a patient’s mood. Even though researchers have not determined it completely effective to treat medical conditions, studies show that it may help some symptoms of depression (x). Some of the best essential oils to boost mood include jasmine, lavender, chamomile, rose, geranium, neroli, bergamot, basil, ylang-ylang, sandalwood and clary sage. You can diffuse them, mix them with a carrier oil and massage them into the skin or take a bath infused with a few drops of essential oil to help the mind and body relax.

Exercise

There is significant data to support exercise as a natural way to manage and possibly even alleviate the symptoms of depression and SAD (x). Set small and achievable goals. Even goals that may seem small can have an amazing effect on the brain. No goal or action is too small.

Meditation

Meditation does not have to have a religious or spiritual intention. There are several secular meditation apps and podcasts that aim to help patients learn how to quiet the mind and find relief from worry and anxiety (x, x).

Expressive Outlets

Creative or expressive activities can have a huge positive effect on mood. Painting, drawing, dancing or writing can cause emotional relief, which patients may find refreshing (x, x).

Supplements for SAD

Patients can also try supplements that may have an effect on mood and some of the other symptoms that may result from seasonal affective disorder, such as sleep and anxiety. However, supplements are not a proper treatment for seasonal affective disorder or any other medical condition. Rather, they can be helpful in conjunction with other medical treatments. Always consult a doctor before starting a supplement regimen.

L-Tyrosine

An amino acid that is a precursor to dopamine, L-tyrosine improves mood. According to studies, it may help treat depression (x). As a supplement, the recommended dosage for L-tyrosine powder is 400 mg (¼ tsp) one to three times a day with meals, unless a physician advises a different dosage. 

L-Phenylalanine

Another amino acid, L-phenylalanine is a precursor to tyrosine, meaning it also helps the body produce dopamine. In studies, researchers concluded that phenylalanine may act as an effective natural antidepressant (x). As a dietary supplement, the typical dosage for L-phenylalanine powder is 500 mg per day between meals. Always consult with a physician to confirm a safe dosage.

D-Aspartic Acid (DAA)

According to research, D-aspartic acid may be an effective way to help combat depression. DAA increases neurotransmitters that release dopamine, one of the chemicals that regulate mood. The body contains it naturally, but in relatively small amounts, so supplements are a great way to enhance the benefits. The recommended dosage for D-aspartic acid powder is 2,500 to 3,500 mg once a day, specifically with the first meal of the day. Speak to a physician before adding aspartic acid to a dietary regimen.

St. John’s Wort

People have used St. John’s wort for medicinal purposes since ancient times. Researchers study the herb extensively for its potential effects against depression. The recommended dose for St. John’s wort extract is 600 mg one to three times per day, unless a physician recommends a different dosage.

Ashwagandha Root

For thousands of years, ayurvedic medicine has utilized ashwagandha root. Researchers have also featured it in modern studies for its potential to help the body manage stress (x). Not only is ashwagandha an antidepressant, but it may also improve focus and concentration and help relieve anxiety. As a dietary supplement, the recommended dosage for ashwagandha root extract powder is 450 mg one to three times a day. Consult with a healthcare provider to determine the safest and most effective dosage.

Gamma-Aminobutyric Acid (GABA)

Patients may be able to use gamma aminobutyric acid (GABA) as a natural treatment for depression, focus and insomnia. Although research on GABA supplements is still limited at this point, studies suggest that low levels of GABA in the body have a strong correlation with depression (x). As a supplement, take 750 mg (¼ tsp) of GABA powder once or twice a day. Talk to a doctor before taking this supplement because it may interact with other supplements or prescription medications. 

Griffonia Seed Extract (5-HTP)

Griffonia seeds contain 5-HTP and the body uses this chemical to produce serotonin, the “feel good” neurotransmitter. When the body has a high amount of serotonin, it can elevate mood, encourage better sleep and relieve anxiety. As a dietary supplement, the recommended daily dose for 5-HTP (griffonia seed extract) runs between 50 and 200 per day with food, unless a doctor suggests a different amount.

The Bottom Line

Seasonal affective disorder (SAD) is a type of depression, triggered by seasonal changes. Depressive symptoms usually flare in the fall or winter and they tend to disappear in the warmer months. However, some patients may experience SAD in the warmer months as well. The symptoms are very similar to depression, but the main characteristic is the seasonal shift. There are many risk factors associated with seasonal depression. For example, people in colder northern climates are more likely to experience SAD than people in warmer climates closer to the equator. Women also report it more frequently than men.

Treatment options may closely resemble treatment for depression — psychotherapy and medication. However, patients may also benefit from light therapy, exposing themselves to bright artificial light during the winter. In addition to other treatments, patients may also benefit from natural remedies, such as meditation, essential oils and exercise. Similarly, supplements may also help improve mood, combat anxiety and regulate sleep. Always consult a doctor before using any natural remedy to help treat a medical condition. Supplements are not a treatment method. Rather, they can help relieve symptoms if a patient uses them with other treatments. Always consult a doctor before starting a supplement regimen.

About the author

Susan Seabury


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