Seasonal affective disorder (SAD) is a type of depression that affects some people during the winter or summer months. The exact cause is unknown but it is thought that people may be affected by the reduction of sunlight (winter SAD) or over exposure to sunlight (summer SAD). Another cause may also be linked to genes.

The difference between depression and SAD is that SAD occurs repetitively at a particular time of year. Starting in autumn then improving in spring (winter SAD) or starting in spring and improving in autumn (summer SAD).

The nature and severity will vary from person to person. Some people find it has a small impact on their lives and they adjust accordingly. While others are more severely affected on a day-to-day basis.

Symptoms Of SAD

Symptoms of SAD in general can include:

1. A persistent low mood
2. A loss of pleasure or interest in normal everyday activities
3. Irritability
4. Feelings of despair, guilt and worthlessness
5. Feeling lethargic (lacking in energy) and sleepy during the day
6. Sleeping for longer than normal and finding it hard to get up in the morning

Symptoms Of Winter SAD

Symptoms specific to winter SAD

1. Oversleeping
2. Appetite changes, especially a craving for foods high in carbohydrates
3. Weight gain
4. Tiredness or low energy

Symptoms Of Summer SAD

Symptoms specific to summer SAD

1. Trouble sleeping (insomnia)
2. Poor appetite
3. Weight loss
4. Agitation or anxiety

What Causes SAD?

As I said the exact cause is unknown. But the affects of the changes in natural light seems to be a common thread along with a possible genetic connection. The main theory for winter SAD is that a lack of sunlight might stop a part of the brain called the hypothalamus working properly, which may affect the:

1. Production of melatonin. Melatonin is a hormone that makes you feel sleepy. In people with SAD, the body may produce it in higher than normal levels
2. Production of serotonin. Serotonin is a hormone that affects your mood, appetite and sleep. A lack of sunlight may lead to lower serotonin levels, which is linked to feelings of depression
3. The body’s internal clock (circadian rhythm) may be affected. Your body uses sunlight to time various important functions. Such as when you wake up, sleep, etc. So lower light levels during the winter may disrupt your body clock and lead to symptoms of SAD

Winter SAD may be linked to a lack of sunlight. But summer SAD is thought to be the reverse of this. With the over exposure to sunlight being a problem for about 10% of all SAD cases. It is thought that it also changes melatonin production. But another cause is thought to be the fact that people stay up later in summer months which throws out their circadian rhythms.

Getting A Disgnosis.

In order to get a clear diagnosis you must first visit your GP. Your GP or main doctor might ask about:

1. How has your mood been?
2. Your lifestyle and any recent changes you have made.
3. What is your eating and sleeping patterns like.
4. Any seasonal changes in your thoughts and behaviour.
5. Do your symptoms impact your normal activities?
6. Any family history of depressive disorders.
7. Carry out a brief physical examination.
8. Do  blood tests.

SAD can be difficult to diagnose because there are many other types of depression that have similar symptoms. As a result it may take some time before your GP will give you a definitive diagnosis.

Complications That Can Arise Due To SAD

Given the symptoms of SAD and the fact that it can get progressively worse over time other problems may arise that will also need treatment. These may include:

1. Social withdrawal.
2. School/college or work problems.
3. Substance abuse.
4. Other mental health disorders e.g. anxiety, eating disorders.
5. Suicidal thoughts or behaviour.

Treatment is very effective and can prevent SAD from worsening. SAD is treated just like any other form of depression and is covered by the NICE guidelines. (National Institute for Health and Care Excellence)

Treatments For SAD

Treatment will be tailored made for the individual and may include all or some combination of the following: Counseling such as CBT (cognitive behavioural therapy), Anti-depressants, Light therapy, Self-help and Alternative therapies.

1. Counseling and psychodynamic psychotherapy is a form of talk therapy used to help you discuss your worries and problem with a trained counsellor. If your SAD has affected your relationships it will be important to get couples therapy.
2. Cognitive behavioural therapy (CBT) uses specific techniques to help the individual change behaviours and thought patterns about different situations.
3. Antidepressants (SSRI’s) are often prescribed to treat severe cases of SAD. They are most effective if taken before symptoms appear. They increase the level of the hormone serotonin in your brain, which can help lift your mood.
4. Light therapy (winter SAD only) can help improve mood considerably. This involves sitting by a special lamp called a light box, usually for around 30 minutes to an hour every day. Please note these special lamps may not be suitable for everyone.
5. Alternative therapies may include: Reflexology, Reiki, Acupuncture, Aromatherapy, Massage etc.

How To Help Yourself With SAD

Self-help can come in many forms:

1. Make sure your basic self-care is in place alongside healthy boundaries.
2. Changing your home and office environment: Opening or closing blinds depending on summer and winter SAD. Cutting back tress/shrubs that block the light to allow light in for winter SAD. Sit closer to windows with winter SAD or further away with summer SAD.
3. Watching your diet intake of sugar as it can make symptoms worse.
4. Stop or reduce products with caffeine, again these make symptoms worse.
5. Don’t over consume alcohol or self medicate.
6. Exercising will help your serotonin levels and reduce stress hormones. So getting out at lunch-time is important for winter SAD suffers. While staying indoors during summer would be better for summer SAD. But you still need to exercise in general to lift your mood.
7. Get enough sleep or ask for help improving your sleep quality. Tackling this should be one of your first priorities. As it recharges your brain and boosts your mood and focus and you’re less likely to be anxious. You will need to block out 7 to 9 hours every day. To get better sleep try to go to bed and wake up at the same time. Keep your room cool, dark, and quiet, and don’t watch TV or use the computer right before bed.
8. Take up a form of meditation will also help with sleep and reduce stress which is also important. Relaxing techniques such as yoga, tai chi, guided imagery, music or art therapy may also help.

Other Things That Might Help.

1. Set priorities in life and each day: Take time now to decide what you want in life (your counsellor should be able to help here). Only have 3 things on your daily to do list. Make sure to break all bigger projects into smaller actionable steps.
2. Never be afraid to ask for help if you need it and don’t let others, burden you with their tasks.
3. Journal: This can help you look for patterns and figure out what makes you anxious. These could include: events, work, or family and friends, even foods or drinks that might not help your mood. Even when we are hungry, tired, angry or feeling lonely it can all have a great impact on our lives. So, think of the acronym HALT. Put this up where you can see it every day to remind you that when you feel any of these things you need to halt and take care of you.
4. Pick up some hobbies. Use your creativity too such as art, writing, music, etc. Your self-confidence will probably take a hit. So building up trust in yourself is important and it will help with stress reduction.
5. Building a team of supporters is also important. Plus join support groups both online and face to face. Your depression will want you to cease all socializing but keeping up your contacts with others will help improve your condition. Take a trip during the months you are affected can also help. So if you are a winter SAD sufferer head off to sunny climates mid season and do the reverse if you are a summer SAD sufferer.

It is important that you stick to your treatment plan once your GP and therapist has devised it for you. A lot of the work you do outside of months you are affected by SAD will hugely impact how you are able to cope during those affected months.

Work With Me.

Remember you are allowed to ask for support. No one is an island. If you need extra support then you can also work with me. We all struggle with stress and overwhelm from time to time. If you find this has become a problem for you and you’d like some support then schedule an appointment with me.