What is Seasonal Affective Disorder (SAD)?
Most of us are familiar with the term ‘winter blues’. People will often describe feelings of tiredness, lack of motivation or feeling flat during the colder months. While for some people this might result in slightly longer sleep ins and perhaps hitting the gym a little less, for others it can take a real toll on their daily life and overall wellbeing. So what is really going on here … and why?
Seasonal affective disorder (SAD), while not considered a unique diagnostic entity on its own, is rather a type of recurring major depression with a seasonal pattern. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person with SAD will generally have depression that begins and ends during a specific season every year for at least two years with more seasons of depression than seasons without depression over a lifetime. It is most common for these depressive symptoms to manifest during winter however they can occur in summer too.
What are the symptoms of SAD?
People who experience depressive symptoms throughout the winter months tend to feel sad, irritable, tired and lethargic, sleep excessively, experience difficulty concentrating, are socially isolated, have low energy levels and experience an increased craving of carbohydrates and sugars. It does appear however, that people who experience depressive symptoms throughout the summer months exhibit slightly different symptoms, with many of these people experiencing poor appetite, insomnia, restlessness, agitation and anxiety.
What are the causes of SAD?
While it is difficult to pin point an exact factors that lead to SAD there are a few theories that have been suggested.Lower levels of serotonin: Serotonin is a neurotransmitter responsible primarily for regulating our mood. In winter when there is less sunlight, our serotonin activity may become disturbed and for some people a decreased serotonin activity might occur thereafter impacting negatively upon their mood.Increase in melatonin: Melatonin is a hormone that helps to regulate your sleep-wake cycle by making you feel sleepy when exposed to darkness.
During winter, the days tend to become darker, for many people who work or study full time it might be dark when diving to work and when heading home meaning that they are exposed to little if any sunlight at all. As a result of this, the production of melatonin tends to increase and in turn, people with SAD tend to feel sleepy, lethargic and may also experience a lack of motivation. Disturbed circadian rhythm: Our circadian rhythm is our internal 24-hour clock body clock that regulates our sleep and wake times based on the light and dark changes throughout the day. With lower levels of serotonin and an increase in melatonin activity, it is very possible that our circadian rhythms may be disturbed; this is particularly the case for people experiencing SAD.
What are the treatment options?
Light Therapy: We know that a lack of daylight might be a trigger for SAD and SAD related symptoms, it has therefore been suggested that using bright artificial light in the morning may be a promising intervention. This is usually done with the use of a light box which emits full spectrum light, mimicking the composition of sunlight. In turn this may assist in regulating our levels of both serotonin and melatonin and may assist in the reduction of SAD related symptoms.
Psychotherapy: Studies have suggested that Cognitive Behavioural Therapy (CBT); a type of therapeutic intervention primarily focussed on identifying and changing negative thoughts and behaviours, can be effective at treating SAD. Psychoeducation and/or programs around improving diet, increasing exercise, managing stress, spending more time outdoors during the day and reducing social isolation may also be useful.
Medication: As SAD is often associated with lower levels of serotonin, anti-depressants such as Selective Serotonin Reuptake Inhibitors (SSRIs) have been found to be an effective treatment option for people experiencing symptoms of SAD as well as other types of depression.While SAD can be a difficult mental illness to live with it is important to remember that there are effective pathways to recovery. If you feel that you or someone you may be experiencing SAD please reach out to your GP or mental health professional for support.