Getting ahead of seasonal affective disorder
10/18/2021 by Craig Sawchuk, Ph.D., and Sydney Kelpin, Ph.D.
Warm summer breezes are slowly transforming into cooler temperatures at night. The leaves are just starting to change colors. The sun is rising a little later in the morning and setting a bit earlier in the evening. And the end of daylight savings time, where "falling back" gains an extra hour of sleep, is not yet here. However, this is also a time of year when people who tend to struggle with seasonal affective disorder (SAD) start to get concerned about changes in their mood and function that arrive later in autumn and early winter.
Those who live in northern states are no strangers to the "winter blues," which is a mild version of seasonal affective disorder. About 15% of the population may struggle with winter blues. Studies have shown that nearly 10% of people in New Hampshire have been diagnosed with seasonal affective disorder, but it affects only about 1% in Florida, the Sunshine State.
Seasonal affective disorder tends to be more common in women, young adults and those who work night shifts. It also has been found to run in families. Symptoms typically come on during the fall and winter and reliably go away during the spring and summer. Many symptoms feel like the need to hibernate.
Common seasonal affective disorder symptoms include:
- Sleeping more but not sleeping well.
- Feeling dragged out and unmotivated, with low energy.
- Craving junk or comfort food.
- Gaining weight.
- Losing interest in activities you once enjoyed.
- Not being able to focus.
- Avoiding social activities.
While many experience these symptoms to some degree, when they become disabling or make it difficult for you to function, you should contact your care team. If you already suffer from depression, seasonal affective disorder can worsen your symptoms.
While there's no exact cause of seasonal affective disorder, researchers have found it may be linked to:
- Your biological clock (circadian rhythm)
The reduced level of sunlight in the fall and winter may cause winter-onset seasonal affective disorder. This decrease in sunlight may disrupt your body's internal clock and lead to feelings of depression.
- Serotonin levels
A drop in serotonin, a brain chemical that affects mood, might play a role in seasonal affective disorder. Reduced sunlight can reduce serotonin, and that reduction may trigger depression.
- Melatonin levels
The change in season can disrupt the balance of a body's level of melatonin, which plays a role in regulating sleep patterns and mood.
Although it may be several more weeks until your seasonal affective disorder symptoms normally start to appear, taking action now will help you get a running start toward developing healthy habits.
Whether it's the winter blues or seasonal affective disorder, here are some things you can try to lift your mood:
- Open your shades to let in the sunlight.
- Head outdoors on sunny days.
- Include physical activity in your daily routine.
- Adjust your diet to include foods that provide energy.
- Plan to stay connected regularly with friends, family and other social supports.
You also can try light therapy. During light therapy, you sit or work near a box that emits bright light mimicking natural outdoor light. The boxes are relatively inexpensive, and they can be bought without a prescription. Some insurance companies cover the cost. They're small, thin and lightweight, and they can be carried when you travel. Many patients find light therapy to be as effective as antidepressants, without the side effects.
Choose a light box that emits 10,000 lux and emits low ultraviolet light. Some light boxes emit off-white light or blue light, but there is no advantage to one color of light over the other.
Here are some tips for using a light box correctly:
- Start using the light box within two weeks of the usual time each year your mood starts to decline.
- Set it at an angle to the left or right, at eye level or higher, and at about an arm's length away. Do not stare directly into the light.
- Keep your eyes open while using it, and feel free to perform other activities like reading or eating breakfast.
- Start light therapy for 20-30 minutes each day within the first hour of waking up in the morning.
Keep using it until the days lengthen and you begin to feel better, which is usually in the early spring to summer. Remember that consistent use is key.
Studies also have shown that cognitive behavioral therapy, a skills-based treatment, can effectively treat seasonal affective disorder. As part of this therapy, participants learn ways that can offset the likelihood of experiencing seasonal affective disorder in the future.
Some people also may benefit from antidepressants. Research has shown that starting a medication several weeks before the usual onset of seasonal affective disorder symptoms tends to be more helpful than starting a medication once it has already started.
Talk to your health care team regarding the best options for managing your seasonal affective disorder. Also, learn more about seasonal affective disorder and how you can brighten your winter mood.
Craig Sawchuk, Ph.D., is a clinical psychologist in Primary Care in Rochester and Kasson's Division of Integrated Behavioral Health. He is the co-chair of Integrated Behavioral Health and co-chair of Clinical Practice within the Department of Psychiatry and Psychology at Mayo Clinic in Rochester.
Sydney Kelpin, Ph.D., is a clinical psychology fellow in Primary Care in Rochester and Kasson's Division of Integrated Behavioral Health at Mayo Clinic in Rochester.