Wintertime is a time of gift-giving and festive holidays, when joy is supposed to ring through the air like the jingles of Salvation Army bell ringers. So why do you feel so sad?
If you feel sad or unmotivated or depressed during the winter, or if a sad mood comes over you during the same season every year, you might be at risk for seasonal affective disorder, or SAD.
Winter is also a time of shorter days, when the sun sets earlier and stays lower in the sky. The further north you live, the more pronounced this effect is.
Less daylight is just one of the seasonal changes that can contribute to seasonal affective disorder symptoms.
Although the mental health condition most commonly occurs to individuals during the winter, some people experience SAD during the spring or summer months.
Regardless of when it occurs, it is important to recognize the symptoms in yourself or in others and to understand treatment options for the condition.
What Are the Symptoms of Seasonal Affective Disorder?
SAD is basically a type of depression, so the symptoms are very similar to what a clinically depressed person might feel.
However, these symptoms may vary according to the season when they experience the condition. In fact, the symptoms for fall/winter versus spring/summer can sometimes almost be opposite of one another.
In the winter time, typical feelings of SAD might be depression, sadness, hopelessness, and a general loss of interest in activities that a person would otherwise enjoy doing. The person might withdraw from social activities or interaction with family and friends.
A person with wintertime SAD might also lack energy and feel tired all the time, which can also lead them to oversleep or to feel a "heavy" feeling in their arms or legs.
Another symptom of sad involves changes in a person's appetite, especially if they begin craving more high-carbohydrate foods or begin gaining weight.
They might have a hard time concentrating or focusing on a particular task, or they could feel greater anxiety.
Anxiety is also a hallmark symptom for those who experience SAD in the spring or summertime. The anxiety can appear as irritability or agitation as well.
Other spring and summertime symptoms can include having a poor appetite, losing weight without trying or good reason, having trouble sleeping or frequent insomnia, and having an increased sex drive.
A person does not have to have all of these symptoms to have seasonal affective disorder. They might experience other different symptoms as well. If several of these seem familiar and interrupt daily activities and routines, it may be worth seeing a mental health professional.
When SAD goes untreated, it can develop into worse complications, such as suicidal thoughts or behavior, social withdrawal, substance abuse, or problems at work or school.
Who Is Most at Risk for SAD?
Individuals who already have a diagnosed mental health condition, such as bipolar, can also experience elevated symptoms due to SAD.
For example, those with bipolar disorder may experience more manic or hypomanic (less intense than full mania) symptoms during the spring or summer.
If a person with bipolar disorder has greater hyperactivity, rapid thoughts or speech, excessive enthusiasm, persistent agitation, or a constantly elevated mood that corresponds to a particular season — especially spring or summer — they should consult their mental health care provider.
Those who already have clinical depression also tend to be more prone to develop SAD than others. Generally, the symptoms the depressed person already experiences simply become worse.
They may require temporary changes in the person's treatment plan to deal with the seasonal changes.
As with other mental health conditions, a family history of depression, bipolar disorder, or SAD can also be a risk factor. If members of a person's family have had the condition, that person is already at higher risk for it.
SAD tends to be diagnosed more often in women than in men, but men can certainly suffer the symptoms as well. In fact, the symptoms can be more severe and/or overlooked in men.
Perhaps unsurprisingly, geography can play a role in SAD too. The further a person lives from the Equator, the greater the risk for SAD.
In the northern hemisphere, living further north can increase the risk because of the shorter, darker winter days and the longer, brighter summer days.
Why Does SAD Occur?
Researchers do not know the exact causes of seasonal affective disorder, but there are several factors that they believe contribute to it.
Because of the risks related to family history and other mental health conditions, genetics might play some part in the condition. A person's age and general chemical make-up may be a part of it as well.
But why would the symptoms change with the seasons then? The answer may lie in what happens to humans' bodies in response to changes in the light they are exposed to.
All humans have an internal body "clock," called a circadian rhythm. These circadian rhythms influence a large number of bodily functions, especially sleep and waking, and they are strongly influenced by exposure to sunlight.
When the days become longer or shorter, and the amount of daylight your body is exposed to changes, it can change the way your body clock operates. This can lead to more sleepiness in the wintertime or more insomnia in the summertime, both of which are major symptoms of SAD.
Another sunlight-related change from the seasons relates to melatonin. Melatonin is a natural hormone made by the body which is also influenced by the sunlight.
In fact, melatonin plays a role in maintaining the body's internal clock. An increase in melatonin helps the body realize it's time to sleep, and a drop in melatonin helps the body realize it's time to wake up.
When the amount of sunlight in one's environment changes, the amount or timing of melatonin produced by the body might change as well, influencing a person's sleeping patterns and mood.
Finally, a brain chemical called serotonin may be related to SAD. Serotonin affects a person's mood and is already known to be related to clinical depression.
A drop in serotonin can lead to feelings of sadness and depression. It is possible that serotonin levels may also drop in response to reduced sunlight.
How Can SAD Be Treated?
When a person visits a medical professional for symptoms of SAD, they will likely undergo a basic physical exam and then fill out a questionnaire or answer detailed questions for the doctor.
There is not a medical test — such as a blood test or brain scan — that can diagnose SAD, so it must be done based on frequency of symptoms and a person's answers to questions about their experience. Therefore, it's important to be honest with the doctor about symptoms.
There are three main medical treatments that can be used for SAD, and then there are several activities people can do to improve symptoms on their own.
A common treatment option involves "light therapy," in which a person sits close to a special light that is calibrated to be a similar intensity and/or color as the sun.
Light therapy boxes may help the body reset the circadian rhythms and/or may influence changes in melatonin or serotonin production.
Another option is psychotherapy — such as cognitive behavioral therapy — that can help a person learn healthy ways to cope with the condition, including managing stress and anxiety.
Finally, a person with SAD might be prescribed antidepressant medications, such as fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), escitalopram (Lexapro), or venlafaxine (Effexor).
These medications may not take effect right away — most take at least two weeks. In addition, each one may not necessarily work for all individuals, and there are side effects to these medications that you should ask your doctor about.
Alternative medicine remedies that may be helpful include yoga, massage therapy, taking over-the-counter melatonin, and increasing the omega-3 fatty acids in your diet through supplements, or fish, nuts, and grains.
There are steps an individual can take on their own that may help lessen symptoms as well. Getting outside and making your home or work environment sunnier and brighter can both help. The idea is to expose yourself to as much sunlight as possible.
In addition, getting regular exercise can often reduce SAD symptoms as well as relieve stress and anxiety.
Most importantly, though, do not ignore symptoms of SAD. It's not healthy or normal to feeling extremely sad or to sleep constantly throughout the winter. If you or a loved one experiences symptoms of SAD, seek the care of a mental health professional who can help determine the most appropriate treatment options.