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Around this time of year, I tend to feel more melancholy than usual. Aside from the colder weather and darker days, there’s no specific trigger—I just definitely feel an underlying sense of bleakness that can be tricky to shake. Now I know I m suffering from a malady called Seasonal Affective Disorder, though when I was younger, I called this feeling “the winter blues.” Aptly, it’s colloquially referred to as SAD.
In an attempt to soothe this unwelcome yet predictable seasonal shift in mood, I’ve experimented with all sorts of healing modalities: happy lamps, hot yoga, therapy, tropical vacations, journaling, and even moving to a sunnier coast. All of these have helped, but experts say that when it comes to beating SAD, certain treatments are scientifically proven to be more beneficial than the rest.
What is Seasonal Affective Disorder?
“Seasonal Affective Disorder is a mood disorder characterized by a cycling of depressive episodes in winter and normal mood during warmer seasons,” explains clinical psychologist Anthony Townsend of Eqnmt. It’s not really related to trauma or stress—it’s actually a chemical imbalance in the brain caused by lack of sunlight during short winter days, which disturbs the circadian system and causes serotonin and melatonin levels in the brain to change.
There is also a less common type of SAD that occurs in the summer, as well a more extreme, bipolar type of SAD which involves cycling between depression in winter and mania in summer.
But regardless of when SAD occurs, it’s important to note that it truly is a form of depression, and shouldn’t be shrugged off. As triple board certified psychiatrist Raafat W. Girgis, MD, medical director at Moment of Clarity explains, “depression is more than just having a bad day or momen—the symptoms are serious and need to be treated by a professional.”
What are the symptoms of SAD?
The most common symptoms of winter-onset SAD occur in the months between early fall and spring and include excessive sadness, increased irritability, increased appetite and overeating, excessive fatigue, disrupted sleep patterns, oversleeping, low self-esteem, and low sex drive. But SAD can also manifest as difficulty experiencing pleasure (also called anhedonia), low motivation, and difficulty concentrating and making decisions. There’s also the potential for feelings of hopelessness to occur and even suicidal ideation.
These are real issues, so if you’re experiencing any of them, it’s important to seek professional help immediately. “SAD is not preventable, but it is treatable,” says Girgis. “Being proactive in taking care of yourself is the key element in prevention.” And, if you are experiencing thoughts of suicide, please remember that help is available by dialing 988 on your phone.
Who gets Seasonal Affective Disorder?
SAD is more common than you may think—it affects up to 5 percent of adults in the United States each year. The numbers may be even higher than that: “It s estimated that up to 25 percent of the population will experience some features of this condition at some point,” Townsend says.
SAD occurs more often in adults and affects more women than men. This is important to call out, because women are often expected to power through health conditions instead of letting their bodies rest. “Those of us who have menstrual cycles sometimes don t acknowledge how our bodies are constantly changing just like the seasons—we continue to work and do what we do as if we re not losing a whole lot of blood and iron and our hormones aren’t fluctuating,” explains clinical psychologist Jeshana Avent-Johnson, MD, a mental health advisor at Selfmade. “We’ve all adopted this capitalistic mindset and our self-worth is tied to being productive.”
People are more likely to suffer from SAD if they live far from the equator. “As you might expect, the prevalence of SAD is much higher in extreme Northern and Southern latitudes because there is less winter sunlight,” Townsend explains. “For example, there is a 2 percent prevalence in Florida and a 10 percent prevalence in New Hampshire.” To that end, he recommends that anyone residing in those latitudes should be sure to start incorporating the beneficial habits mentioned below into their routines when the change of season begins.
Those who are prone to clinical depression (MDD) also tend to have higher rates of Seasonal Affective Disorder. “They can overlap,” explains psychiatrist Byron Young, MD, medical advisor at Selfmade. “But studies have shown that the same things that you do for depression can work for seasonal affective disorder.”
How is SAD treated?
Luckily, SAD is treatable and predictable. “If you have suffered from seasonal depression, you know what to expect,” says Girgis. “It’s just important to understand that it can last for several months or even years.”
But never fear. Because SAD is caused by lack of sunlight, most experts say getting as much natural light as possible is one easy fix. That might mean bundling up for an outside walk or sitting near a window while you’re at work, but either way “focusing on maximizing natural and artificially bright light exposure can be immensely helpful,” says Townsend.
This is where my aforementioned “happy lamp” or light box also comes in. Research shows these extra-bright lamps help improve a low winter mood. “One of the most effective current treatments for SAD is phototherapy,” explains Townsend. “This involves exposing yourself to bright light (2500 lux) for two hours upon waking, and avoidance of bright lights after sunset.” He says daily use of phototherapy can result in a “lifted” mood within three to four days, and remission of SAD symptoms within two weeks.
Those are impressive results, but if you really want to amp up the effects, you can double down with additional proven treatments. In particular, cognitive-behavioral therapy (CBT) has been shown to do the trick, says Townsend. “Cognitive-behavioral therapy helps you tackle negative thought patterns and shift behaviors to improve your mood,” he explains. “Often by thinking better and behaving better, we start feeling better. Recent research shows that these combined treatments helped 73 percent of people with SAD gain relief from symptoms.”
CBT isn’t the only type of therapy that can be beneficial when it comes to treating symptoms of SAD—any kind of professionally-guided therapy could help, especially because SAD also occurs during the holiday season when old wounds often get dredged up. “The cycle of the seasons coinciding with the cycling of trauma can trigger a season of depression,” Avent-Johanson notes. “I believe everybody should have a therapist. Having someone to talk to and validate that you are not alone is important; it can have mood-changing effects.”
To that end, she also recommends making a concerted effort to stay connected to family and friends. “When we are in spring and summer we socialize more naturally, and in the winter months when it is cold and dark we tend to isolate,” she says. “Finding ways to connect with others is critical to managing seasonal depression.” Townsend agrees: “Don’t isolate yourself,” he urges. “Push yourself to stay connected with those you care about even if it’s hard—you’ll feel better after spending time with them.”
There are, of course, many things you can do on your own to help ease symptoms of SAD. Studies have found that increasing your intake of Vitamin D can be helpful, as can adhering to your usual tried-and-true wellness basics like eating a well-balanced diet and exercising regularly. “Ensuring that you get at least 150 minutes of exercise each week has been shown to significantly boost your mood,” Townsend says. “Remember, exercise doesn’t have to be lifting weights; it’s anything that gets your heart rate up. Walking or dancing naked in the kitchen works, too.”
Speaking of getting your heart rate up, using daily deliberate cold exposure therapy for SAD has also shown promising results. “This option is interesting as it harnesses the innate cold of winter to your advantage,” says Townsend. “Research indicates that deliberately immersing yourself in cold water that is 50 to 60 degrees Fahrenheit for about two minutes can significantly reduce depressive symptoms for several hours.” It works because it catalyzes the release of neurohormones such as epinephrine and dopamine, which in turn boost your mood. “As such, the cause of your sadness may also be your route out of it,” Townsend says. “The cold can be your enemy—or it could perhaps be your healer.”
If a cold plunge sounds too intense, Avent-Johnson recommends other, more gentle remedies like restorative yoga, breathwork, and mindfulness meditation. “Tapping into the mind-body connection can help reset the nervous system and release tension stress. It can help increase our serotonin levels and decrease an enzyme called monoamine oxidase, or MAOs.” she says. “It’s important to be intentional about moving slower. When we move fast we create anxiety. When we create anxiety, it can become depression and we feel isolated. It s just a vicious cycle.”
If you are having trouble getting out of that vicious cycle, medication can help. “Data shows that the combination of medication and therapy are the most robust in terms of improving depression and anxiety,” says Byron. But he says that’s usually a last resort: “If someone is having really severe symptoms, what we call anhedonia (inability to feel pleasure) to the point where they re not getting out of bed and there are passive thoughts around death and dying, I’m going to recommend medication very strongly.”
It’s important to remember that experiencing SAD is both common and normal—and there’s absolutely no shame in getting help or treating yourself with extra care. “Just like the falling leaves, it may even be an instinctual or evolutionary reminder to slow down and let things go that no longer serves us to prepare for new growth,” says Avent-Johnson.
