This type of depression is related to changes in seasons and begins and ends at about the same times every year.
Seasonal affective disorder (SAD) is a type of depression that's related to changes in seasons — SAD begins and ends at about the same times every year. If you're like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. These symptoms often resolve during the spring and summer months. Less often, SAD causes depression in the spring or early summer and resolves during the fall or winter months.
Treatment for SAD may include light therapy (phototherapy), psychotherapy and medications.
Don't brush off that yearly feeling as simply a case of the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year.
In most cases, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. Less commonly, people with the opposite pattern have symptoms that begin in spring or summer. In either case, symptoms may start out mild and become more severe as the season progresses.
Signs and symptoms of SAD may include:
Symptoms specific to winter-onset SAD, sometimes called winter depression, may include:
Symptoms specific to summer-onset seasonal affective disorder, sometimes called summer depression, may include:
People who have bipolar disorder are at increased risk of seasonal affective disorder. In some people with bipolar disorder, episodes of mania may be linked to a specific season. For example, spring and summer can bring on symptoms of mania or a less intense form of mania (hypomania), anxiety, agitation and irritability. They may also experience depression during the fall and winter months.
It's normal to have some days when you feel down. But if you feel down for days at a time and you can't get motivated to do activities you normally enjoy, see your health care provider. This is especially important if your sleep patterns and appetite have changed, you turn to alcohol for comfort or relaxation, or you feel hopeless or think about suicide.
The specific cause of seasonal affective disorder remains unknown. Some factors that may come into play include:
Seasonal affective disorder is diagnosed more often in women than in men. And SAD occurs more frequently in younger adults than in older adults.
Factors that may increase your risk of seasonal affective disorder include:
Take signs and symptoms of seasonal affective disorder seriously. As with other types of depression, SAD can get worse and lead to problems if it's not treated. These can include:
There's no known way to prevent the development of seasonal affective disorder. However, if you take steps early on to manage symptoms, you may be able to prevent them from getting worse over time. You may be able to head off serious changes in mood, appetite and energy levels, as you can predict the time of the year in which these symptoms may start. Treatment can help prevent complications, especially if SAD is diagnosed and treated before symptoms get bad.
Some people find it helpful to begin treatment before symptoms would normally start in the fall or winter, and then continue treatment past the time symptoms would normally go away. Other people need continuous treatment to prevent symptoms from returning.
Even with a thorough evaluation, it can sometimes be difficult for your health care provider or mental health professional to diagnose seasonal affective disorder because other types of depression or other mental health conditions can cause similar symptoms.
To help diagnose SAD, a thorough evaluation generally includes:
Treatment for seasonal affective disorder may include light therapy, psychotherapy and medications. If you have bipolar disorder, tell your health care provider and mental health professional — this is critical to know when prescribing light therapy or an antidepressant. Both treatments can potentially trigger a manic episode.
In light therapy, also called phototherapy, you sit a few feet from a special light box so that you're exposed to bright light within the first hour of waking up each day. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood.
Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to a few weeks and causes very few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving SAD symptoms.
Before you purchase a light box, talk with your health care provider about the best one for you, and familiarize yourself with the variety of features and options so that you buy a high-quality product that's safe and effective. Also ask about how and when to use the light box.
Psychotherapy, also called talk therapy, is another option to treat SAD. A type of psychotherapy known as cognitive behavioral therapy can help you:
Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe.
An extended-release version of the antidepressant bupropion (Wellbutrin XL, Aplenzin) may help prevent depressive episodes in people with a history of SAD. Other antidepressants also may commonly be used to treat SAD.
Your health care provider may recommend starting treatment with an antidepressant before your symptoms typically begin each year. He or she may also recommend that you continue to take the antidepressant beyond the time your symptoms normally go away.
Keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try different medications before you find one that works well for you and has the fewest side effects.
In addition to your treatment plan for seasonal affective disorder:
Certain herbal remedies, supplements or mind-body techniques are sometimes used to try to relieve depression symptoms, though it's not clear how effective these treatments are for seasonal affective disorder.
Herbal remedies and dietary supplements aren't monitored by the U.S. Food and Drug Administration (FDA) the same way medications are, so you can't always be certain of what you're getting and whether it's safe. Also, because some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions, talk to your health care provider or pharmacist before taking any supplements.
Make sure you understand the risks as well as possible benefits if you pursue alternative or complementary therapy. When it comes to depression, alternative treatments aren't a substitute for medical care.
These steps can help you manage seasonal affective disorder:
You may start by seeing your health care provider or a mental health professional such as a psychiatrist or psychologist.
Here's some information to help you get ready for your appointment.
Before your appointment, make a list of:
Some basic questions to ask may include:
Don't hesitate to ask other questions during your appointment.
Your health care provider or mental health professional is likely to ask you a number of questions, such as:
Your health care provider or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your appointment time.