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Seasonal Affective Disorder (SAD): Signs, Symptoms, & Treatments

Published: September 28, 2021
Published: 09/28/2021
Headshot of Eric Patterson, LPC
Written by:

Eric Patterson

LPC
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Is Seasonal Affective Disorder?Definition
  • Seasonal Affective Disorder SymptomsSymptoms
  • Signs of Seasonal Affective Disorder" class=
  • What Causes Seasonal Affective Disorder?Causes
  • How Is Seasonal Affective Disorder Diagnosed?Diagnosis
  • Ways to Manage SAD Symptoms5 Tips
  • Treatment of Seasonal Affective DisorderTreatment
  • How to Get Help for Seasonal Affective DisorderGet Help
  • Seasonal Affective Disorder StatisticsStatistics
  • Additional ResourcesResources
  • Seasonal Affective Disorder (SAD) InfographicsInfographics
Headshot of Eric Patterson, LPC
Written by:

Eric Patterson

LPC
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD

Seasonal affective disorder is a mental health condition marked by mood symptoms that shift with seasonal changes. It impacts about 5% of the population.1 Although the term “seasonal affective disorder” is not a recognized diagnosis, mental health professionals can identify these mood patterns connected to depression or bipolar disorder and offer medications and psychotherapy to effectively manage symptoms.

What Is Seasonal Affective Disorder?

Seasonal affective disorder (SAD), sometimes called seasonal depression, is a mental health condition where someone’s thoughts, feelings, and behaviors are influenced by the changing seasons. Commonly, their moods are more depressed in the fall and winter and less depressed or manic in the spring and fall, but they could display the opposite pattern. Depending on the severity, the condition could be seriously debilitating to the person and their family.

TV, movies, and other media sources often cite a condition called seasonal affective disorder, but in reality, the American Psychiatric Association (APA) does not officially acknowledge this diagnosis. The APA does use the specifier “with seasonal pattern” that may be applied to depression and bipolar disorders.2

What separates SAD from standard depression or bipolar disorder is the time and season-focused presentation of symptoms. SAD involves symptoms that almost always develop during the corresponding season. People could still feel depressed in the summer and manic in the winter, but these episodes would be the exception, rather than the rule.

It is important to take these symptoms seriously. Although some people may try to dismiss these seasonal changes as normal “winter blues,” you need to recognize the point when the effects of SAD become problematic.3

Winter vs. Summer Seasonal Affective Disorder

With SAD, the winter commonly means periods of depression with the summer months involving periods of no symptoms or manic episodes, depending on the individual and their condition. Some people will not fit into this pattern, though, and will note mania in the winter and depression in the summer.

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Seasonal Affective Disorder Symptoms

People from both groups will most likely endure depressive episodes during the winter. The most common symptoms of depressive episodes include:2

  • Low mood or increased irritability
  • Low energy
  • Low motivation to engage in pleasurable activities
  • Changes in eating and sleeping habits
  • Feeling slowed down or sped up behaviorally
  • Increased feelings of guilt and worthlessness
  • Poor attention, concentration, and decision-making skills
  • Thoughts of death, dying, and suicide

The symptoms will present most of the day for more days than not over the last few weeks.

For people who have depression with seasonal patterns, the summer months will be a welcome relief from the symptoms, while people who have bipolar with seasonal patterns will risk periods of mania. Mania is marked by a distinct period of higher energy, elevated mood, and an increased focus on completing goals.2

Signs of Seasonal Affective Disorder

SAD creates a pattern where the weather and seasons dictate the person’s mental health, physical health, and overall well-being. A person with SAD will show predictable and consistent mood changes caused by a change in season. Seasonal affective disorder may emerge at any age. Most cases do not begin until adulthood, so children with the condition will be rare.1

People who have depression with seasonal patterns will often present as mentally healthy during the summer months. Perhaps they will be more physically active, more social, more energetic, and display signs of happiness. They will thrive during these periods.

Someone who has bipolar disorder with seasonal patterns will have a different experience in the summer. During warmer weather, these people will be more likely to display signs of mania, including increased energy, decreased need for sleep, and reckless behaviors.2

In the fall and winter, though, the effects of the spring and summer will give way to low mood, worthlessness, low energy, and other unwanted symptoms of depression. During these depressive episodes, the people with the condition will barely resemble the other versions of themselves.

During the colder months, the person may be unable to work, go to school, and maintain responsibilities at home. Their relationships will struggle, and their disposition will be less desirable. They may feel the urge to stay in bed most of the day and hibernate through the season.

What Causes Seasonal Affective Disorder?

A combination of risk factors, causes, and triggers of seasonal affective disorder put some people at greater risk of the condition. With enough risk factors for SAD, the condition will most certainly present and bring with it drastic changes to mood, energy, motivation, and sleep.

Causes of seasonal affective disorder include:3

  • The individual’s biological clock: Levels of sunlight influence each person’s circadian rhythm. As daylight changes, the rhythms change as well.
  • Serotonin changes: Serotonin is a brain chemical linked to mood and depression. Serotonin tends to drop during the winter months.
  • Melatonin changes: Melatonin is an important chemical associated with sleep and mood. Like serotonin, seasons influence the amounts of melatonin in the body.

Risk Factors for SAD

Some of the most significant risk factors of seasonal affective disorder include:3

  • Family history of depression or bipolar disorders
  • Having major depressive episodes or manic episodes
  • Living far from the equator. Due to the impact of seasons and weather on SAD, people who live closer to the poles report increased incidents of SAD

How Is Seasonal Affective Disorder Diagnosed?

Only a mental health professional can diagnose seasonal affective disorder or a seasonal pattern related to a depressive or bipolar disorder. Rather than using tests or measurements, clinicians will complete a thorough interview to gather information and record their findings.

If depression or bipolar disorder is present, the professional will inspect the existence of the seasonal pattern. To do this, the clinician will ask about the recent mood episodes to track their presentation. If the episodes mostly fit the seasonal changes, SAD could be the proper diagnosis.

Experienced clinicians will also check to see if other issues or situations for the symptoms exist. Someone who experiences extra stress or sadness in the winter because of grief and loss issues, lack of money associated with seasonal work, or increased substance use would not qualify as having a seasonal pattern.2

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5 Ways to Manage SAD Symptoms

Living with seasonal affective disorder is a challenge for anyone, but by using positive coping skills and avoiding unhelpful impulses, a person can live a happy and fulfilling life.

Five ways to manage the symptoms of SAD are:

1. Plan Ahead & Consult a Mental Health Professional

Many people experience seasonal symptoms during the same months or even weeks each year. With this information, a person would be wise to begin consulting with mental health professionals and adjusting their treatment in the time before the season changes. With SAD, prevention is invaluable.

2. Be Open About Your Seasonal Affective Disorder

There is no need to live with shame related to SAD or any mental health disorder. Rather than keeping your condition private, tell the important people in your life what is coming. Together, you can prepare for the road ahead.

3. Avoid Alcohol & Substance Use

As the weather changes and influences your brain, you may be more tempted to seek out the comfort of alcohol and other drugs to help regulate the chemistry. This behavior is always negative, though, as it uniformly results in more problems and stress in the future.

4. Create Consistency with Schedules & Routines

SAD creates frustrations and inconsistencies in your life. You can fall victim to the flux, or you can create a program focused on consistency. By setting schedules, following routines, and encouraging others to keep you accountable, you can keep SAD well-managed. Using your light therapy, taking your medication, and engaging in psychotherapy regularly will help along the way.

5. Be Patient & Kind to Yourself

Even the best coping skills may not be enough to erase all symptoms of SAD, so if complete symptom relief is what you are expecting, you could feel quite let down. Give yourself some kindness and patience by allowing yourself some “bad days.” Just work to keep them as limited as possible.

Positive coping skills are never very exciting or glamorous, but the benefit they can offer people with SAD is invaluable. Be patient and take your time to find the best possible results.

Treatment of Seasonal Affective Disorder

The type of treatment for seasonal affective disorder will depend on if there is an underlying diagnosis of depression or bipolar disorder. In either case, a combination of therapy and psychiatric medications will be offered by a team of mental health professionals to create the desired reduction of symptoms. Depressive and bipolar disorders are serious conditions, but treatment providers are skilled at assessing and managing symptoms.

Paul Desan, MD, PhD“The best treatment for someone with SAD (winter depression type) is exposure to bright light of 10,000 lux intensity for at least 30 minutes before 8 a.m. every day of the week. Many research studies support this therapy. Individuals with depression should always work with a professional qualified to treat depression and should never treat themselves.

SAD is not caused by Vitamin D deficiency and taking extra vitamin D will not help most people. Individuals who want light therapy should obtain a proper device (see Yale School of Medicine’s list of recommended light boxes): most lights sold on the internet are too dim and too small to work well,” says Paul Desan, MD, PhD, associate professor of psychiatry at Yale University.

Therapy

Experts utilize and recommend several therapy styles for SAD including:4,5

  • Cognitive behavioral therapy (CBT): CBT is one of the most effective therapy styles for seasonal affective disorder. CBT helps people understand the link between their thoughts, feelings, and behaviors, so they can adjust their patterns to produce more desirable results.
  • Acceptance and commitment therapy (ACT): ACT teaches people to accept their current status while also making the decision to commit to change. With this combined technique, people can cope with unwanted thoughts, clarify their values, and shift their perspective.
  • Dialectical behavioral therapy (DBT): As a blend of CBT and meditative techniques, DBT works to build mindfulness, communication skills, distress tolerance, and emotional regulation in specific blocks of treatment.
  • Interpersonal therapy (IPT): For adolescents and adults dealing with depression linked to SAD, IPT is a way to address symptoms by focusing on communication skills and relationships.

People may need ongoing treatment to address the behavioral patterns that emerge with changing seasons, or they could utilize a few sessions at certain times of the year to regulate symptoms. As always, people should consult with their therapist, rather than making any impulsive decisions alone.

Medication

Because much of SAD is regulated by changing chemicals in the body, medication management may be an essential aspect of treatment. Psychiatrists, nurse practitioners, and primary care physicians (PCPs) can offer trials of medications to see which options best meet the individual’s needs.

Some of the most popular medications prescribed for seasonal affective disorder are selective serotonin reuptake inhibitors (SSRIs) like citalopram (Celexa), escitalopram (Lexapro), and fluoxetine (Prozac). As a class of medications, SSRIs help to increase the amount of serotonin available in the brain and include.3,4

Aside from SSRIs, another type of antidepressant medication called bupropion (Wellbutrin) may be used to prevent and manage the depressive symptoms connected to SAD. The prescriber may recommend taking medication all year or only in the months leading up to season changes.3

How to Get Help for Seasonal Affective Disorder

To get help for seasonal affective disorder, people should seek treatment from whatever sources are accessible and available. People can contact their PCP, insurance company, school psychologist, or the local mental health facility to inquire about SAD treatment.

How people can get help for seasonal affective disorder is important, but it may not be as important as when they get help. If someone waits until they are deep into the season before seeking treatment, it could prove more challenging to address the condition.

How to Get Help for a Loved One

If a loved one seems to be struggling with seasonal affective disorder, depression, or bipolar disorder, the best choice is to kindly and gently address the situation from a stance of love and understanding. Never blame, name call, or address your concerns during periods of anger. Always take steps to maintain and preserve open communication, so the relationship can survive.

Seasonal Affective Disorder Statistics

Changing levels of happiness, energy, and motivation linked to the seasons affect many people. Fortunately, though, seasonal affective disorder only impacts a small percentage of the population.

Consider the following SAD statistics to learn more about the condition:1,6

  • About 5% of the population experiences SAD
  • For these people, symptoms last about 40% of the year
  • About 24% of people with bipolar disorder have a seasonal pattern to their symptoms
  • About 10% of people with major depressive disorder note a seasonal pattern
  • People with SAD go to bed between 30 minutes to one hour earlier in the winter than they do in the summer
  • SAD may not last as only 27% of people with a prior SAD diagnosis still had the condition 12 years later

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Talk Therapy 

Online-Therapy.com – Get support and guidance from a licensed therapist. Online-Therapy.com provides 45 minute weekly video sessions and unlimited text messaging with your therapist for only $64/week. Get started  Get Started

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For Further Reading

Remember, at this point, seasonal affective disorder is not a fully recognized mental health disorder according to the APA. This status may continue to evolve and change over time, and it will be professional organizations that lead the way with research and studies to better understand the condition.

Some of these valuable organizations include:

  • American Psychological Association
  • National Alliance on Mental Illness
  • National Institute of Mental Health

Seasonal Affective Disorder (SAD) Infographics

Seasonal Affective Disorder Seasonal Affective Disorder Definition Signs of Seasonal Affective Disorder

Tips for Coping and Managing Seasonal Affective Disorder Symptoms Benefits of Positive Coping Skills for Seasonal Affective Disorder Winter Vs Summer Seasonal Affective Disorder

Triggers and Causes of Seasonal Affective Disorder Therapy for Seasonal Affective Disorder Seasonal Affective Disorder Statistics

6 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • American Psychiatric Association. (2017, January).Seasonal Affective Disorder (SAD). Retrieved from https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.

  • Mayo Clinic. (2017, October 25). Seasonal Affective Disorder (SAD). Retreived from https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651

  • Anxiety and Depression Association of America. (n.d.) Therapy. Retrieved from: https://adaa.org/finding-help/treatment/therapy.

  • Lawson, Karen, Towey, Sue. (n.d.) What Lifestyle Changes are Recommended for Anxiety and Depression? University of Minnesota. Retrieved from https://www.takingcharge.csh.umn.edu/what-lifestyle-changes-are-recommended-anxiety-and-depression

  • Ghaemi, S. N. (2020, January 28). Seasonal Affective Disorder (SAD): Facts and Misconceptions. Medscape. Retrieved from https://reference.medscape.com/slideshow/seasonal-affective-disorder-6007256

update history

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: October 5, 2020
    Original Author: Eric Patterson, LPC
    Original Reviewer: Kristen Fuller, MD

  • Updated: September 28, 2021
    Author: No Change
    Reviewer: No Change
    Changes: Updated for Readability; Revised “Treatment of Seasonal Affective Disorder”; Added quote from MD on relevant treatments;

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Headshot of Eric Patterson, LPC
Written by:

Eric Patterson

LPC
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Is Seasonal Affective Disorder?Definition
  • Seasonal Affective Disorder SymptomsSymptoms
  • Signs of Seasonal Affective Disorder" class=
  • What Causes Seasonal Affective Disorder?Causes
  • How Is Seasonal Affective Disorder Diagnosed?Diagnosis
  • Ways to Manage SAD Symptoms5 Tips
  • Treatment of Seasonal Affective DisorderTreatment
  • How to Get Help for Seasonal Affective DisorderGet Help
  • Seasonal Affective Disorder StatisticsStatistics
  • Additional ResourcesResources
  • Seasonal Affective Disorder (SAD) InfographicsInfographics
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