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 work to quickly 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, sometimes shortened to SAD, is a mental health condition where the individual’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 recognize the “with seasonal pattern” specifier that may be applied to depressive and bipolar disorders.2
If a person experiences depression and other mood changes triggered by the seasons, but then returns to a normal level of functioning during the other months, they might have a depressive disorder with seasonal patterns. When a person experiences periods of depression in certain seasons and periods of mania or hypomania in the other seasons, a bipolar disorder with seasonal patterns could be the best diagnostic fit.2
Nearly all people are influenced by the changing seasons due to colder weather, shorter days, and decreased physical activity, but seasonal affective disorder denotes serious symptoms that impair a person’s ability to function. Although seasonal affective disorder is not an official diagnosis, mental health professionals understand what the term implies and can offer the appropriate information to effectively treat the condition.
With SAD, it is important to take these symptoms seriously. Although some people may try to dismiss these seasonal changes as normal “winter blues,” one must recognize the point when the effects of SAD cross the line to become problematic.3
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.
Signs of Seasonal Affective Disorder: What It Looks Like
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.
There are two types of SAD:2
- Seasonal affective disorder connected to depression
- Seasonal affective disorder connect to bipolar disorder
No matter the type, people with SAD will experience unwanted symptoms related to depression in the fall and winter months in most cases. The difference comes in the spring and summer.
People who have depression with seasonal patterns will often present well 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.
Children and teens may be less negatively impacted by SAD, but they may show signs of seasonal affective disorder like changing friendships, energy levels, sleeping patterns, and moods. Teens may appear more defiant and rebellious during the winter months before returning to their normal presentation during the summer.
Seasonal affective disorder may emerge at any age. Most cases do not begin until adulthood, so children with the condition will be rare.1
As mentioned, most members of the general population experience the influence of weather and seasonal changes, but SAD is much more than being down during a rainy weekend or really happy when the sun is shining. SAD creates significant symptoms that make life hard to manage.
Symptoms of Seasonal Affective Disorder
Since SAD mirrors the effects of depression for some people and bipolar disorder for others, the symptoms of seasonal affective disorder can include each symptom of depressive episodes and manic episodes. Not every person will experience every symptom, but many people will note a range of effects depending on the time of year.
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
During this period, the individual will note several common symptoms of manic episodes including:2
- Higher self-esteem
- Decreased need for sleep
- Being more talkative
- Having racing thoughts
- Increased distractibility
- Increased involvement in risky behaviors, including using drugs, having casual sex, overspending money, or making impulsive life decisions
Manic episodes must last for a week or more, while hypomanic episodes share most of the same symptoms but last for a shorter duration. Like all other mood episodes, manic episodes will create a major impact on someone’s expected thought and behavior patterns.
The idea of having more motivation and energy may sound appealing, but manic episodes commonly end with relationship, legal, financial, or employment troubles.
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.
Sometimes, SAD is separated into two categories: 3
- Fall and winter SAD with symptoms of oversleeping, eating more with weight gain, and feeling tired
- Spring and summer SAD with symptoms of insomnia, poor appetite, weight loss, and increase agitation
Causes & Triggers of 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.
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 personally
- 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
These risk factors set the stage for SAD to emerge, but the causes of the condition activate seasonal affective disorder.
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.
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.
The first step of the process will be to identify the presence of a depressive or bipolar. A person could experience issues related to the changing seasons, but if the symptoms are not severe enough, they will not meet the criteria for SAD.
Second, when a 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, and increased substance use would not qualify as having a seasonal pattern.2
Treatment of Seasonal Affective Disorder
The underlying depressive or bipolar disorder will drive the treatment of seasonal affective 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.
Therapy
Psychotherapy performed by a psychologist, professional counselor, or social worker will be a great treatment for seasonal affective disorder. Therapy may look differently depending on the style and therapeutic orientation of the professional.
The following are general therapy goals:3
- Identifying and changing the thoughts that could be contributing to unwanted symptoms
- Learning healthy coping skills while reducing avoidance of triggering activities
- Improving stress management skills
Common Type of Therapies
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.
Intended Treatment Outcomes & Timeline
It may be beyond the capacity of therapy alone to completely resolve symptoms of SAD, but therapy can help a person:
- Understand their triggers
- Prepare for the season changes
- Reduce the impact of shifting moods
All therapy options will vary depending on the symptoms, their severity, and the combination of other conditions the person is experiencing. In some cases, a person may benefit from CBT or IPT in as little as 12 sessions.5
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 will 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). As a class of medications, SSRIs help to increase the amount of serotonin available in the brain and include:3,4
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
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
Lifestyle Changes
Lifestyle changes, when incorporated into a person’s daily routine, can make significant improvements to any mental health condition. Because of the nature of seasonal affective disorder, these changes could have a more pronounced influence.
Perhaps the most important change to consider is the regular use of a lightbox. This product exposes the person to bright light that mimics the feeling of being outside, which seems to improve the levels of mood-altering brain chemicals. Just a few hours each day could result in great benefits, but people should always consult their treatment team to understand ways to properly use the device.3
Some other helpful lifestyle changes for SAD focus on physical health. The condition will have the power to shift someone’s diet, exercise, and sleep levels, so a person could improve their state by spending increased energy improving these facets. Dedicate enough time to sleep, eat balanced meals, and find ways to squeeze in plenty of exercise to reduce the SAD influence.5
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
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.
Additional Resources for Seasonal Affective Disorder
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:
