SAD isn’t just an on-the-nose nickname. It stands for Seasonal Affective Disorder, and it’s a type of depression that comes and goes with the changing seasons—most often in the winter and fall.
This year, with the COVID-19 pandemic and a turbulent election causing higher stress levels and feelings of isolation, people with SAD could experience more intense symptoms than usual. So let’s dive into what SAD is and what you—or your loved ones—can do about it.
What is SAD?
As the days get shorter and darker, people vulnerable to SAD may experience common symptoms of depression like feeling low-energy, losing interest in once-beloved activities, or having trouble concentrating. SAD also brings along a few of its characteristic symptoms, such as oversleeping (called hypersomnia), increased cravings for sugary and starchy carbs, and social withdrawal.
If that sounds a lot like hibernation—or just daily life in the year 2020—you’re not wrong! But for those who suffer from clinical seasonal affective disorder, the complications can be serious. SAD can interfere with your work and social life, and in severe cases, even lead to thoughts of death and suicide.
Mental health professionals follow specific guidelines for diagnosing SAD, including the severity of symptoms and seasonal recurrence for at least two consecutive years. They estimate about one in 20 American adults suffer from SAD, with millions more experiencing some lesser form of the “winter blues”.
SAD is more common in women than men, usually begins in young adulthood, and is more frequent among people who live in northern regions of the country—especially those who relocated from sunnier climates.
What causes SAD?
Sunlight, neurochemicals, and circadian rhythms all play a part in whether an individual experiences SAD—and similar to other types of depression, genetic predispositions. Understanding what causes this syndrome will help you understand how to best treat it.
Sunlight, serotonin, and melatonin
While we don’t fully understand the exact mechanisms behind SAD, we do know sunshine is key. We also know sunlight plays a role in how your skin produces vitamin D. Research suggests that vitamin D may impact how your brain produces two important chemicals: serotonin and melatonin.
Serotonin acts as a neurotransmitter—a kind of “chemical messenger” that sends information and instructions throughout your brain and body and helps regulate your mood. If you experience SAD, that regulation doesn’t function properly during the winter months when you get less sunlight and less vitamin D, leading to lower levels of serotonin production.
Melatonin is a hormone that helps keep your sleeping cycle on track. When you produce too much melatonin, you feel sleepy and low-energy, even if you’ve got a solid eight hours of slumber. And you guessed it—research suggests that people with SAD produce too much melatonin.
To sum this all up: SAD and sunlight go hand-in-hand. You absorb sunlight through your skin, helping you produce vitamin D and serotonin and regulating your production of melatonin. When days get short, and we stay inside, you don’t get as much sunlight. For people vulnerable to SAD, that can lead to depressive symptoms.
The frustrating thing about SAD is that when you’re suffering from the disorder, all you want to do is hide under the covers all day. But this behavior is precisely what makes the cycle worse, because you’re further disrupting your natural circadian rhythms.
“Circadian” simply means “about a day” in Latin—it’s how your body follows a 24-hour cycle of waking, eating, and sleeping. Anyone who’s flown to a faraway time zone knows exactly what it feels like when jet lag disrupts your circadian rhythms. Your body needs time to catch up to the new light-and-dark patterns, so you’re wide awake at 2 a.m. and falling asleep during your afternoon museum tour.
In the case of SAD, when the days are short, you don’t get much sunlight, and your brain isn’t producing enough serotonin or too much melatonin, your circadian rhythms will be affected.
Fortunately, your circadian rhythms can be influenced by your environment so that you can counteract some of this less-than-ideal neuroscience with intentional behavior changes. (More on that in a minute.)
What you can do about SAD
If you suspect you’re experiencing the symptoms of SAD, the happy news is that there are several treatment options available: light therapy, talk therapy, medication, and a whole range of coping behaviors.
We can’t all move to San Diego, but we can simulate sunlight through a device called a lightbox, in a practice known as light therapy or phototherapy.
A good lightbox will give off at least 10,000 lux, about 20 times brighter than ordinary indoor lights. Lightboxes have plastic screens that filter out harmful UV rays, unlike tanning beds, and you can easily purchase them online.
Dr. Norman Rosenthal, who coined the term “SAD” in his 1984 study, recommends sitting near a good-sized lightbox (one foot by one-and-a-half feet) for about 20-30 minutes every morning, ideally placed with the light shining down on you from above—just like natural sunlight.
Lightboxes may not work for everyone, but when they’re effective, they tend to work quickly. Research shows that most people start to feel a difference between just a few days and two weeks.
If you have a history of eye sensitivity, diabetes, or bipolar disorder, consult with a doctor before using a lightbox to avoid potential side effects.
Good old-fashioned “talk therapy”, also known as cognitive behavioral therapy, is another effective treatment for SAD. There’s even a specific adaptation, CBT-SAD, that focuses on reframing negative thoughts and managing the day-to-day realities of living with SAD.
During this time of COVID-19, virtual therapy visits or group sessions may be a good choice.
While ZOOM+Care doesn’t offer long-term talk therapy, we can help you get started on your journey. Our mental health specialists can give excellent guidance, support you with medication management, and provide counseling referrals if needed. Talk to a ZOOM+Care Mental Health specialist today!
Medication and supplements
In some cases, antidepressant medications that increase serotonin levels, called SSRIs, can be used to treat SAD—although they can cause side effects, and it could take weeks before you start to notice a difference in your mood.
A ZOOM+Care specialist can help you determine if treating SAD through medication is the right path forward.
Coping with SAD
In addition to therapies or medications, you can also impact the severity of SAD symptoms through your own behavior—meaningful but simple changes you can make to your routine to help regulate your mood and internal clock.
Let there be light
Get as much sunlight as possible, especially in the mornings. Even on a cloudy day, taking a 15 to 30-minute walk outside can make a big difference. Other ways to increase your light exposure: move your desk or favorite chair close to a window, open your blinds, trim away sun-blocking branches or bushes outside, and clean your panes.
Sunlight is key to SAD, and every little bit helps.
Move your body
Note that we didn’t say “exercise”, which can be intimidating. Your goal isn’t to look like the next Marvel action star. You just need to move your body enough to help you feel awake and stimulate endorphins, the so-called “feel-good” chemicals your brain produces when you exercise. Research shows that even low-impact movements like stretching, walking, and gentle yoga can help reduce depression—as long as you do it consistently. (For bonus benefits, use a lightbox during indoor exercise!)
Pay a visit to Mother Nature
Don’t feel like working up a sweat? You’re in luck. It turns out there’s a less strenuous way to combat SAD—forest bathing.
Before you pack your swimsuit, we should specify that forest bathing isn’t an actual bath. Rather, it’s the act of spending time outdoors, slowing down, and becoming immersed in the natural environment. According to a recent study, the benefits of forest bathing include relaxation, less stress, and decreased depression, anxiety, and anger.
Keep a sleep routine
Staying up late or sleeping in on the weekends can wreak havoc on your circadian rhythms, so as much as possible, stick to a consistent bedtime and wake-up time through the winter months. Nightly rituals like a cup of herbal tea before bed or a sunrise-simulating alarm clock can help.
Fuel your brain through food
Since your goal this winter is to produce more serotonin and vitamin D, eat meals and snacks that will help—research suggests more whole grains, healthy fats, fish, veggies, and fruits, paired with less sugar and processed carbs.
Curb your carb cravings
If you’re dealing with SAD, though, you’ll likely crave sweet and starchy foods—ones that will only cause your blood sugar to spike and crash, making your energy levels more unstable.
Manage your cravings by savoring treats during outings or special occasions, like a long walk to your neighborhood coffee shop for a holiday latte, or meeting a friend for a social-distanced hot cocoa. Keep your kitchen stocked with healthy foods to lower your chance of carb-heavy binges on bad days.
Eat at consistent times
When it comes to circadian rhythms, it’s not just what you eat, but when you eat, that matters. If you can, eat breakfast at a consistent time every day, and stop eating a few hours before your bedtime. These signals (or lack thereof) will help your body know when it’s time to wake up and time to go to sleep.
You can’t always control how you feel, but you can avoid triggers that you know make you feel worse. During this tumultuous year, that might mean limiting your news consumption to 30 minutes a day, banning your phone from your bedroom, or deleting addictive social media apps altogether.
Ask for social support
Socializing is not going to come naturally this winter, but like all types of depression, having support from loved ones will help make it easier to cope with SAD.
On a good day, tell trusted family members or friends that you’re dealing with SAD, and ask them to check in with you when you go quiet. Find an accountability buddy to help stick to your movement goals. Schedule those awkward virtual hangouts in advance. (You’ll cancel sometimes, and that’s okay.)
Bottom line: be kind to yourself, and take it a day at a time.