By Elise Kraus, Grace Cottage Psychiatric Mental Health Nurse Practitioner
Are there seasons of the year when you tend to feel sad for days or weeks on end? You may be suffering from a disorder called Seasonal Affective Disorder (SAD).
SAD is a type of clinical depression experienced during a specific time of year. For most people, this comes during the winter months, when it’s dark and cold, with full symptom remission in spring or summer, but for other people, SAD occurs during the summer.
How do you know if you’re actually experiencing the disorder called SAD, and not just reacting to working hard or dealing with temporary stress in your life?
To answer that question, it’s important to make a distinction between feeling unhappy and being depressed. While this disorder goes by the acronym SAD, there IS a difference between feeling sad and clinical depression. We all have reasons to feel sad: bad news, financial worries, a relationship break-up, a death, loss of a job, or some other disappointment. This sadness can last a while.
While depression includes sadness, it’s more than that. When feelings of sadness disrupt your life over an extended period of time, so that you have trouble taking care of yourself, or you are relying on drugs, alcohol, food, or another addictive substance, it’s time to ask for help.
There is no shame in this. It may be a genetic reaction. While the pathophysiology (the physical-functional changes) that accompany SAD are not completely understood, medical providers and researchers have observed that SAD most often occurs during the darkest part of the year, so it is likely connected to decreased exposure to sunlight. The theory is that the neurotransmitter named serotonin may not be working optimally in people who experience SAD. Serotonin is a natural body chemical that helps to control mood.
It is also thought that there may be a connection between increased melatonin and SAD, as the body naturally makes more melatonin when it’s dark outside for longer periods of time. Melatonin is important to the sleep-wake cycle. Increased levels of melatonin can lead to daytime fatigue.
While it’s not uncommon to feel a bit sad or lethargic during the winter months, it is the recurring pattern over time in the same season that helps us to diagnose this as SAD.
Those with a family history of SAD are more likely to experience SAD themselves. Statistically, females are more likely to experience SAD, as are young adults aged 18-30. Anyone who is prone to depression in general is at a higher risk of developing SAD.
The good news is that SAD can improve quickly for those who seek help. However, if improvement is more gradual for you, it’s important to give yourself time and patience. There are many things you can do.
The first line of treatment includes light therapy, antidepressants, and psychotherapy. Medications often work best when you also engage in talk therapy.
Over time, those who experience recurring bouts of SAD can learn to plan ahead, incorporating routines that help them. For example, for some people, increasing exercise towards the end of summer and starting to use a light box in the fall can help. And if you can, planning a trip to a sunny spot during the winter can be a real boost. It doesn’t have to be a trip; plan things you look forward to instead of dreading the winter months. Focus on the positives and things within your control and do your best to let the other things go.
We often underestimate how routines, mindfulness, and self-care such as a healthy diet and enjoyable exercise can improve our mental and physical wellbeing. As with any illness, treating yourself with compassion is important for relieving symptoms of SAD.
So, if your life is being disrupted by recurring bouts of tiredness during the day and difficulty sleeping at night, if you crave carbohydrates and tend to keep overeating this time of year, if you are especially irritable and anxious, and if you tend to withdraw from society every winter, it’s worth talking to your provider about SAD. And, VERY important, if you are experiencing hopelessness or any suicidal thoughts, please get help right away!
Grace Cottage has providers who can help. Help is also available 24/7 by calling 988, the Vermont Mental Health hotline. You can also reach out to the Vermont chapter of the National Alliance on Mental Illness at www.namivt.org or call their hotline at 1–800-950-6294. Two more resources include the national Substance Abuse and Mental Health Services Administration helpline 1-800-662-HELP (services in English and Spanish) and the National Suicide Prevention hotline 1-800-273-8255.
Remember: depression is not a sign of weakness! Do not walk the road alone. Open up to your support systems and please seek help if you need it. Contact your care provider or reach out to one of these resources. You are not alone.