Depression And Mental Health: Is Seasonal Affective Disorder A Myth?

Many people experience distressing mental health symptoms in certain climates or during certain types of weather. Others may find that changing seasons impact their environment and mood. Although not its own category in the DSM-5, seasonal affective disorder (SAD) is a recurring major depressive disorder with a seasonal pattern, with symptoms similar to major depressive disorder. People who develop seasonal affective disorder may report feeling hopeless and experiencing negative thoughts in response to cold weather or lack of sunlight. Others may develop SAD in response to a specific season, such as summer or spring. These individuals may experience similar mental health symptoms. 

While many people experience symptoms of this affective condition, others may believe it is a myth or should not be considered in treatment. Learning more about SAD and how it might impact you can be beneficial when understanding whether the condition is a "myth." 

What is seasonal affective disorder (SAD)?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), seasonal affective disorder (SAD) is a subset of major depressive disorder triggered by seasonal changes. For many, SAD affects them in autumn and may continue throughout winter. Symptoms of seasonal affective disorder are the same as those of major depressive disorder (e.g., weight gain, low energy, hopelessness, etc.) and may involve the brain chemical serotonin. Reduced UV light or light intensity can cause serotonin activity to drop, which may cause people to gain weight, sleep too much, and have trouble concentrating, among other SAD symptoms. 

Symptoms of SAD

People who have seasonal affective disorder (SAD) may gain weight and experience mood changes in response to a specific season, such as late winter or early spring, when cold weather is a factor. Other specific symptoms of SAD may include:

• Low mood
• Feeling hopeless
• Negative thoughts
• Changes in appetite or weight gain
• Changes in sleep patterns 
• Lack of enjoyment in previously enjoyed activities
• Difficulty with memory, focus, or cognitive function 
• Fatigue, or the tendency to feel sleepy during the day
• Difficulty with self-care 
• Irritability 

Vitamin D and winter-specific depression

Vitamin D deficiency may sometimes cause winter-specific depression. One study showed a connection between a lack of vitamin D and depressive symptoms. The sun is a significant provider of vitamin D. In areas where winter months are long, or there is heavy cloud cover or rain, individuals might experience symptoms of seasonal depression. 

This mental health disorder is also experienced during the summer

Although many people experience this type of depression during autumn or winter, some individuals also experience the health condition in response to the summer months. People experiencing this form of seasonal depression may feel irritable, stressed, or depressed in response to heat. Symptoms may also be connected to thyroid difficulties. 

Is seasonal depressive disorder a myth?

Seasonal affective disorder is a form of depression. However, some researchers question the existence of seasonal affective disorder. As modern psychologists further study the human mind, some psychologists have published reports believing that seasonal affective disorder does not exist. 

For example, Megan Traffanstedt, Sheila Mehta, and Steven LoBello of Auburn University at Montgomery published a study in Clinical Psychological Science arguing a lack of substantial evidence for a season-based pattern for major depressive disorder. The study assessed a cross-sectional US survey of adults who completed the Patient Health Questionnaire-8 (PHQ-8) Depression Scale to determine if a seasonally related pattern of occurrence of major depression could be demonstrated in a population-based study.

The study questioned 34,294 adults ranging in age from 18 to 99 years. The PHQ-8 asked eight questions about whether and how often the participants experienced a particular depressive symptom during the previous two weeks. The results showed that depression levels did not correlate with seasonal changes. Season, the latitude of residence with a season, and sunlight exposure significantly affected depression scores.

Lobello, Mehta, and Traffanstedt cited a report by Hansen et al. in 2008, which found no increase in depression symptoms among residents of northern Norway during a two-month dark period of eternal night north of the Arctic Circle. Nor did the report claim a decrease in mental distress during the polar day of perpetual daylight.

"The idea that depression occurs along with seasonal changes or worsens in winter appears to be a well-entrenched folk theory," the study claims.

Evidence supporting seasonal affective disorder

The pair also studied Norway's residents, like LoBello, Mehta, and Traffanstedt. However, Targum and Rosenthal found that 14% of Oslo residents displayed SAD symptoms. In comparison, 4.7% of New York City residents exhibited symptoms of SAD.

"In fact," writes Dr. Rosenthal, "someone may have winter blues while living in southern climates and convert to full-blown SAD if they move to a northern climate." This study shows that geographic locations with more extended periods of constant darkness might cause higher levels of depression as opposed to southern locations with more bright UV light intensity throughout the year.

In another study, Sue Penckofer, Ph.D., RN, Joanne Kouba, Ph.D., RD, Mary Byrn, BSN, RN, and Carol Estwing Ferrans, Ph.D., RN, FAAN, published an article in Issues in Mental Health Nursing discussing the relationship between vitamin D and depression. Their material cites a study of 29 randomized patients divided into two groups, including 16 with SAD and 13 controls. 

These patients received either one hour or 15 minutes of seasonal affective disorder light therapy each morning for two weeks during winter, when SAD is often most prominent. Depressive symptoms significantly decreased in the SAD group receiving one hour of light therapy versus the control group. This study indicates that natural sunlight lamps that mimic a bright sunny day may benefit those experiencing seasonal winter depression.

According to Harvard Health Publishing, lack of sunlight may reduce serotonin activity and increase melatonin production. The brain chemical serotonin is known as the body’s “feel-good chemical,” while melatonin helps the body relax in preparation for sleep. This might explain why people with SAD experience sadness and low energy during cold weather months (i.e., late winter and early spring). 

Is Seasonal Affective Disorder a myth?

While studies may suggest that seasonal affective disorder does not exist, most studies support the DSM in labeling it as a subset of depression. 

Dr. Targum and Dr. Rosenthal both found increases in depression during winter months, emphasizing the comparison of Norway versus New York City. Sue Penckofer, Joanne Kouba, Mary Byrn, and Carol Estwing Ferrans discussed patients with SAD reporting fewer symptoms of depression after attending light therapy treatments.

The verdict: Is Seasonal Affective Disorder a myth?

Therefore, while some scientists may argue against the existence of seasonal affective disorder, compelling evidence in much more significant amounts continually supports the presence of the disorder.

Common misconceptions: What SAD is and isn’t

Like many mental health conditions, SAD tends to be misunderstood, despite scientific research. Some of the most common misconceptions related to seasonal affective disorder (SAD) include: 

• It only happens to women: Gender is just one of many risk factors that could contribute to the development of SAD. Family history, age, and geographic location also play a role. 
• It’s just the winter blues: According to the American Psychiatric Association, the only major difference between SAD and major depressive disorder is that it occurs during a specific season. 
• It only happens during cold weather: SAD affects most people during the winter, but it can also occur during the summer or spring.  

The Centers for Disease Control (CDC) recommends seeking support if you feel sleepy during the day, have mood changes, or other symptoms of SAD that persist for two weeks or more. 

Risk factors: Who is more likely to develop SAD? 

According to the American Psychiatric Association, approximately 5% of adults are considered SAD patients. There may be certain risk factors that make some people more likely to develop seasonal affective disorder. Some of these risk factors include:

• Age
• Gender
• Family history of SAD or other mental health conditions

People living in northern states in the U.S. may also be more vulnerable to this condition. The Centers for Disease Control recommend therapy as a first-line treatment for SAD and other types of depression. 

Lifestyle strategies to combat seasonal depression

Lifestyle changes can play an important role in the prevention and management of specific symptoms of seasonal affective disorder (SAD). Here are some healthy habits you can implement if you have symptoms of SAD or you’ve been diagnosed with this mental health condition: 

• Regular exercise: If it’s a bright sunny day, exercise outside if possible to take advantage of the light intensity. 
• Let natural light in: Open blinds and sit close to a window when you’re inside.
• Keep a normal sleep schedule, even if you feel like sleeping more. 

Some people who implement lifestyle changes to alleviate SAD symptoms may need additional support to treat depression with a seasonal pattern.

Finding mental health support for seasonal affective disorder

Light therapy

There are treatment options for seasonal affective disorder, and some patients experience full remission. Bright light therapy, also known as phototherapy, is a popular treatment method where patients sit near a UV light therapy box that gives off a bright light, mimicking that of natural outdoor light. Patients may also attend psychotherapy sessions to release unease, anxiety, and depression, which are all often related to seasonal affective disorder that may occur during the cold weather months, such as late winter and early spring.

Antidepressant medications

Antidepressant medications are also an effective treatment for SAD. Selective serotonin reuptake inhibitors (SSRIs) such as Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil), and Sertraline (Zoloft) are common choices to treat depression symptoms. Doctors may also prescribe vitamin D supplements in prescription amounts to aid in other treatments for a potential mood boost in those experiencing SAD during the winter months. Do not take any action without consulting a qualified medical professional. Therapy such as cognitive behavioral therapy is often recommended in conjunction with medication for treating SAD.

The role of therapy in managing SAD

SAD affects nearly every aspect of a person’s life, but effective treatment options are available that could bring the condition into full remission. Experts recommend psychotherapy to treat depression with a seasonal pattern, particularly cognitive behavioral therapy. This form of talk therapy is considered the most effective in terms of decreasing negative thoughts and improving mood. A mental health professional typically monitors patient progress, tracking therapy benefits and any changes in mood or behavior after starting treatment.

Online therapy for depression, anxiety, and other mental health conditions

Additionally, online talk therapy can be beneficial to treat depression and seasonal affective disorder for people who face barriers to in-person counseling. In this type of counseling, clients can choose between video, phone, or live chat sessions with a licensed therapist and can set a schedule that works for them. Studies show that internet-based treatment modalities such as cognitive behavioral therapy can effectively treat symptoms of depression, anxiety, bipolar disorder, and other mental health conditions. If you develop SAD symptoms and are interested in trying online counseling to improve your mental health, consider signing up through a platform like BetterHelp.