Exploring Healthy Coping Skills For Seasonal Affective Disorder Symptoms

Some people might experience positive mental health for most of the year but suddenly develop depressive symptoms when the seasons change. In such cases, symptoms could be caused by seasonal affective disorder (SAD). To understand whether you might be living with this condition, it can be helpful to learn more about the definition of seasonal affective disorder, its common symptoms and risk factors, and the treatment options available. 

What is seasonal affective disorder (SAD)?

Seasonal affective disorder is a depressive disorder that causes depression symptoms to coincide with seasonal changes. SAD begins and fades around the same time each year, causing an extended depressive episode that doesn't dissipate until the weather changes. For some, SAD can cause significant functional difficulties.  

Those living with SAD often experience the following symptoms during the affected season: 

• Sadness or restlessness for most of the day every day 

• Loss of interest in previously enjoyed activities (anhedonia)

• Loss of energy and persistent fatigue

• Sleep changes (hypersomnia or insomnia) 

• Difficulty concentrating, thinking clearly, or making decisions

• Overwhelming hopelessness, misplaced guilt, or thoughts of worthlessness

• Intrusive suicidal thoughts 

If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.

To meet the criteria for SAD, you must exhibit the symptoms of major depressive disorder (MDD) that occur during specific seasons for at least two consecutive years.

Fall and winter SAD

Winter-onset SAD, also called winter depression, often begins during late fall or early winter and persists until the longer sunny days of late spring and early summer arrive. In addition to the SAD symptoms listed above, you may also oversleep, experience weight gain due to craving and overeating carbohydrates, and/or feel constantly tired and have low energy. 

Spring and summer SAD

Summer-onset SAD, also called summer depression, often starts in late spring or early summer and lingers through late fall or early winter. Beyond the SAD symptoms listed, some people with spring and summer SAD have difficulty sleeping and may experience weight loss due to decreased appetite. Agitation, anxiety, and increased irritability are also common. 

What causes seasonal affective disorder?

Some people adjust to changes in the weather and amount of sunlight better than others. Circadian rhythm changes can lead to SAD. Researchers also believe a neurochemistry imbalance, vitamin D deficiency, negative thought patterns, and/or melatonin boosts may contribute to the development of SAD. Other risk factors may include the following: 

• Another mood disorder comorbid with SAD, such as bipolar disorder 

• Close biological relatives with SAD or other mental health conditions 

• Living in far southern or northern light-limited places far from the equator

• Living in cloudy regions without much sunlight or day light

How is SAD diagnosed?

The process of diagnosing seasonal affective disorder often involves a physical exam to rule out other potential causes for your symptoms. Your healthcare provider may order lab tests to check whether your thyroid functions correctly and whether you may have any vitamin deficiencies. You may also be asked to complete psychological evaluations that help a healthcare provider or mental health professional review your feelings, thoughts, and behaviors to screen for conditions like SAD.

Before your first appointment, consider making a list of your symptoms, depression patterns, other illnesses, major life stressors, unexpected life changes, all medications, vitamins, and supplements you take, and questions you want answered by a professional. 

SAD and other mental health conditions

People with bipolar II disorder may have an increased risk of developing SAD. They may experience mania linked to the summer months, with depressive symptoms more likely during the fall and winter. 

Most people with SAD begin experiencing symptoms during adulthood, and the risk of developing it increases with age. Fewer people are diagnosed with the condition under the age of 20.

Seasonal affective disorder treatments

Below are some of the most common forms of treatment for seasonal affective disorder. 

Psychotherapy

Talk therapy may help you explore your past experiences and thought patterns and their link to your current emotions and behavior. Cognitive behavioral therapy (CBT) in particular can help an individual learn to identify harmful behaviors and thinking patterns and make positive changes. That said, there are over 400 therapeutic modalities available today.

Light therapy

Light therapy, or phototherapy, involves sitting a few feet away from a special lightbox that exposes you to bright light during the first hour you’re awake each day. This treatment mimics natural outdoor light and may induce brain chemistry shifts related to mood. 

Antidepressant medications

Some individuals benefit from antidepressant medications to help them manage SAD symptoms temporarily. Speak to your doctor before starting, changing, or stopping any medication or medical treatment.  

Vitamin D

Spending time outside in the sunshine, if possible, may boost your mood when living with SAD. It can help to maximize the natural sunlight in your home or office and consider taking a vitamin D supplement as well, if your doctor agrees. 

How does light therapy work?

Light therapy uses a special therapy lamp called a lightbox. These light therapy lamps are specially designed for this purpose, with white fluorescent tubes covered with a special coating to block ultraviolet rays. Phototherapy lamps are approximately 20 times brighter than standard indoor light, with a light intensity of about 10,000 lux, while producing as little UV light as possible. 

Doctors often prescribe using a light therapy lamp, such as those made by Northern Light Technologies, during the first hour of being awake for roughly 20 to 30 minutes. Position the lightbox approximately 16 to 24 inches away from your face for maximum efficiency. Your eyes should be open during light therapy, but try not to look at the light directly. Some clients may begin noticing results within the first four days of using these light technologies, though it may take up to two weeks to experience the full benefits. Be sure to only use a light box specifically designed for this purpose and to use it as directed.

Is light therapy safe?

Light therapy using a light box is considered safe and is well-tolerated by many. However, don’t engage in light therapy without talking to a doctor if you have diabetes, a retina condition, or are taking certain antibiotics or anti-inflammatories that make your skin more light-sensitive. 

This therapy may not be recommended for people with bipolar disorder, as the combination of using a seasonal depression lamp and taking antidepressants may incite manic or hypomanic episodes. Standard light therapy side effects include eye strain, fatigue, headaches, insomnia, and irritability. 

When to reach out for help

If your SAD symptoms cause significant distress and interfere with your ability to function in one or more areas of your life, it may be beneficial to seek professional support. If you don't know where to start, talk to your doctor or another healthcare provider about an assessment for SAD. 

Learning to live with seasonal affective disorder can be difficult on your own. Working with a licensed therapist online through a virtual therapy platform like BetterHelp can be valuable, as you can engage in therapy without leaving home.

Research suggests that, in many cases, online therapy can deliver similar outcomes to treatments in the traditional setting, often offering shorter wait times and lower costs. Some clients reported the physical separation from the therapist made discussing personal details easier. Others said the convenience of attending from home was a major draw, allowing them to participate more consistently.