Seasonal affective disorder or SAD is a type of depression that just like the seasons will come and go. It is also referred to as ‘winter depression” as the symptoms are usually more prevalent in the winter.

As we are now in the depth of winter and are still navigating the difficulties brought about by coronavirus, it is safe to say that we are all feeling a little fragile right now. 

But what if there was a biological and scientific reason as to why our moods worsen in the winter?

Seasonal Affective Disorder or SAD is a type of depression that just like the seasons will come and go. It is also referred to as ‘winter depression” as the symptoms are usually more prevalent in the winter. Everyone usually feels a little low during the colder months, however, SAD refers to people whose low moods are interfering with their daily activities, and this feeling returns at the same time of year, every year.

Working within the field of mental health, I am no longer a stranger to people with depression, I have seen people of all different ages and walks of life suffer from mild to severe depression and as a condition there are more than 300 million people worldwide who suffer from depression.

Symptoms of depression and SAD are very similar, they include but are not limited to:

• Lack of energy
• Finding it hard to concentrate
• Not wanting to socialise
• Problems with sleep (having more or less sleep than usual)
• Feeling low, hopeless or guilty
• Changing in appetite
• Being more prone to physical health problems (e.g. colds)
• Loss of interest in physical contact
• Suicidal thoughts

The difference between depression and SAD is that as mentioned before, for SAD, the symptoms will present at similar times in the year based on the seasons or weather.

In most cases, patients with SAD will have a flare-up of their symptoms in winter, or when the weather is colder or raining. However, some cases have shown that patients may get their symptoms in summer and their mood will improve in winter.

Studies have been done to attempt to identify the cause of SAD but it is still not fully clear as to why there is a link between winter and low moods. There are some factors that may contribute to the decline in mood. For instance, during the winter there is a reduced level of sunlight and this could disrupt the bodies circadian rhythm (biological clock). This disruption could lead to feelings of depression. This lack of sunlight could cause a drop in serotonin in the body. Serotonin is known as the bodies “happy hormone” and a decrease in levels could negatively affect someone’s mood. The levels of melatonin are also fluctuating in people with SAD, this hormone regulates your sleep and disruptions can compromise sleep and mood.

There are certain factors that may put someone at risk of developing SAD. Studies have shown that SAD is four times more common in women than in men and is more prevalent in people between the ages of 18-30. Those with a family disorder of depression or SAD as well as those who themselves suffer from major depression or bipolar disorder are also more at risk. Another risk factor appears to be those living far from the earth’s equator, this would be linked to the lower levels of sunlight they receive during the winter.

Any form of depression can cause complications to someone’s life, they may find it harder to complete normal daily activities, they could have problems in the workplace or at school/university. People with depression may go down a path of substance abuse or be more susceptible to other mental health disorders. In extreme cases, people may get suicidal thoughts or tendencies and if this is not identified there may be suicide attempts.

Treatment for SAD is based more on lifestyle measures and behavioural therapy rather than pharmacotherapy. Light therapy is a special treatment used for SAD that involves exposing someone to a bright light to mimic the natural outdoor light. Although this treatment is not offered on the NHS, lightbox therapy can be sought privately or lightboxes can be purchased online. It is always important to get advice from a doctor before you decide to try light therapy to ensure it is the appropriate treatment for you.

In some cases, people may benefit from antidepressant therapy, this is usually reserved for those with more severe symptoms. Usually, antidepressants can take several weeks to provide significant benefit, and for this reason in those with known SAD, antidepressant therapy may be started before symptoms develop each year in hopes to prevent a flare-up. The medication will usually be stopped after symptoms go away.

The most common treatment for SAD is talk therapy, an example of which is cognitive behavioural therapy. The basis of this treatment is to identify and attempt to change your negative thoughts and help you find ways to cope with SAD. Other techniques that may be used are also relaxation techniques, medication and music therapy.

Although everyone may feel a bit more slow and low during the winter months, it is important to seek medical advice if you think your symptoms are affecting your daily activities. It is also very important to seek urgent support if you are feeling severely depressed or suicidal. Points of contact can range from a family member to your GP or local pharmacist and after that appropriate referrals and support networks can be identified.

For those who are feeling suicidal or in an extremely low place, please take the step to talk to your family members, friends or colleagues. If you don’t feel like speaking to someone you know, you can always turn to services such as Samaritans (Call 116 123) or call NHS 111. Other helplines also include CALM (Call 0800 58 58 58) or if you are in serious danger then call 999 or get someone to call for you. HealthHubble also lists a number of charitable organisations and mental health professionals who can help in times of need.

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