What Is Seasonal Affective Disorder (SAD)? How is it treated?

5 ways to deal with most common form: winter depression

Young woman with Seasonal Affective Disorder (SAD) receives counseling.

5 ways to deal with most common form: winter depression

The winter months can weigh on our moods. Less sunlight may have something to do with it. It’s normal to feel a little down or tired during this time of the year. But when the symptoms appear more like depression that occurs around the same time each year, you may have Seasonal Affective Disorder (SAD).


“If you have severe symptoms, like feelings of hopelessness or worthlessness, and your depression is limiting your ability to engage in work, family life or other normal activities, make an appointment with your physician,” says Lawrence Schlitt, MD, a family medicine physician at Scripps Clinic Del Mar.


“SAD is a recognized medical condition. Don’t hesitate to reach out for medical expertise to help you get through these months if you need it.”

What is SAD?

SAD symptoms in their most marked form are the same as for major depression, including feeling depressed nearly every day, problems sleeping and concentrating and even frequent thoughts of death or suicide.


With SAD, there is one main distinction. Symptoms tend to improve when the seasons change. Usually they start in the fall, get worse in the winter and improve in spring or early summer. A less common form of SAD causes depression during the summer months.


While symptoms go away on their own with seasonal change, treatment for SAD can help alleviate symptoms more quickly. Treatment may include light therapy, medication, talk therapy or a combination of these.

Who gets seasonal depression?

Severity of SAD symptoms vary among people who get it. About six percent of the US population, mainly in northern states, is affected by SAD in its most marked form. Another 14 percent of the population experiences the winter blues, which is a lesser form of seasonal mood changes, according to the National Institutes of Health.


Those most at risk include:


  • Young people
  • Women
  • People with a family history of depression
  • People who live farther from the equator

What causes SAD?

The exact cause of SAD is unknown. To be diagnosed with SAD, one must have had the cyclical symptoms for two or more years in a row.


SAD has been linked to the effects that reduced sunlight may have on people who are most at risk for this type of depression.


According to the National Institute for Mental Health (NIMH) people with SAD:


  • Have problems regulating serotonin, a key neurotransmitter involved in mood
  • May overproduce melatonin, a hormone that regulates sleep. Darkness increases melatonin, which causes sleepiness and sluggishness
  • May produce less vitamin D, which plays a role in serotonin activity.

What are SAD symptoms?

According to the NIMH, symptoms of the winter depression form of SAD include:


  • Low energy
  • Hypersomnia (excessive daytime sleepiness)
  • Overeating
  • Weight gain
  • Craving for carbohydrates
  • Social withdrawal


“If these feelings persist, there are ways to counteract the mood-dampening effects of winter,” Dr. Schlitt says.


These are five ways to cope with SAD and the winter blues.

1.   Cut the white carbs

SAD symptoms may include cravings for starchy and sugary foods that you may want to avoid too much of.


“As the days grow shorter in the winter, you may find yourself craving comfort foods — simple carbohydrates like bread, pasta, sugary pastries and potatoes,” says Dr. Schlitt. “But the crash that follows a carb or sugar binge can leave you feeling worse than you did before.”


Dr. Schlitt recommends a healthy diet that includes amino-acid-rich, lean protein sources, such as poultry, fish and eggs, along with nutrient-dense whole grains and plenty of fresh fruits and vegetables.


“Foods such as oatmeal, whole grain bread, brown rice, and bananas can boost your feel-good serotonin levels without the sugar crash,” Dr. Schlitt says. “Foods rich in certain omega-3 fats — such as oily fish, walnuts, soybeans, and flaxseeds — can improve your mood.”

2.   Make time to get moving

Even though a blue mood may make exercise feel like the last thing you want to do, you should give it a try. Movement should be one of your top priorities during the dark winter months as regular exercise can help alleviate SAD symptoms.


“To get the biggest mood boost from exercise, go outside and do it during daylight hours,” says Dr. Schlitt. “Schedule some exercise in the morning or in the afternoon to get your endorphins flowing and to let your body make some sunlight-fed Vitamin D at the same time.”


Mild to moderate daily exercise could be enough to positively affect your mood — especially walking, jogging, biking, dancing or even jumping rope.


“These rhythmic forms of exercise can put your mind into a meditative state, which can help with stress management and help bolster your mood,” he says.

3.  Consider light therapy

Light therapy, also known as phototherapy, can help improve SAD symptoms. Light therapy boxes are available at retail stores but are not regulated by the Food and Drug Administration for SAD treatment. Check with your doctor before deciding on this option.


Light therapy works by replacing the missing daylight of winter through daily exposure to bright, artificial light. SAD symptoms may be relieved by sitting in front of a light therapy box that emits very bright light and filters out harmful ultraviolet (UV) rays). It usually requires 20 to 60 minutes a day, according to NIH.


“It’s important to note that tanning beds are not light therapy,” Dr. Schlitt says. “Light therapy boxes work because the light is visible and enters the eyes indirectly. They filter out the harmful ultraviolet rays that can cause skin cancer.”


While light therapy is generally safe, people who have been diagnosed with bipolar disorder and are not on medication should not try light therapy without a doctor’s supervision because it may trigger a manic episode.

4.  Talk to your doctor about medication for

Medication can be used to treat SAD symptoms. Selective Serotonin Reuptake Inhibitors (SRIs) are antidepressants that affect serotonin levels in the brain. Talk to your doctor about the benefits and potential risks of using this medication, including side effects.

5.   Get your thoughts in line with talk therapy

Your doctor may also refer you to a Cognitive Behavior Therapy (CBT) specialist to help you deal with SAD symptoms. CBT is a type of psychotherapy that focuses on changing one’s thoughts about a situation or condition and response to them.


“CBT teaches people to challenge negative thoughts and incorporate more enjoyable activities into daily life during the winter months,” says Dr. Schlitt.


A person with SAD may be in the habit of saying “I can’t stand the darkness of winter.” A CBT specialist may encourage reframing those thoughts to say “I prefer summer and spring and dislike winter.”


A person with SAD may also be asked to commit to 10-15 minutes of pleasant activities of their choice each day, such as listening to relaxing music or spending time with a pet.