Millions of Americans experience the winter blues every year.

It can be difficult for the average person to distinguish between cabin fever and Seasonal Affective Disorder, also known as SAD.

Knowing how to identify SAD and treating it can be a crucial role of health care professionals, since patients may not recognize the symptoms themselves.

Learn the signs to watch for so treatment can begin as soon as possible.

What is Seasonal Affective Disorder? 

Many people have heard of the winter blues, but don’t necessarily associate the term with a depressive disorder. However, that is exactly what SAD is.

Seasonal Affective Disorder is defined as a mood disorder triggered by the low light levels in the fall and winter months. The lower light levels lead to the body producing less serotonin, which helps to regulate moods. This can lead to a disruption of sleep patterns, along with depression. This is why it is considered both a mood disorder and a sleep disorder.

Melatonin levels may also be impacted by lower light levels, exacerbating the sleep problems associated with SAD. Both disrupted sleep, and hypersomnia (a need for excessive sleep) are symptoms of SAD. The sleep changes and depression may create a vicious cycle in which one symptom worsens the other, making it difficult for the patient’s body to bounce back on its own. 

SAD is different from other depressive disorders in that it is only temporary. Patients do not experience symptoms during spring and summer when natural light levels are higher. Rather, the symptoms are limited to the lower light months and resolve on their own once the light levels begin to increase. 

Who is at Risk for SAD? 

The National Institute of Mental Health has given guidelines outlining those at greatest risk of developing Seasonal Affective Disorder.

According to their guidelines, the further one lives from the equator, the greater their risk of developing SAD. It also disproportionately affects females. Women are diagnosed with SAD four times as often as men. Individuals with family history of other depressive illnesses are also more likely to show symptoms. 

Since Missouri is approximately 2,658 miles from the equator, residents are at a higher risk of SAD than those living in more southern states. However, the risk is not as great as in more northern states. 

Symptoms of SAD 

Symptoms of SAD commonly overlap those of other depressive disorders. The main difference is that SAD is only temporary, while other depressive disorders exhibit symptoms year round. Seasonal blues symptoms may include:  

• Low energy

• Oversleeping (hypersomnia)

• Cravings

• Weight gain

• Irritability

• Heaviness in limbs

• Social anxiety or withdrawal

• Mood Swings 

• Feeling sleep deprived even after getting excessive amounts of sleep

• Having trouble falling asleep or suffering middle-of-the-night insomnia

Treatment Options 

There are multiple treatment options available for Seasonal Affective Disorder. Each individual case should be considered when determining which combination of treatments will be most effective. 

Phototherapy

Phototherapy is the most widely known treatment for SAD. It is also known as light therapy. The Somnosure Education Center advocates for the use of phototherapy as a primary treatment for winter depression.

In an article on SAD causes and treatments, they state,

“The Seasonal Affective Disorder Association estimates that phototherapy is effective for 85 percent of users after two or more weeks of application, which requires users to expose themselves to artificial light units for around an hour daily...

Phototherapy is delivered via concentrated artificial light delivery systems to stimulate proper circadian rhythms.” 

While the light boxes can be purchased directly by consumers, in many cases the cost is eligible for reimbursement from insurance companies if an accompanying diagnosis is submitted. They range in strength between 2,500 to 10,000 lux. 

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy, also known as CBT, is another option for treating SAD. It is sometimes referred to as talk therapy because patients talk about their symptoms and seek relief through group and individual therapy sessions. 

Medical Daily issued a report on treatments for SAD in which it summarized a study by the University of Vermont. The study compared SAD patients who were treated with phototherapy versus patients who were treated using CBT.

They found that, “After undergoing treatment for two winters, 46 percent of subjects in the light therapy group reported depression during the second winter, while only 27 percent of those in the CBT group reported a second bout of symptoms. Those who used light therapy also reported experiencing more severe symptoms than those who talked about their anxieties in group therapy.” 

Awareness of Seasonal Affective Disorder 

Seasonal Affective Disorder is relatively common in patients living at latitudes furthest from the equator.

As the days are getting shorter, the risk of developing SAD increases.

Healthcare professionals need to be especially observant of it in their patients.

By knowing the symptoms and warning signs for SAD healthcare professionals can help their patients seek timely treatment.

Treatments should be administered based on each individual case, as different treatment combinations may prove most effective for different patients.