GoodTherapy | Feeling SAD?

Once we turn the clocks back in the fall and the hours of daylight get shorter, people might start to notice these concerning symptoms. See if any of this sounds like you starting in mid-November that gets better in the spring:  

• Depressed mood more often than not 

• Loss of interest or pleasure in activities once enjoyed 

• Increased appetite, especially for carbohydrates 

• Increased restlessness or not wanting to move 

• Worthlessness or feelings of guilt 

• Difficulty concentrating or making decisions 

• Thinking about dying or suicide 

You are not crazy, and you are not alone. There are biological reasons for why our moods get worse in the winter. And there are ways to lessen these symptoms.  

If you checked off several of these, you may be experiencing Seasonal Affective Disorder (SAD). About two thirds of individuals that are diagnosed with depression will also experience SAD during the winter months. Some people without symptoms throughout the rest of the year experience this type of depression when it is darker outside. Symptoms typically get better starting in March with more hours of daylight, but you don’t have to wait until then. 

Why Seasonal Affective Disorder (SAD) Happens

There are several real reasons why SAD happens. One has to do with the overproduction of melatonin. This is a hormone that increases drowsiness in response to darkness. In the winter months, there are less daylight hours as well as decreased levels of sunlight because the sun is lower on the horizon. Sunlight helps our skin produce vitamin D which allows us to absorb calcium that aids bone growth. Low levels of vitamin D can make fatigue, muscle pain, ability to fight infection, and depression worsen. Additionally, people with SAD may have difficulty regulating serotonin, the feel-good neurotransmitter that affects our mood, appetite, and sleep. Studies have shown that sunlight keeps serotonin levels high by decreasing serotonin transporter (SERT) activity. Those who have SAD are found to have higher levels of SERT in the winter, which also can lead to depressive symptoms and poor mood regulation. Medications known as anti-depressants work by blocking SERT. They enhance the effects of serotonin, which is believed to reduce symptoms of depression. 

Less sunlight decreases serotonin activity which increases depression. The combination of these factors is a recipe for low mood, energy, and desire to take the very steps that make us feel better.  

If you or someone you love has a hard time in the winter, take action now. Being proactive can reduce the onset and impact that less sunlight has on us. Some people don’t notice SAD’s effects as much in December as we are distracted by the holiday season, setting up for a crash in January. The following tools may help to reduce and cope with the symptoms of SAD: 

• Monitor your vitamin D levels. In the colder months, we spend less time outside, often becoming deficient. Try to get at least 15 minutes a day of natural sunlight. Do not put on sunscreen for this short time as sunscreen blocks the production of vitamin D. If your levels are low, your doctor can prescribe a high dose of it to bring levels back quickly. Vitamin D is a supplement that is available over the counter. You can also increase your levels by eating foods rich in vitamin D. These include fatty fish, almonds, cheese, egg yolks, mushrooms, and fortified foods like milk, yogurt, cereal, and orange juice.

• Re-evaluate medication. If your symptoms are severe, consider taking an anti-depressant for this portion of the year. If you are already on medication, it may make sense for your provider to increase your dose or add another medication during the winter months.  

• Identify other medical issues. Your healthcare provider can rule out medical issues like hypothyroidism, anemia, infections, and mononucleosis that have symptoms similar to those listed above. 

• Take your vacation in the winter instead of the summertime. Travel to the southern latitudes. The closer you are to the equator, the more exposure you get to the benefits of the sun.  

• Consider therapy if SAD’s symptoms are affecting your activities of daily living. A therapist can help develop coping skills and offer accountability for healthy outlets when motivation is lower. 

The day with the least hours of daylight is the winter solstice which occurs on December 21st. Every day after we add a few more minutes of sunlight. Remembering that this is just a season and trying some of the suggestions above can help reduce feeling SAD. 

Cyndi Turner, LCSW, LSATP, MAC is the Co-Founder & CEO of Insight Into Action Therapy and Insight Recovery Centers. She is a harm reduction therapist who has been treating substance use disorders for three decades.  She designed the Alcohol Moderation Assessment which predicts who may be a successful candidate for alcohol moderation. Cyndi is the author of numerous articles and three books including The Clinician’s Guide to Alcohol Moderation: Alternative Methods and Management Techniques and Practicing Alcohol Moderation: A Comprehensive Workbook.  

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.