Seasonal Affective Disorder: When it’s not all pumpkin spice and everything nice

Sep 16

We are breezing through September, with Labor day officially in the past. This means the leaves are changing, the sunlight is getting shorter, and it’s time to proudly order your pumpkin spice latte. For many people, fall feels comforting. You’re wrapped up in a chunky sweater with the cooler temperatures. Football games (Go Birds!), warm drinks, holidays, and evenings spent at home can make the season feel like a welcome change. However, for some people, the transition into fall brings another kind of change that looks like lower energy, less motivation, changes in sleep, increased cravings, social withdrawal, and a noticeable shift in mood.

If you find yourself thinking, “I don't know what's wrong with me. I just don't feel like myself this time of year,” there may be more going on than simply needing a lil more vitamin D. You may be experiencing Seasonal Affective Disorder (SAD).

What Is Seasonal Affective Disorder?

Seasonal Affective Disorder, commonly called SAD, is a type of depression that follows a recurring seasonal pattern. This is also typically known or referred to as seasonal depression. The most common form is fall- and winter-pattern SAD, in which symptoms typically begin in the late fall or early winter and improve during the spring and summer. There is also a less common form called spring- and summer-pattern SAD, in which depressive symptoms occur during the warmer months. The important distinction is that SAD is more than occasionally feeling gloomy on a rainy day or wishing summer would last a little longer. SAD can affect your mood, energy, sleep, appetite, concentration, motivation, relationships, and everyday functioning. Because it can develop gradually, you may not immediately recognize that something has changed.

SAD vs. the “Winter Blues”: What's the Difference?

It's completely normal to have days when you're less energetic, less motivated, or simply not feeling your best. After all, the sun sets earlier, and in Jersey, the weather becomes cold enough where it feels nice to sit inside binge watching Netflix. Rather than go somewhere, you have your dog and a spot on the couch. You are comfy with your cup of cocoa. This isn’t necessarily seasonal depression. What differentiates having less motivation from SAD is the severity, duration, and impact.

With SAD, symptoms can become persistent enough to interfere with work, school, relationships, self-care, or the activities you normally enjoy.

You might notice:

You're sleeping significantly more than usual.
You're exhausted even after getting plenty of sleep.
You don't feel interested in things you normally enjoy.
You're withdrawing from friends or family.
You're having difficulty concentrating.
You're eating more or experiencing strong carb/sugar cravings.
You're feeling hopeless, down, or unusually irritable.
Everyday responsibilities suddenly feel much harder.
You feel like you're “hibernating” through the season.

What distinguishes this from regular depression is SAD comes up the same time every year and follows a pattern.

What Does Seasonal Depression Feel Like?

SAD doesn't always feel like what we traditionally imagine depression to feel like. I have clients tell me “well I can go to work every day, and I’m not crying.” This doesn’t mean you don’t have SAD. SAD can actually look and sound like the following:

“I'm just so tired.”
“I don't want to do anything.”
“Why does everything feel like so much work?”
“I just want to stay home.”
“I can't seem to get motivated.”
“I'm sleeping all the time.”
“I don't feel like myself.”
“I'll feel better once spring comes.”

The last one, “I’ll feel better in the spring” is probably the biggest clue that this is SAD rather than depression. However, even with SAD, there is no need to be like a bear and hibernate for the season. You can get treatment to feel better.

Why Does SAD Happen?

There isn't one single explanation for why someone develops Seasonal Affective Disorder. Researchers believe that changes in daylight exposure, circadian rhythms, serotonin, and melatonin may play a role in winter-pattern SAD. As daylight decreases in the fall and winter, your body's internal clock can be affected. Changes in daylight may also influence systems involved in mood regulation and sleep. SAD is not just having a bad attitude during the winter, and just because winter may be your least favorite season, doesn’t mean SAD occurrs. There’s more to it with biology. On top of this, your routines, activity level, sleep, social connection, stress, and thought patterns can all influence how you experience seasonal changes.

Is SAD More Common in Women?

Yes it is. Some more facts about SAD:

SAD is diagnosed more frequently in women than in men, and winter-pattern SAD is more common than summer-pattern SAD.
SAD tends to begin in young adulthood.
Other factors that may increase the likelihood of experiencing SAD include a personal or family history of depression, bipolar disorder, or SAD, as well as living farther from the equator where seasonal changes in daylight are more pronounced.

Is There a Connection Between ADHD and Seasonal Affective Disorder?

As an ADHD therapist, I came across an old study from 2016 from Wynchank and company, and I was intrigued. It actually inspired me to write this blog post, and post on social media. There may potentially be a connection between Attention Deficit disorder and SAD. This is an area that researchers have explored, although the relationship is not yet fully understood.

One older study looked at women with SAD and explored whether certain genetic differences involving the serotonin system were associated with retrospective childhood ADHD symptoms. The researchers found an association between one genetic variation and higher reported childhood ADHD symptoms within their small sample. However, this was a small, preliminary study, and it does not mean that ADHD causes SAD, that SAD causes ADHD, or that one particular gene determines whether someone will develop either condition (Wynchank et al., 2016).

Why is the ADHD connection worth talking about?

Why do I care, and why even bother if the study was small? Well, seasonal changes can disrupt many of the things that help people with ADHD function such as routine, sleep, activity, structure, stimulation, and consistency. When daylight disappears earlier and you spend more time indoors, your normal routines may change. You may be getting less movement or spending less time outside. You may be socializing less. You may have less structure after work. You may be sleeping differently (it’s truly hard to wake up when the sun is set).

If you already struggle with executive functioning, motivation, or emotional regulation, those changes can feel particularly noticeable. That doesn't mean every seasonal change in ADHD symptoms is SAD; however, it does mean that if you have ADHD and notice a significant seasonal shift in your mood, energy, motivation, or functioning, it may be worth exploring what's happening rather than simply telling yourself to “try harder.”

How Is Seasonal Affective Disorder Treated?

Light Therapy

Light therapy, also called phototherapy, is a commonly used treatment for fall- and winter-pattern SAD. It typically involves using a specialized light box that provides bright light for a specific amount of time, often in the morning. Light therapy isn't the same thing as turning on a lamp or sitting near a window, and not every light box is appropriate for everyone.If you're considering light therapy, talk with a healthcare professional about whether it's appropriate for you and how to use it safely.

Psychotherapy

Therapy can help you understand and manage the thoughts, behaviors, routines, and emotional patterns that can contribute to seasonal depression. Cognitive Behavioral Therapy adapted specifically for SAD, sometimes called CBT-SAD, incorporates strategies such as challenging unhelpful seasonal thoughts and behavioral activation.Behavioral activation is particularly relevant because depression often creates a frustrating cycle:

You feel bad → you do less → you feel worse → you withdraw more → you feel even less motivated.

Therapy can help you begin interrupting that cycle with realistic, meaningful activities rather than waiting until you “feel motivated.”

Medication

Antidepressant medication may also be appropriate for some people with SAD, particularly when symptoms are moderate to severe or recur predictably. Medication decisions should be made with a qualified healthcare professional such as your primary care physician, psychiatrist, or psychiatric nurse practioner who can consider your individual history, symptoms, and needs.

Lifestyle and Routine Changes

Small changes can also support your mental health during darker months.

Consider:

Getting outside during daylight hours.
Maintaining a consistent sleep and wake schedule.
Staying physically active.
Keeping plans with friends and family.
Continuing activities you enjoy rather than withdrawing completely.
Getting as much natural light into your environment as possible.
Paying attention to changes in your mood before symptoms become overwhelming.

These strategies aren't a replacement for professional treatment when you need it, but they can be pieces of a larger plan.

Don't Wait Until You're Completely Burned Out

One of the biggest challenges with SAD is that you may know exactly when it's coming. If every November or December you notice the same pattern of exhaustion, withdrawal, low motivation, and depressed mood, you don't necessarily have to wait until you're deep in it to do something.

Start paying attention to your patterns and get help before it hits too hard. Ask yourself the following, or talk it over with your therapist:

When do your symptoms begin?
What changes first — your sleep, energy, appetite, motivation, or mood?
What happens to your social life?
What happens to your exercise routine?
What happens to your ADHD symptoms, if you have ADHD?
What do you need during this season that you aren't currently giving yourself?

Your Mental Health Deserves Attention in Every Season 🍂

At Perspectiva Counseling, therapy can be a space to better understand your mental health, recognize patterns, and develop tools that help you feel more like yourself in every season.

Ready to start? Book a therapy session with Perspectiva Counseling today.

Resources used:

Wynchank, D. S., Bijlenga, D., Lamers, F., Bron, T. I., Winthorst, W. H., Vogel, S. W., ... & Kooij, J. S. (2016). ADHD, circadian rhythms and seasonality. Journal of psychiatric research, 81, 87-94.

Becky Ye