Everything you need to know about Seasonal Affective Disorder

By Smriti Joshi, Lead Psychologist, Wysa

Every year with the onset of fall and winter, many people find themselves experiencing symptoms similar to depression. They may feel sad, lonely, hopeless and fatigued. This isn’t just a case of winter blues. Seasonal Affective Disorder or SAD is a type of recurrent depression which occurs during the same season every year, usually in autumn and winter, and resolves by spring.

For many people, this change of seasons means adjusting to the reduced levels of sunlight, the days becoming shorter, and a change in how much we can go out and socialize with other people. This can affect your mood and circadian rhythm. Seasonal Affective Disorder can also occur in the summer and is called summer depression, but this is much less common.

Symptoms of Seasonal Affective Disorder

People diagnosed with SAD have mood changes and symptoms as seen in people with depression. The symptoms may vary from mild to severe in intensity as is the case in depression as well, and include the following:

• Physical sensations such as lethargy or over tiredness
• Feelings of sadness, anxiety, despair, hopelessness, irritation, and depression
• Loss of interest in activities you once enjoyed
• Oversleeping or hardly sleeping at all
• Having trouble concentrating or making decisions
• Lack of energy and fatigue
• Low motivation
• Changes in appetite, usually eating more, craving carbohydrates and weight gain
• Feeling worthless or guilty
• Thoughts of death or suicide
• Increase in purposeless physical activity (e.g. inability to sit still, pacing, handwringing) or slowed movements or speech. These actions must be severe enough to be observable to others

⚠️If you or someone you know is having suicidal thoughts, help is at hand. Please visit this list of helplines and resources for different countries.

All these symptoms can make it difficult to complete daily tasks, especially those related to work. SAD can creep up on us quite suddenly. While it is hard to notice how much the changes in weather are affecting us on a day-to-day basis, SAD has a visible impact on our ability to manage work-life balance and be productive.

While those with winter SAD tend to oversleep and overeat, summer SAD often has symptoms such as insomnia, poor appetite, weight loss, agitation and anxiety. Summer SAD is linked to heat and humidity. Research also suggests that mood-regulating compounds like norepinephrine, serotonin and dopamine are linked to regulating body temperature as well. Many researchers expect that there will be more mood variations as the impact of global warming increases.

Causes of Seasonal Affective Disorder

Approximately 5% of the US population experiences Seasonal Affective Disorder every year, with symptoms present for about 40 percent of the year. Although the condition is limited to certain seasons, patients may experience significant impairment from the associated depressive symptoms. SAD is more common among women and young adults.

Other risk factors for SAD include:

• Family history:
  People with SAD may be more likely to have blood relatives with SAD or another form of depression.
• Having major depression or bipolar disorder:
  People who have any of these conditions are more likely to have SAD than those who do not.
• Living in latitudes far from the equator:
  SAD is more common among people who live far away from the equator. This may be due to reduced exposure to sunlight during winter. It is believed that this lack of sunlight leads to an imbalance in the production of hormones such as melatonin and serotonin which affect sleep and mood respectively. It also disrupts the body’s internal clock.
• Low levels of vitamin D:
  People experiencing SAD are often deficient in Vitamin D. Reduced sunlight and lack of vitamin D from food may result in low levels of vitamin D in the body.

Diagnosis and treatment of Seasonal Affective Disorder

In the Diagnostic Manual of Mental Disorders (DSM-5), Seasonal Affective disorder is listed as a type of depression – Major Depressive Disorder with Seasonal Pattern. The diagnosis of SAD can include both physical and psychological evaluation to rule out other conditions. You may be diagnosed with SAD if you have seasonally trackable episodes of major depression occurring at the same time over a period of at least two years.

Its treatment usually includes a combination of the following:

• Bright light therapy: Also called phototherapy, bright light therapy is one of the first-line treatments for SAD. It requires exposure to a bright artificial light (called a SAD lamp or light therapy lamp or light box) that mimics natural outdoor light for a fixed duration in the morning after waking up. Most patients experience clinical improvement within a couple of weeks of starting this treatment. To avoid relapse, light therapy should be continued until spontaneous remission of symptoms in spring or summer.
• Medication: People experiencing SAD are often Vitamin D deficient so taking supplements, along with using special light therapy lamps, and Cognitive Behavioral Therapy (CBT) has proven to be effective treatment options. In some cases, antidepressant medication can also be necessary to relieve SAD symptoms. 
• Psychotherapy: Research has shown that a type of psychotherapy called cognitive behavioral therapy (CBT) is effective in treating SAD. It can help you recognize and change negative thought patterns and manage stress better. It can also aid in learning healthy ways of coping with SAD, such as getting regular exercise and sleep. 

Self-care tips to manage Seasonal Affective Disorder

There are some self-care remedies you can follow to improve symptoms of Seasonal Affective Disorder:

• Get as much natural sunlight outdoors as possible. For instance, you can go out for a daily walk during the daylight hours.
• Ensure that you get regular exercise as physical activity can reduce stress and improve your mood.  
• Make your office and home well-lit and bright by opening curtains and blinds and removing objects that block sunlight. Sit close to windows during the day.
• Follow a regular sleep schedule, where you go to bed and wake up every day. Avoid napping and oversleeping.
• Eat a well-balanced diet with enough vitamins and minerals, even if you are craving starchy and carbohydrate-rich foods.
• Plan ahead for what you can do if SAD symptoms get worse. Monitor your symptoms so that you can start treatment early if you already know when they usually begin.

For summer SAD, frequent cold showers or baths can help, as well as taking an early morning walk. Wearing dark glasses and drawing curtains to lessen exposure to light, heat and humidity can also bring relief. 

How can employers help with SAD?

In colder and darker regions, HR departments are generally aware of the effects of Seasonal Affective Disorder, but the pervasiveness and severity of symptoms are still not fully understood. Companies might bring out light boxes when October hits, but people affected by SAD each year need multi-faceted care. If you have employees in regions with a high frequency of SAD, especially remote workers, it is essential to monitor their symptoms, provide information and offer digital mental health solutions so that they receive effective treatment and symptoms do not worsen. 

The major signals to watch out for are lack of attentiveness, exhaustion, or a decrease in engagement in meetings, communication platforms and email. Look for any changes in behavior or temperament that might indicate your employee is struggling. It is better to catch SAD symptoms early before a person is too fatigued and depressed to take care of themselves. 

Employers need to be prepared for the changes they see happening every year. At an infrastructural level, this means installing sun lamps or warm lights which can physically help with SAD as employees transition back to offices. It is also important to offer mental health resources to employees. 

Solutions such as Wysa, an AI-based interactive platform that delivers mental health support based on CBT techniques, can be particularly effective in treating SAD when paired with appropriate treatments. They can provide effective and more accessible avenues to treatment, especially for those working from home or in high-stress fields with limited time and energy to seek care. 

With Wysa, employees can get help anywhere at any hour of the day rather than waiting for an appointment. This sense of companionship and being able to talk to someone at any point in the day offers a great deal of comfort for individuals with SAD, who commonly face challenges such as loneliness, depression and sadness. It can prevent mental health conditions like SAD from worsening and affecting the quality of life and productivity. It has resources on productivity to improve motivation, morning mindfulness meditations to help those with SAD feel more centered and grounded, and sleep stories and sounds to regulate sleep and circadian cycles. You can check out the services provided by Wysa by visiting us at https://www.wysa.io/for-individuals and https://www.wysa.io/for-employers