Prevent Seasonal Affective Disorder This Winter

It's that time of the year again. The amount of daylight is decreasing every day. Here in Seattle, the clouds, rain, and cold have moved in. People who are sensitive to the effects of weather and sunlight may notice that their moods are significantly impacted by the change in season. Seasonal affective disorder (SAD) is a common experience here in the Pacific Northwest due to our geographic distance from the equator. According to the American Psychiatric Association, SAD affects 5% of adults in the U.S. and can last on average 40% of the year. ​

The changes in weather and sunlight can impact our brain chemistry and circadian rhythm, which controls our sleep, exercise, eating patterns, and mood. I used to struggle with SAD symptoms when I first moved to the Pacific Northwest nine years ago but I have created a winter routine of coping strategies that really works for me. In this blog post, I offer some ideas for preventing and coping with SAD symptoms. 

Is Seasonal Affective Disorder Real?

A 2016 study, published in Scientific American looked at the depression rates of individuals based on geographic location, season and sunlight but found no correlations between these factors and depression. The author suggests that the scientific jury is still out on whether SAD is "real" even though it is recognized as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

Whether scientists have come to any definitive conclusions about SAD or not, you are the expert of your life. If you have noticed a pattern of struggling with symptoms of depression with the change in seasons, it may be helpful to engage in some preventative coping strategies so that you can feel your absolute best, even when it is dark and gloomy outside. 

What are the Symptoms of Seasonal Affective Disorder?

The symptoms of SAD are very similar to that of major depressive disorder, which includes:

• Feeling depressed, sad, irritable, hopeless, numb, and/or empty
• Crying spells 
• Social isolation 
• Decreased interest in the things that usually brings you pleasure
• Changes in appetite and/or weight 
• Changes in sleep patterns - sleeping too much or not enough, trouble falling asleep, waking up in the middle of the night
• Feeling restless or it takes more effort to move and do the things you usually do
• Difficulty getting out of bed 
• Decreased energy, fatigue
• Increased physical tension and pain 
• Feeling excessive guilt, worthlessness, low self-esteem
• Difficulty concentrating, making decisions, remembering 
• Thoughts of suicide and/or self-harm 
• The symptoms are significantly impacting your daily functioning, relationships, and school/work

In addition to the symptoms of major depressive disorder, the following signs are characteristic of SAD: ​

• The mood changes have a clear seasonal pattern 
• The mood changes do not seem to be related to other life stressors or changes in context
• Decrease in energy, feeling lethargic, decreased motivation 
• Increase in the amount of sleep, sleepiness, or not feeling rested after waking up from a full night of sleep
• Overeating and craving sweets or carbohydrates
• In individuals with bipolar disorder, SAD can bring on an episode of mania or hypomania as well as depression 
• While SAD is mostly associated with the fall and winter time, some individuals experience SAD in the summertime 
• Younger people and women seem to be at higher risk for SAD ​

Strategies to Prevent and Cope with Seasonal Affective Disorder

First, formal assessments by medical and mental health professionals are helpful to rule out other possible medical or mental health concerns. Your primary care provider can conduct a physical exam and run labs to determine whether you are struggling with a physical health concern, which sometimes can look like depression, and if you are deficient in your hormones or vitamin levels. Your mental health provider can assess whether your symptoms meet diagnostic criteria for SAD and/or if there are other mental health concerns present. ​

If you are diagnosed with SAD, below are some evidence-based strategies to prevent or cope with the symptoms: ​

• Light therapy - Light therapy is the use of a special light that mimics daylight. You simply sit in front of the light box for 15 to 45 minutes a day. You can engage in other activities such as reading, eating, watching TV, talking on the phone, or working while sitting in front of the light box that emits at least 10,000 lux. Researchers suggest that light therapy can be as effective as antidepressant medication, for unipolar or bipolar depression. Light therapy has relatively little side effects and light boxes are now more affordable to the general public. For instance, I have one on my desk at work and I turn it on for 15 minutes the first thing I get to the office while I am checking email. Work with your medical provider to discuss the benefits and  potential risks of using light therapy. 

• Psychotherapy - Working with a therapist who has expertise in treating SAD can help you identify the first signs of mood changes, identify the thoughts, emotions, and behaviors that are impacted by SAD, and practice effective coping strategies to decrease stress and manage your mood.

• Medical Treatment - Talk with your medical provider about traditional Western medicine, naturopathic medicine, and Eastern medicine for managing your mood. Researchers have shown that anti-depressant medications, herbal medicine,  aroma therapy, and acupuncture can be effective at preventing and treating symptoms of SAD. Traditional Chinese medicine and Ayurvedic medicine have different understandings of the mind-body connection and how to treat mood disorders. As I had shared in a previous blog post, they can be powerful treatments for a variety of mood related concerns and can be used along side traditional Western medicine.

• Exercise - Exercise has been shown to be effective in treating mood disorders in general and can be an effective way to prevent and cope with SAD. From a Health at Every Size approach, I always encourage my clients to move their bodies in ways that are joyful instead of obligatory. Enjoying movement and exercise is key to maintaining a positive relationship to exercise and to our bodies. One way to bring joy, pleasure, and excitement into movement is to trying a new physical activity. Embrace the cold weather by trying a winter sport like skiing or snowshoeing. Stay indoors and try taking a dance class (e.g., salsa, swing, burlesque, hip hop, West African, etc.), rock climbing, ax throwing, ice skating, or joining a local dodgeball team. When was the last time you played mini golf or laser tag? Also consider adding restorative and restful exercises such as Tai Chi or Yin Yoga.

• Food and Supplements - Food is medicine. Eating a balanced diet full of nutrients is supportive of mental health in general. From a Health at Every Size and Intuitive Eating perspective, the pleasure and satisfaction that we get from eating delicious food is an important part of establishing a healthy relationship to food. So eat foods that you enjoy as well as nutritious for your body. One study has found that a traditional Australian diet high in vegetables, fruit, meat, fish, and whole grains was associated with better mental health. Another study suggests a link between vegetarianism and higher risk of SAD; the participants in this study who were vegetarians were 3 to 4 times more likely to experience SAD. There is some debate as to whether vitamin D supplements are helpful with SAD symptoms. Talk with a nutritionist, a naturopathic doctor, an Ayurvedic practitioner, or a traditional Chinese medicine practitioner may help you identify foods that will be especially supportive of your body and your mood in the winter. 

Counseling to Treat Seasonal Affective Disorder

If you are seeking additional help in managing SAD or depression, our licensed therapists can help provide you with effective coping strategies. We provide treatment for SAD and depression and would love to speak with you. You can schedule a free 15-minute consultation to get started.