Seasonal Sadness

No matter how much you love snow, a roaring fire or a hearty bowl of stew, less daily sunshine, more layers of clothing and icy roads that force you to stay indoors can make anyone feel a little blue. But for some, a biochemical imbalance in their brain causes a seasonal depression that feels so overwhelming that it interferes with daily functioning. 

According to the American Psychiatric Association, around five percent of adults in the U.S. experience seasonal affective disorder (appropriately abbreviated as SAD), which typically lasts about 40 percent of the year. Technically, SAD is not considered its own diagnosis. Instead, it’s a type of recurring major depression with a seasonal pattern. 

“People naturally experience a decrease in energy and motivation, and some decrease in their mood over the winter due to less sunlight and cooler temperatures reducing their motivation to be active,” explains Yesi Yoon, a doctor and psychiatrist at Clearwave Mental Health. “But seasonal affective disorder is a little more than just the winter blues. It affects your ability to accomplish your daily tasks at home or work and your desire to interact with others. To receive this diagnosis, your symptoms must occur during a specific season, most likely during the winter, for at least two consecutive years. So, if you had just one winter that you were feeling down, but the next winter you did pretty well, then you wouldn’t qualify for a diagnosis of seasonal affective disorder.”

Do I have SAD?

“If, as the days get shorter, you begin feeling drowsier, your mood changes, you feel less energetic and your appetite changes, you may be struggling with seasonal depression,” says Ashleigh Miller, an LCSW based in Stamford. “Other symptoms include a decrease in your sex drive, general grogginess, social withdrawal, trouble thinking clearly, an inability or decreased ability to focus and even headaches.” 

SAD most commonly begins between the ages of 18 and 30 and affects more women than men.

Other symptoms include:

• Changes in your sleep, usually an increase.
• Difficulty thinking, concentrating or making decisions.
• Eating more than before and craving carbohydrates.
• Feeling worthless or guilty.
• Lack of energy, even though you are sleeping more.  
• Lack of interest or pleasure in participating in activities you previously enjoyed.
• Moving or speaking so much slower that people comment on it.
• Struggling to sit still, pacing back and forth or doing other physical activities without a purpose. 
• Thoughts of death or suicide.

Not everyone diagnosed with SAD will have every symptom, and you may experience some symptoms more intensely than others. But if you experience a depression that begins and ends during a specific season for at least two years (while less frequent, SAD can occur in the summer), or if you’re having more seasons with than without depression, then you’d likely be diagnosed with the disorder. 

“If you’re lucky, you’ll have a close enough relationship with somebody who can say, ‘Hey, what’s up with you?’” says Miller. “But typically, it tends to be more of an awareness we have on our own. It’s a feeling within yourself – you’ll notice you’re not as productive or don’t feel like doing the things you enjoyed before. It could be that you don’t feel like taking care of your kids the same way, making the same dinners, cleaning the house or even doing laundry. It’s a depletion of motivation.”

What can I do to treat it?

If you think you may have SAD, Yoon says the first thing to do is talk to your health care provider, whether it’s a primary care doctor or your mental health professional if you are currently seeing someone. 

“Please do talk to them first,” she recommends. “But also, at the same time, there are things you can do to lift your mood and decrease the effects of seasonal affective disorder. Since a decrease in light is the main cause, you can purchase a light box and begin light therapy. But make sure your light is at or above 10,000 lux, which is the amount of light that comes out. If it’s lower than that, it’s not very effective.”

Also, you’ll need to sit in front of the light daily for 30 to 40 minutes. 

“Most people do this first thing in the morning,” Yoon explains. “While they’re getting ready or having breakfast, they will turn on the light box and place it next to them. Or they’ll turn it on right when they get into the office while they’re checking emails and working at their computer. The earlier in the morning, the better. That way, you have a better chance of enjoying the effects of light therapy throughout the day. And be careful about using your light box in the evening because it can affect your sleep schedule. Your circadian rhythm is determined by a decrease in the light in the evening, so this could keep you up.”

Yoon also recommends getting your vitamin D levels checked by your primary care physician and taking a supplement if you’re low. 

“Increasing your vitamin D can elevate your mood, activate your motivation and increase your energy,” she says.

Another option is to bundle up, leaving your face exposed (to capture that vitamin D), and get outside while the sun is shining. Take a walk, play a game (anything from tag with your kids to soccer with some friends), go for a light jog, etc. Getting fresh air and exercising is always good for you, especially when you’re feeling depressed.

“Having the winter blues or seasonal effective disorder will decrease your motivation to move – your mind and body are talking to each other,” Yoon explains. “Your mind is telling your body to slow down, but you can reverse it by moving your body. It will motivate your and increase your energy. So, going outside, as long as it’s safe, is always a good idea.”

You should also do what Miller calls “scheduling opportunities for joy.”

“If you’re always feeling bummed around 4:00 p.m. as the sun starts to go down, think about what you can schedule in at that time that’s different from your daily routine,” she recommends. “Can you have a chat with a friend? Can you plan to meet somebody for coffee or tea? Can you take your kids out to do something? Whatever it may be, schedule an opportunity for joy if you know you tend to feel down at a certain hour.”

Seeking professional help

Working with a mental health professional is another key treatment component. A good therapist is one who you feel comfortable talking to and who provides you with helpful advice. You won’t connect with everyone, and many professionals have limited (if any) openings, so call around and make several introductory appointments. When you find a clinician who is a good fit, cancel your other introductory appointments so someone else can move up on the list and potentially find their person.

“When you find yourself unable to function in your roles, that’s a very clear indicator of when it’s time to seek professional help,” Miller advises. “We all have our issues, but when you really find yourself struggling to do things, like get in the shower, get dressed and go to work, or when you’re saying no to your friends and you stop showing up, then it’s time to speak with a professional.”

While antidepressants are often part of a treatment plan for chronic depression, it’s rare for a person to take them for a few months a year. To treat SAD, many professionals will use a therapeutic approach called cognitive behavioral therapy, or CBT. 

“In CBT, we talk about how thoughts, feelings and behaviors are all connected,” Miller explains. “Or we’ll talk about and identify stressors, then discuss how to manage those things in a way that makes sense to that person. Because no two people are alike or have the same symptoms, no two treatment plans will be exactly the same.”

If you experienced SAD the previous winter and worked with a professional you liked, put a note in your calendar to call towards the end of August to book appointments for approximately one month before your symptoms began. Getting ahead of it can prevent you from struggling as much as you did the previous year.

Seasonal tips for everyone

Whether you struggle with seasonal depression, the winter blues or had a few bad days or weeks, Yoon says that knowing strategies to lift your spirits during the darker winter months can help everyone. 

“Try something new, be more active, make commitments to go out to lunch with friends and maximize those daylight hours,” Miller recommends. “And designate a friend you trust to have that honest conversation about how you’re feeling and how the changing seasons are impacting you. It’s far more widespread than I think people realize. Because people don’t check in enough with one another, they think everyone else is doing better than they are.”

This article was published in the November/December 2023 print edition of Connect to Northern Westchester.