Seasonal Affective Disorder: Beyond the Winter Blues

Learn the truth behind SAD — and what you can do about it

For some, spring seems like a distant dream during the short, dark days of winter — and not just because of biting cold or impending storms. These people suffer from seasonal affective disorder (SAD), a distinct type of depression, says clinical psychologist Beth G. Dixon, PsyD, of Cleveland Clinic’s Center for Behavioral Health.

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How can you tell if you have more than just the winter blues? And if it is SAD, what can you do about it? Dr. Dixon offers advice below.

How do you know it’s SAD?

Many people experience a post-holiday letdown or dwindling energy and motivation in the winter, Dr. Dixon says. But SAD goes much further.

“Seasonal Affective Disorder is a type of mood disorder that goes beyond the ‘blues,’ with profound depressive symptoms that affect daily functioning and the ability to enjoy life,” she says.

The seasonal pattern distinguishes SAD from other types of depression. It typically starts in fall and lasts until spring. People with nonseasonal depression often have insomnia and loss of appetite, but those with SAD tend to experience extreme sleepiness and increased appetite and weight gain. They also may feel a heavy, “leaden” sensation in the limbs. But SAD and nonseasonal depression have common features, too, including a loss of interest, sense of hopelessness, lack of energy, social withdrawal and irritability.

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What if you think you have SAD?

People with SAD symptoms should seek help from a mental health professional or their primary care physician, Dr. Dixon says. There is no test for SAD, but doctors will look at your history to see if you have more episodes from the fall to the spring, among other things.

Left untreated, SAD tends to get worse over the season. “I tell people with a [SAD] history to prepare to start treatment in the early fall, don’t wait until the middle of winter when the symptoms are in full swing, affecting your daily life,” Dr. Dixon says.

What can you do to treat SAD?

Light therapy is often the first line of treatment, Dr. Dixon says. Light therapy uses certain types of light to mimic the sunlight that too many of us miss during winter.

“The effectiveness of light therapy is fairly quick, with individuals typically reporting improvement within a few days to a week of starting the therapy, in contrast to antidepressants that can take several weeks,” Dr. Dixon says. However, in severe cases, antidepressants offer more benefit than light therapy alone.

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A few issues may make light therapy inappropriate: medications that make you sensitive to light, certain eye issues or a history of bipolar disorder. Talk to your doctor to identify these issues and help minimize potential side effects such as headache, eye strain and insomnia. Typically, people start with a 15-minute early morning session in front of a 10,000-lux light box (available at retail).

On top of light therapy, Dr. Dixon recommends regular exercise, getting outdoors daily, and eating foods that sustain your energy (steer clear of simple carbs that rapidly metabolize). Cognitive behavioral therapy — an approach that helps you develop adaptive behaviors and thought patterns about winter — can also help, particularly in combination with light therapy.

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