Each year on the morning of February 2, we wait for Punxsutawney Phil to emerge from his burrow in Punxsutawney, Pennsylvania to predict the weather. According to Groundhog’s Day tradition, if the famous rodent sees his shadow, then the winter season will linger on for another six weeks. But if Phil doesn’t see his shadow, an early spring will begin. On Groundhog’s Day 2023, Phil indeed saw his shadow and retreated back to his shelter to escape the cold. While weather predictions by a groundhog may not be the real deal; the impact of a lengthy winter can have a real impact on one’s mental health. It is called Seasonal Affective Disorder (SAD).
What is Seasonal Affective Disorder?
Seasonal Affective Disorder (SAD), as defined by the American Psychiatric Association (APA), is a form of depression; and also referred to as seasonal depression, winter blues or winter depression. Because it almost always aligns with select months, SAD symptoms begin and end at about the same times every year.
“SAD affects approximately 5% of Americans each year, and is most common among women and people living in northern latitudes in the winter months,” Jeff Gladd, MD, a practicing integrative medicine physician and chief medical officer at Fullscript, tells AmeriDisability.
Those affected by SAD experience mood changes which usually subside with arrival of spring. Yet, although less common, some may experience SAD during spring or summertime.
Symptoms of Seasonal Affective Disorder
“Patients experiencing severe SAD often describe the condition as debilitating, overwhelming and inescapable,” Gladd explains. “Because SAD is considered a form of depression, it is classified as a disability and is thus covered by the Americans with Disabilities Act (ADA).”
According to the National Institute of Mental Health (NIMH), a person with SAD may experience some (or all) of the following:
- Feeling depressed most of the day, nearly every day (during the seasonal timeframe)
- Losing interest in activities once enjoyed
- Experiencing changes in appetite or weight
- Having problems with sleep
- Feeling sluggish or agitated
- Having low energy
- Feeling hopeless or worthless
- Having difficulty concentrating
- Having frequent thoughts of death or suicide
For winter-pattern SAD, NIMH notes that additional symptoms may include:
- Oversleeping (hypersomnia)
- Overeating, particularly with a craving for carbohydrates
- Weight gain
- Social withdrawal (feeling like “hibernating”)
For summer-pattern SAD, NIMH notes that additional symptoms may include:
- Trouble sleeping (insomnia)
- Poor appetite, leading to weight loss
- Restlessness and agitation
- Episodes of violent behavior
Causes of Seasonal Affective Disorder
Experts believe that less sunlight and shorter days are directly linked to a biochemical imbalance in the brain. The reduced level of sunlight can disrupt one’s biological clock, melatonin levels and serotonin levels. These drops can impact sleep patterns and feelings.
A person may have an increased risk of SAD if he/she/they already suffers from depression or bipolar disorder, has low vitamin D levels, has a family history of depression, and/or lives in a locale where the days are shorter and darker (further from equator).
Treatment of Seasonal Affective Disorder
Treatments such as antidepressant medications, light therapy and/or talk therapy may help lessen the severity of SAD symptoms.
Light therapy, which involves the use of a lamp that emits white light designed to simulate sunlight, is a standard treatment, says Gladd. Light therapy addresses SAD symptoms by signaling the brain to reduce the production of melatonin, the primary hormone that regulates the sleep-wake cycle, and increase the production of serotonin, a hormone associated with mood regulation and wakefulness.
“Using a light therapy lamp is simple — all you need to do is turn it on for about 30 minutes, preferably after waking in the morning if you don’t have access to early morning exposure from the sunrise in the darker, winter months,” Gladd says, adding, “When shopping for a light therapy lamp, opt for one that emits at least 10,000-lux of light.”
Gladd says that supplements can also be effective. “Vitamin D plays an important role in mood regulation, and research shows that having low vitamin D status is linked to depression and SAD. Thankfully, low vitamin D levels can be corrected using vitamin D supplementation,” he assures. Vitamin D is a fat-soluble vitamin found in limited dietary sources, such as fatty fish and fortified foods. He adds, “It’s unique because the natural way we get vitamin D is by the body synthesizing vitamin D when skin is exposed to sunlight. Considering that many people in North America have less exposure to sunlight during the winter months, it can be more challenging to meet your body’s needs for vitamin D and supplementation becomes important.”
Gladd says that St. John’s wort is an herb best known for its effectiveness in addressing symptoms of depression, including SAD, however it’s important to note that it can interact with prescription medications. That’s why it’s always important to talk to your healthcare provider before introducing supplements. “Typically for my patients that have symptoms of SAD annually, we take a proactive approach by measuring their vitamin D blood levels in the fall to be sure they are on the right dose of supplementation if needed and proactively begin St. John’s wort at that time as well,” Gladd says.
Those impacted by SAD or any mental health condition may benefit from adopting a healthy lifestyle inclusive of exercise, proper dietary choice, ample sleep and social support, in addition to specific treatments outlined by one’s doctor.
With the proper diagnosis and treatment, SAD is a manageable condition. If you or someone you know is severely depressed and contemplating self-harm, please seek help immediately with the nearest healthcare provider. The National Suicide Prevention Lifeline is also available 24/7 at 1 (800) 273-TALK (8255).
FYI, data shows that Punxsutawney Phil’s six-week predictions have been right just about 40% of the time. So, maybe, Phil’s predictions will be wrong and the winter season will be shorter and more tolerable after all.
Editor’s Note: The content of this article is not intended as medical advice. Readers should seek personalized care with their own physician.