Seasonal depression is real, it may be happening to you now, and it’s treatable.
Despite seasonal depression being officially recognized by the American Psychiatric Association as a type of depression back in the 1990s, people who live with it still tend to brush it off. (“It’s nothing.”) Or they downplay it. (“I’m just feeling a little low.”) Or they simply live with it. (“It’s how I am, I’m hardwired this way.”)
None of those perceptions is very helpful to those with the condition. Seasonal depression (formally called Major Depressive Disorder with Seasonal Pattern) is serious, debilitating, potentially life-threatening, and not merely a case of the “winter blues.”
Most importantly, you can recover from it.
Changes in latitude, changes in attitude
Seasonal depression, also known as seasonal affective disorder (SAD), is triggered by a change in seasons, usually around the start of fall. It often gets worse through the winter before ending when spring arrives.
Plenty of people feel a little down in the winter months. That’s expected. You often don’t get out as much, there’s not as much sunlight, you don’t socialize or exercise as much. All these can contribute to a lower mood.
But seasonal depression goes beyond that. A serious form of depression, it affects daily life, including how you feel, think, and function.
Note: There’s a rare form of seasonal depression called “summer depression,” which has similar characteristics to winter depression, except it comes on in the spring, peaks in summer, and tends to recede in the fall. It is not clear what triggers the summer variety.
Seasonal depression is more common in women than men (researchers don’t know why), and in people who live farther from the equator. It tends to start between the ages of 20 and 30.
About 3 to 5 percent of adults in the U.S experience seasonal depression, but that frequency can vary greatly depending on latitude. For example, it affects around 1 percent of people living in Florida, and 9 percent who live in Alaska. Experts believe that up to 15 percent of the population experiences a milder form of seasonal depression that negatively affects mood, energy levels, eating, and sleep patterns.
Do I feel down, or do I have seasonal depression?
The symptoms of seasonal depression are the same as with major depressive disorder (aka depression), they just come and go seasonally. They include:
- Sadness, feeling depressed most of the day, almost every day
- Changes in appetite (eating significantly less or more than usual)
- Extreme fatigue and lack of energy
- Feelings of hopelessness or worthlessness
- Trouble concentrating
- Feeling irritated or agitated
- Heaviness in the arms and legs
- Loss of interest in activities you normally enjoy, including social outings
- Sleep problems (either insomnia or sleeping much more than usual)
- Thoughts of death or suicide
A provider may diagnose you with seasonal depression if you have:
- Symptoms of major depression.
- Episodes of depression that occur during specific seasons for at least two consecutive years.
- Episodes of depression that happen more frequently during a specific season than during the rest of the year.
Risk factors for seasonal depression
You’re at higher risk if you:
- Have another mood disorder, such as major depressive disorder or bipolar disorder.
- Have relatives with seasonal depression or other forms of depression, or have a another mental illness such as schizophrenia, substance use disorder, eating disorder, anxiety disorder, or PTSD.
- Live at latitudes far north or far south from the equator. There’s less sunlight during the winter at these latitudes.
- Live in cloudy regions.
What causes seasonal depression?
Researchers don’t know the answer to this yet. But it is likely due to one or more of these factors:
Biological clock change: When there’s less sunlight, your biological clock shifts. This internal clock—sometimes called your circadian rhythm—regulates your mood, sleep, and hormones. When it shifts, you get out of step with your daily schedule, and don’t adjust to changes in daylight length.
Brain chemical imbalance: Brain chemicals called neurotransmitters send communications between nerves. One of these is serotonin, which contributes to feelings of happiness. A person at risk of seasonal depression may already have less serotonin activity. Since sunlight helps regulate serotonin, the lack of sunlight in the winter can make things worse.
Vitamin D deficiency: Your serotonin level also gets a boost from vitamin D. Since sunlight helps produce vitamin D, less sun may mean less serotonin—and a worse mood.
Too much melatonin: Melatonin is a body chemical that affects your sleep patterns and mood. (It also comes in pill form as a sleep aid.) The lack of sunlight may stimulate an overproduction of melatonin in some people, which can make you sluggish and sleepy in the winter months.
4 proven treatments for seasonal depression
Again, this condition is not just a passing case of the “winter blues.” It’s a form of depression that knocks millions of people down every winter for months at a time.
These people—and maybe you’re one of them—need help to feel normal again. They need evidence-based treatments that work. Here are four.
Light therapy is the first-line treatment for seasonal depression. With this therapy, you expose yourself to a bright light every day during the winter months to make up for the lack of sunshine.
The technique is simple and painless: You sit in front of a light box at a brightness of 10,000 lux every day for around 30 minutes (you’ll want to work up to that). It’s most effective to do this first thing in the morning preferably before 8 am, starting in the late fall, and continuing through the winter. People often read, watch TV, or check the feeds on their smartphones while they get this therapy.
Light boxes are about 20 times brighter than ordinary indoor light, and they filter out potentially damaging UV light. People with certain eye diseases or those who take certain medications that increase sensitivity to sunlight may need to use alternative treatments.
Many with seasonal depression see noticeable improvement within days of using light therapy. Others take longer. If your symptoms don’t go away, your doctor may increase your light therapy sessions to twice daily.
Psychotherapy or “talk therapy”
Cognitive behavioral therapy (CBT) is a type of talk therapy that helps people learn how to cope with difficult situations.
CBT has even been adapted for those with seasonal depression. Known as CBT-SAD, this therapy is typically given in twice-a-week sessions for six weeks. The premise is simple, and can be quite effective: You focus on replacing negative thoughts related to the winter season with more positive thoughts.
When researchers compared CBT with light therapy, both treatments were equally effective in improving seasonal depression symptoms.
As with other types of depression, seasonal depression involves changes in the brain chemical serotonin. That’s why antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) can be effective in treating seasonal depression symptoms. Commonly used SSRIs include fluoxetine, citalopram, sertraline, paroxetine, and escitalopram.
The FDA has approved another type of antidepressant for seasonal depression called bupropion (Wellbutrin). Taken in extended-release, bupropion may prevent episodes of seasonal depression when taken daily from the fall until early spring.
All medications can have side effects. Talk to your doctor about the possible risk of using these medications for your condition.
People with seasonal depression sometimes have a vitamin D deficiency. In these cases, a vitamin D supplement may help improve your symptoms. However, studies testing whether vitamin D is effective in treating seasonal depression have produced mixed findings. Some results show it is as effective as light therapy; others show it has no effect.
Adequate treatment of co-occurring disorders like PTSD, substance use disorders, eating disorders and anxiety disorders improves depression treatment outcomes.
What You Can Do
Alongside the above-mentioned treatments, consider the following home remedies as well. Note: They’re beneficial even if you don’t have seasonal depression. They include:
Make your environment sunnier and brighter. Open blinds and curtains and sit closer to bright windows while at home, at school, in the office, or working remotely at the coffee shop.
Get outside. Take a walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun for a few minutes. Even on cold or cloudy days, outdoor light can help. Try to time it so you’re getting out within two hours of waking up in the morning.
Stay active. Regular movement that feels good to you (aka pleasurable movement) helps relieve stress and anxiety, which can both exacerbate seasonal depression symptoms. Being active also helps to boost mood.
Connect. Avoid the pull to isolate! Connect with your natural support systems, including family, friends, your spiritual or religious community and colleagues. Let people know what’s going on. You are not alone.
This will sound like a cliché but it is entirely apt for seasonal depression: The first step is recognizing you have a problem. And seasonal depression is definitely a problem.
If you suspect you may have it, ask your doctor, therapist, or an urgent care provider about the condition. This provider will help you set up a customized treatment plan that gets you on the road to feeling better all winter long.