Column by Amy Marschall, Psy.D.

We have officially entered the Autumn season in the midwest, which means hot drinks, cool weather, and cardigans. As the days get shorter, though, many people find themselves feeling down, irritable, and exhausted. Low sunlight impacts each person differently, but some people feel this shift more than others.

Many people are familiar with Seasonal Affective Disorder (SAD), a type of depression manifests during the shorter days of winter. But what is SAD, and what can you do if you are experiencing symptoms?

What is Seasonal Affective Disorder?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes SAD as a subtype of Major Depressive Disorder. In a clinical setting, SAD is known as Major Depressive Disorder with Seasonal Onset. Basically, someone who experiences major depressive episodes following this seasonal pattern has SAD.

A major depressive includes at least five of the following symptoms:

• Depressed mood (feelings of sadness, hopelessness, or just feeling “down) most or all of the day
• Loss of interest in activities you used to enjoy
• Changes in appetite, either eating significantly more or less than usual
• Changes in sleep patterns, either sleeping much more or less than usual
• Changes in movement, either becoming agitated and fidgety or sluggish
• Significant fatigue or loss of energy
• Feelings of guilt, shame, or unworthiness
• Difficulty with concentration, focus, decision making, or other tasks that require thinking
• Thoughts of death or suicide (If you or someone you know is experiencing suicidal thoughts, call the Lifeline at 1-800-273-8255 for immediate support.)

Experiencing five of these symptoms for two weeks or longer meets criteria for a depressive episode. Typically, those experiencing SAD will have these symptoms either continuously or for most of the time during the fall and winter months.

I Feel Down, But I Don’t Know If I Meet Criteria for SAD.

Many people experience a drop in mood during the winter months but do not necessarily meet the full diagnostic criteria for SAD. Some changes in mood are typical and expected, and you can still take steps to improve your mood and self-care even if you do not meet criteria for a depressive disorder. There is no minimum struggling to get some support.

If you find your energy levels, mood, or alertness changing during the shorter days of winter, here are some things you can do:

• Invest in a SAD lamp. There are lamps that imitate sunlight and “trick” your brain into thinking it is getting more sun. This article provides information on choosing and purchasing a SAD lamp.
• Connect with people you care about. Make a point of spending time (virtually if necessary) with the important people in your life. Social connections boost mood, and social support can help people get through difficult times.
• Follow a schedule. If you are able to keep a similar schedule each day, try to go to bed and wake up around the same times, and eat meals at consistent times. Consistency helps your mind maintain self-care patterns even when you are having a difficult time.
• Reduce alcohol or drug use. Alcohol is a depressant, and even though it can seem like it lifts your mood, the long-term effects can contribute to these symptoms. Other substances can trigger depressive episodes or other mental health symptoms. If you feel you need support for your substance use, information about treatment is available here. 
• Move around. Even if it is just in your home, find ways to move your body for about 30 minutes per day. This helps with fatigue and low moods associated with SAD.
• Get sunshine when you can. Even though there is less sunlight during winter months, you can still take advantage of the light during the shorter days. Sit by a window, or if the weather permits, spend a few minutes outside to improve your mood.
• Rule out medical issues. Mental health is health. Your brain is an organ, and it interacts with the rest of your body. Low vitamin D, thyroid problems, and stomach issues can cause symptoms that look like depression. The low light in winter can impact vitamin D levels, and other medical conditions can be exacerbated. Your primary physician can do blood work to see if any medical issues could be impacting your mental health symptoms.

Can I Get Treatment for SAD?

Like other mental health conditions, support is available! SAD is treated similarly to other forms of major depressive disorder. Therapy services can treat SAD, and you might benefit from having a therapist that you see for support around the time that your symptoms emerge each year for ongoing support, or you might continue to see them the rest of the year to work on skills that can benefit you in the winter.

People with SAD might also take antidepressant medication. You can talk to your physician about the decision of whether antidepressant medication is right for you.

It can be frustrating to struggle with your mental health, but there are steps you can take to alleviate your symptoms. If you need additional support, treatment is available – whether medication, therapy, or a combination of the two is the best fit for you, you can get on the best path for your treatment.