Seasonal affective disorder is usually distinctive in that it starts in the Fall or early Winter as the days grow darker and colder. If you are experiencing this sadness yourself, or someone you love seems to be, there are many ways to help them and get help for yourself.
"Experiencing seasonal depression is quite common, so I screen for it pretty regularly among my clients," said Shanthi Mogali, MD, director of psychiatry at Mountainside Treatment Center.
Dr. Mogali finds that the onset of these feelings very often begins in the late Fall, usually around daylight saving time. People both with histories of depression and without can start experiencing feelings of sadness and anxiety thanks to shorter days and less light, creating an overall seasonal affective feeling. "Psychiatrists should consider — if they're not already doing so — proactively addressing new feelings that occur with the seasonal changes with their clients," Dr. Mogali said. For people who have a history of substance abuse and depression, it's particularly important to examine what cravings look like and how they change when it gets closer to the Winter and holiday season.
Symptoms and warning signs
Common symptoms of seasonal affective disorder/seasonal depression include isolating yourself from peers and friends and self-medicating with substances like alcohol or prescription medications. Increased sleeping and feelings of exhaustion are other key signs. Another thing to look out for is anhedonia. "For example, if you are a social person who enjoys going to parties and networking events, and suddenly as the Winter season sets in, the prospect of those activities feels dull and disappointing — you would rather just sit at home by yourself, which is not your 'normal' — that is definitely a sign that something is up," Dr. Mogali said.
If the feelings you have during the Winter persist and get even more severe, that is a signal that something even more serious is going on. "If you're feeling hopeless and worthless, those are significant emotions associated with depression (not just the seasonal kind). Other major signs of something more serious include not being able to get out of bed and take care of yourself — perhaps you are skipping out on normal hygienic routines such as showering and brushing your teeth," Dr. Mogali said. Drinking yourself into a stupor to deal with your feelings (and being unable to stop) is another signifier for a lot of people.
And, very importantly, if you're feeling like life is not worth living, that is not seasonal blues. That is major depression.
Major shifts in mood or behavior, persistent feelings of depression, the sensation that your feelings are out of your control . . . these changes must be addressed in some way. "Often, people facing depression can recognize for themselves that they need help. They realize they aren't paying their bills on time, or that they can't leave the house, or they can't take care of their medical needs or their children. Other times, someone close to the depressed person will point out the behavior patterns to them, which can trigger their understanding that they need help. Perhaps their spouse is miserable and giving ultimatums; perhaps someone in the family has started to express concern," Dr. Mogali said.
It's important that if you are experiencing serious depression, you speak with someone as quickly as possible — particularly a healthcare or psychiatric professional. "The beauty of the internet is that you have more access to resources than ever before. Go online and google therapists in your area; visit your insurance website to search for therapists/counselors in-network, or check out ZocDoc or Psychology Today," Dr. Mogali said. Start making calls and see what fits. Then set up an appointment.
Talk therapy is a foundation to recovery: it can help you peel back the layers and identify what is really going on with you and your mental wellness. "People with depression can have cognitive distortions, so addressing guilt and shame and feelings of depression with a licensed therapist can really help understand what is driving your seasonal depression. Some people have deeper issues going on, like a trauma. Talk therapy can set you in the direction of understanding if there is indeed another issue under the surface," Dr. Mogali explained.
Some people benefit from antidepressants, but it may be better to start early, as the medication can take around six to eight weeks to become effective. "If you know you're susceptible to depression during the Winter, consider speaking to your doctor well in advance about your concerns and to make a plan," Dr. Mogali said.
For people who specifically experience seasonal affective disorder (SAD), one treatment option with proven efficacy is light therapy. "It involves allocating time to sit with a special lamp that is meant to substitute natural light. Essentially, the light enters your retina and tricks your brain into thinking it is getting more light during the course of the day," Dr. Mogali said.
Natural treatment options
Nutrients can help! Vitamin D, rhodiola, and SAM-e are all natural mood boosters. "Low levels of vitamin D have been associated with feeling blue. Make sure to eat a vitamin-D-rich diet, with foods like salmon, fortified milk, eggs, yogurt, and cheese, or from vitamin D supplements," said Lindsey Bristol, MS, RD, coauthor of The Sexy Abs Diet, and registered dietitian with Swanson Health Products. The herb rhodiola rosea can help boost serotonin levels, which helps impart a sense of contentment and mental ease. "Rhodiola is also an adaptogen, which can help fight the mental and physical effects of stress. Rhodiola is tough to get from food, so look for a supplement like Swanson's Rhodiola Rosea root," Bristol said. S-adenosyl methionine (SAM-e) is a nutrient that's found in essentially every cell in our bodies. "It promotes vital neurotransmitter production to help optimize serotonin and dopamine. Try to get 200 to 400 mg every day," Bristol added.
Another option for people experiencing SAD — and, really, depression in general — is exercise. "Feelings of low self-confidence and unhappiness can arise when people are more sedentary, which can happen during the Winter. People should find ways to stay active during this time to benefit from the natural endorphins released through physical fitness," Dr. Mogali said.