What is SAD and how do you cope?

Less sunlight in winter can trigger seasonal affective disorder

What is SAD and how do you cope?

As fall turns to winter and it gets dark earlier, many people will begin grappling with seasonal affective disorder (SAD).

SAD is a type of depression that happens most often in the fall or winter and is more common in the northern regions of the United States than it is the southern regions. As days get shorter, research indicates the diminishing sunlight may trigger a chemical change in the brain that leads to depression symptoms.

It is more common in women than men and more common among people over the age of 20. If affects an estimated 10 million Americans.

Find a doctor: Behavioral health care at Sanford Health

Jonathan Aligada, Psy.D., is a clinical psychologist at Sanford Health Detroit Lakes Clinic in northwest Minnesota. As someone who provides care to a community where the nights get long this time of year, he is familiar with the challenges presented by the onset of winter.

Dr. Jonathan Aligada headshot
Dr. Jonathan Aligada

“I use the metaphor of preparing for cold weather,” Dr. Aligada said. “When we get dressed for cold weather, we put on multiple layers. People have the ability to socialize this time of year — we have gatherings to look forward to like Thanksgiving and Christmas. These can be layers of protection for people against depression.”

Risks and signs of SAD

Research has not completely nailed down the causes of seasonal affective disorder, but less sunlight and shorter days are thought to be linked to a chemical change in the brain.

Melatonin, a sleep-related hormone, also has been linked to SAD. The body naturally makes more melatonin when it’s dark. So when the days are shorter and darker, more melatonin is made.

“Less sunlight may also contribute to decreased levels of serotonin,” Dr. Aligada said. “Serotonin is another brain chemical that plays a role in mood, appetite and sleep.”

Symptoms of SAD include:

  • Low energy
  • Excessive sleepiness (hypersomnia)
  • Decreased ability to focus
  • Weight gain
  • Craving for carbohydrates or sweets
  • Loss of interest in activities you used to enjoy
  • Social withdrawal

“It’s in the category of mood disorders — we would diagnose it as a major depressive disorder episode or part of a bipolar disorder episode,” Dr. Aligada said. “But the trigger for it in this case is the change in season.”

Treating SAD

Psychologists attempt to put depression in context by understanding when patients are first noticing symptoms. When it becomes clear these symptoms are showing up in the fall, providers have several options for treatment.

Light therapy is considered the first line of treatment for SAD, Dr. Aligada said.

“Light therapy should consist of a special lamp that is rated at 10,000 lux for 30 minutes a day,” he said. “Ideally, this would be started before the sun comes up to extend the amount of time that person is exposed to bright light. “

Other treatments for SAD can include:

  • Exposure to sunlight. Spending time outside or near a window can help ease symptoms.
  • Cognitive-behavioral or interpersonal therapy. It helps change the distorted views you may have of yourself and the environment around you. It can help you improve relationship skills. And it can help you identify things that cause you stress and learn how to manage them.
  • Prescriptions. There are medicines that can help correct the chemical imbalance that may lead to SAD.

Add layers of protection

You can be creative about how you combat the symptoms of seasonal affective disorder, Dr. Aligada said.

In addition to getting more light – from the sun or a therapeutic lamp – there are also things you can do for yourself to help ease symptoms:

  • Get help. If you think you may be depressed, see your primary care provider as soon as possible. If you or a loved one is in a crisis and need help, call 988.
  • Set realistic goals. Don’t take on too much. Break large tasks into small ones, set priorities, and do what you can as you can.
  • Spend time with others. Try to be with other people and confide in someone. Let your family and friends help you.
  • Do things that make you feel better.
  • Get regular exercise.
  • Eat healthy, well-balanced meals.
  • Stay away from alcohol and illegal drugs. These can make depression worse.
  • Delay big decisions until the depression has lifted. Talk over any big decisions that need to be made with others who know you well.
  • Be patient with yourself. People don’t often snap out of depression. But they can feel a little better day by day.

“There are things you can do to keep the winter moving,” Dr. Aligada said. “Society puts things in place for us to make it a little bit easier. This winter, I’d really encourage people to be intentional and proactive about creating meaningful activities and nurturing healthy relationships on a consistent and ongoing basis.”

Learn more

Posted In Behavioral Health, Detroit Lakes, Family Medicine, Healthy Living, Internal Medicine