by MCF Clinical Supervisor Ronnie Biemans, MA, LCPC
Last month, we presented options and opportunities to survive the winter doldrums. This month, we take a look at a more serious and lingering emotional and behavioral response to seasonal changes, Seasonal Affective Disorder. As described on the National Institutes of Health (NIH) website: “Seasonal Affective Disorder (SAD) is a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer. Depressive episodes linked to the summer can occur, but are much less common than winter episodes of SAD.”
In 1987, the American Psychiatric Association added SAD to their official diagnostic manual. Interestingly, just six years prior, The Washington Post featured an article that described ongoing interest and research at the National Institute of Mental Health (NIMH) that was focused on seasonal fluctuations observed in those suffering from Manic Depressive disorder. At the end of the article The Post made a pitch for the researchers, inviting those who might be suffering from a seasonal depression to contact the NIMH to be assessed as research subjects. Researchers were stunned when 3,000 replied. Clearly seasonal blues were very real, quite serious and more commonplace than previously thought. We now know that an estimated 10 to 20 percent of recurrent depression cases follow a seasonal pattern.
According to NIMH, in order to be diagnosed with the disorder sufferers must meet the criteria for major depression plus the criteria for one of the seasonal types of SAD, winter pattern SAD or summer pattern SAD.
Symptoms of Major Depression include:
Feeling depressed most of the day, nearly every day
- Feeling hopeless or worthless
- Having low energy
- Losing interest in activities you once enjoyed
- Having problems with sleep
- Experiencing changes in your appetite or weight
- Feeling sluggish or agitated
- Having difficulty concentrating
- Having frequent thoughts of death or suicide
Symptoms of the Winter Pattern SAD include:
- Having low energy
- Weight gain
- Craving for carbohydrates
- Social withdrawal (feel like “hibernating”)
- Poor appetite with associated weight loss
- Episodes of violent behavior
There are three treatments that have been demonstrated by research to effectively address SAD symptoms. Those are: (1) Light Therapy; (2) Medication (usually
Selective Serotonin Re-uptake Inhibitors are prescribed as well as Bupropion; and (3) Psychotherapy, specifically Cognitive Behavioral Therapy, where
negative thoughts are identified and replaced with positive thoughts.
In his book, Winter Blues, NIMH researcher Norman Rosenthal also recommends dietary changes (decreasing carbohydrates and increasing protein),
exercise, meditation and mindfulness, and taking vacations to sunny places during the winter months.
For more information, try these resources:
- Light Therapy – Why and What is it?
- Light Therapy – Choosing a light therapy box
- Seasonal Affective Disorder (SAD) Medication
- Mental Health Medications
- Cognitive Behavioral Therapy: Beating the Winter Blues
- Cognitive-Behavioral Therapy: Proven Effectiveness