Feeling down as the seasons change? You’re not alone. Many people report feeling more tired and sluggish during the shorter days of winter.
While for some it’s simply a part of the body’s natural response to seasonal change, for others the shift in seasons coincides with a type of depression called seasonal affective disorder. Most patients experience SAD in winter (“winter-pattern SAD”), while a smaller group experiences the condition in the hot summer months (“summer-pattern SAD”). There are also people that experience what is known as subsyndromal SAD, or the “winter blues.”
“There’s a whole continuum between people who tend to be more vulnerable in the winter,” says Dr. Paul Desan, director of the Winter Depression Research Clinic at the Yale School of Medicine.
Our 24-hour internal clock, also called our circadian rhythm, regulates many important physiological processes (like the release of different hormones that help you sleep at night). When the seasons change, our clocks shift to adjust to shorter days and longer nights. Some have internal clocks that aren’t as great at adjusting to these shifts — which contributes to SAD.
For this reason, light therapy, in which patients sit in front of a SAD lamp that emits artificial sunlight to jumpstart their circadian rhythm, is one of the top treatments for SAD. Many researchers believe light therapy is uniquely suited for treatment of the disorder, because it addresses the underlying mechanisms, saysDr. Alfred Lewy, professor emeritus of psychiatry at Oregon Health and Science University.
“(It’s) getting at the root cause of the trigger for getting depressed in the winter, not just treating the symptoms,” Lewy says.
While the evidence shows light therapy can help, there can be negative side effects including nausea, headaches and jitteriness. Others find light therapy can cause them to have trouble sleeping. Plus, light therapy is only effective if used daily for 30 minutes to an hour, which may be inconvenient for people with busy morning schedules.
If light therapy isn’t working for you, or you want to try another treatment, here are some methods that can help to reduce symptoms of SAD.
Walk or exercise outside during daylight hours
Maximizing your exposure to outdoor light can help readjust your circadian rhythm and therefore reduce some of the symptoms of SAD, says Desan. Bright outdoor light has the same effect as the light emitted by a SAD lamp, so getting outside at the right moment can have similar benefits.
Whether natural or artificial, the bright light helps to regulate the circadian process disrupted by SAD: it reduces the production of the hormone melatonin, which makes you sleepy, and increases the mood-boosting hormone serotonin.
Getting some light exercise while you’re soaking up the outdoor light can help boost your mood, too, says Desan.
“There are some people who can just get out first thing in the morning, and work in the garden or jog when the sun comes up — they’re using every bit of natural light,” he explains.
Try therapy
Cognitive behavioral therapy is commonly used to help treat patients struggling with depression, anxiety and addiction. It blends behavioral therapy and cognitive therapy to help patients find practicable ways to address the everyday problems their diagnosis causes. For SAD patients, this can mean reframing negative thoughts about the cold season, developing coping mechanisms and designing a personal relapse-prevention form.
Research has found that CBT can help treat the symptoms of SAD: a 2015 clinical study found CBT was comparable to the benefits of light therapy, and another study found that it led to better long-term outcomes for some patients. Other research from Scandinavia shows that changing your mindset toward winter can lead to better outcomes.
Anyone struggling with SAD should see a mental health medical provider to determine the cause of their symptoms, Desan says. SAD is clinically distinct from major depression, which a psychiatrist can accurately differentiate and diagnose.
Consider medication
The depression brought on by SAD can be treated with antidepressant medication like other kinds of major depression.
“For some people, the light therapy doesn’t work, or they don’t find it very convenient,” Desan says. “So some people do try pharmacological antidepressants.”
Research has found that Wellbutrin (known generically as bupropion) can be effective in treating the effects of seasonal affective disorder. For now, it is the only FDA-approved antidepressant for SAD. Other recent studies have found promising results from the medications Zoloft (known generically as sertraline) and Prozac (known generically as fluoxetine). Unlike taking antidepressants for major depression, patients with SAD generally take the medication only part of the year, timed to the onset of symptoms, and then are weaned off when the symptoms abate as the season changes.