Is It Seasonal Affective Disorder Or Depression?

This fall or winter, when your mood is low, you’re sleeping more than usual, and you don’t feel like socializing, you may ask yourself: Is this depression, or could it be seasonal affective disorder (SAD)? And as both conditions have similar symptoms, it may be easy to confuse the two—though there are several distinctions.

First, it’s helpful to understand some basic facts about both conditions.

For starters, about 21 million Americans experience depression annually, while up to 3% of all Americans may experience SAD every year. What’s more, both have a tendency to disproportionately affect women.

Thankfully, treatments are available for both SAD and depression. Here’s what you need to know about each condition, including symptoms and treatment options.

In cases of depression, the primary symptom adult patients report experiencing is an overwhelming sense of sadness lasting for at least two weeks. (Children may experience irritability instead of sadness.) What’s more, they may not get pleasure from activities they previously enjoyed, and may stop doing them as a result. This can lead to social withdrawal.

However, the signs and symptoms aren’t just limited to feelings of sadness. Instead, there are many other signs you or someone you know may be struggling with depression:

• Noticeable weight gain or loss, often due to appetite changes
• Disruptions to sleep habits, either sleeping too much, or insomnia
• Persistent fatigue
• Lack of energy for even basic activities
• Feelings of restlessness, leading to jitteriness, such as leg shaking, finger tapping, or pacing
• Feelings of guilt, worthlessness, or blaming yourself for things out of your control
• Difficulty concentrating or making decisions
• Thoughts of self-harm, death, and/or suicide

Depression typically causes distress or impairment in at least one important area of life—negatively affecting your performance at work or your relationships with loved ones.

Make an appointment with your doctor or a therapist if you’ve felt sad or irritable for a few weeks, you’re having trouble functioning, or you’re feeling too overwhelmed to do things that you normally do. Doctors can determine whether the symptoms are caused by another medical condition, a medication, or if you may have depression.

If you’re having thoughts about death, dying, or suicide, visit a walk-in crisis center or emergency room.

Despite popular opinion, SAD is a type of depression, not a separate condition.

Someone with SAD experiences sadness, but their change in mood is tied to the change in seasons. Most people notice an onset of symptoms in the fall or early winter, with symptoms usually resolving in the spring or early summer. However, a small subset of people have the opposite pattern, experiencing symptoms in the spring and summer, then getting relief in the fall and winter.

People whose SAD arises in the fall or winter usually feel depressed, sleep too much, eat too much, and gain weight during the colder months. It’s also common for them to experience social withdrawal or social avoidance.

Those who experience SAD in the spring and summer typically feel depressed, have less of an appetite, lose weight, and experience insomnia. Some people feel restless, anxious, and agitated.

In order for someone to be diagnosed with SAD, they must experience these periods of depression during the same seasons for at least two years, and their symptoms must go away when the seasons change and the days get longer.

Winter-onset SAD is often associated with the decrease in daylight hours during the colder months. Going to work in the dark and coming home in the dark may negatively impact your mood.

See your doctor or a therapist if you’ve noticed that you’ve fallen into the same pattern that you’ve experienced in previous winters—feeling sad, sleeping more, overeating, or relationships suffering.

People with depression may benefit from cognitive behavioral therapy (CBT), a type of talk therapy. Others may benefit from medication or a combination of both. Through CBT, patients can gain coping skills to tolerate the stress of failure and imperfect success.

During CBT, a therapist helps someone identify what they may do to feel better, such as engaging in enjoyable activities again. CBT therapists help people clarify their values, and motivate toward making time for them. This activation often involves engaging in self-care, doing enjoyable activities, revisiting old hobbies, socializing regularly, and exercising often may help some people to prevent the onset and reduce the symptoms of depression. And while exercise alone is not enough to pull somebody out of depression, it can be an importance component of treatment.

Another important skill to (re)learn often includes assertiveness—practicing advocating for our needs, and setting limits on inappropriate impositions and requests.

People with depression and SAD often experience negative thoughts about themselves, the world, and the future. They may feel hopeless—that there’s no possibility for a positive outcome or future. They might also feel helpless, like there’s nothing we can do to change their situation. Other thoughts include rigid or perfectionistic thinking about unrealistic standards we set for ourselves, others, or how others “must” treat us. Depressive thoughts are often about failure, remorse, or regret.

Through CBT, therapists can help people reframe these thoughts, and to treat themselves and others with realistic expectations and compassion.

Although not always necessary, medications can be an important component of treatment. Antidepressants can be helpful for moderate depression, and are often necessary for severe depression.

The same treatments that work for depression are effective for SAD, but the emphasis on certain techniques may differ. For example, CBT for SAD may emphasize sleep hygiene and insomnia interventions, in addition to adding meaningful and enjoyable activities to the schedule and reframing negative thoughts.

Because people with winter-onset SAD are often affected by less exposure to daylight, increasing light exposure may be an effective treatment.

Some providers recommend light-box therapy for people with SAD. An ideal light box emits 10,000 lux of light with as little ultraviolet light as possible. It’s about 20 times brighter than indoor light. People expose themselves to the light box for about 45 minutes every morning without looking directly at it.

Additionally, exercise is also helpful for SAD, especially if you can get outside during daylight hours.

Some doctors prescribe vitamin D to patients with SAD during the winter, when we’re more likely to get less sun exposure. Ask your physician if this is appropriate for you.

Doing enjoyable activities, engaging in self-care, and finding ways to get more sunlight into your days may help prevent and treat SAD. Instead of giving in to an impulse to hibernate, hang out with friends. It doesn’t matter what you do, as long as the activities are meaningful to you and you’re doing them with people you care about.

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