Mental Health, Seasonal Affective Disorder, and the Changing Seasons: What You Should Know

Navigating mental health challenges during the holidays and the changing seasons can be difficult. From Thanksgiving festivities to the New Year’s countdown, these times of celebration can also bring about heightened stress, unmet expectations, and challenging family dynamics to the forefront. Staying mentally well amidst the festivities poses its own set of difficulties, especially when we are all expected to be joyous.

Additionally, many people struggle with periods of sadness in the wintertime, which could be a result of the “winter blues” or seasonal affective disorder, a form of depression that often occurs during the fall and winter months. Seasonal affective disorder, or SAD, is characterized by a combination of symptoms such as persistent low mood, lack of interest in activities, sleep disturbances, and changes in appetite.[1]

The already-challenging holiday season can become even more daunting for those struggling with SAD and other seasonal issues, as the festivities that are supposed to bring joy and warmth may instead amplify your feelings of isolation and melancholy. Today Clear Behavioral Health will explore seasonal affective disorder and other seasonal-related stressors to promote more understanding and well-being for all during this holiday season.

What is Seasonal Affective Disorder?

Seasonal affective disorder is a type of depression that occurs at a specific time of year, often in the winter when overall sunlight exposure is reduced. It’s sometimes referred to as winter depression, as its symptoms tend to be more pronounced during the fall and winter months.[2] However, some people may experience a different pattern with symptoms occurring in the spring or early summer as well.

Commonly reported symptoms of seasonal affective disorder include:[3]

• Low energy: Individuals with SAD often feel fatigued and report lower-than-normal energy levels
• Depressed mood: An increase in feelings of sadness, hopelessness, and irritability
• Difficulty concentrating: People with SAD may have trouble focusing and making decisions.
• Changes in sleep patterns: SAD can lead to either oversleeping or having trouble sleeping
• Changes in appetite: Increased cravings for carbohydrates and weight gain are common symptoms, although some individuals may experience weight loss and a lack of appetite

Is Seasonal Affective Disorder an Official DSM Diagnosis?

SAD is not considered to be a unique diagnosis in and of itself.[4] Rather, it is classified as a specifier for recurrent major depressive episodes in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), with the following criteria:

• There exists a regular relationship between the onset of major depressive episodes and a particular time of the year (such as the fall or winter)
• Full remissions occur at a characteristic time of the year (such as the depression lifting in the spring)
• In the past two years, at least 2 major depressive episodes have occurred that demonstrate the relationships above
• Seasonal depressive episodes outnumber the nonseasonal major depressive episodes in someone’s life

It’s also important to note that such depressive episodes can also occur within the context of bipolar disorder, which can also display seasonal patterns of mania, hypomania, and characteristics of major depressive disorder.

What Causes Seasonal Affective Disorder?

While it’s not fully understood what causes SAD symptoms, it has been linked to changes in the levels of certain chemicals in the brain.[5] One of these chemicals, serotonin, helps to regulate your mood. In the wintertime, people with SAD may have higher levels of a protein called SERT, which makes serotonin less active and can contribute to feelings of depression. During the summer, sunlight tends to keep SERT levels lower.

Melatonin, a naturally-occurring hormone that makes you feel sleepy, has also been studied as a contributing factor. As the days get darker in winter, people with SAD may produce more melatonin, leading to feelings of lethargy and sleepiness.

The combination of lower serotonin and higher melatonin levels can affect our internal body clock, known as circadian rhythms. These rhythms help our bodies respond to the daily changes in light and darkness. In people with SAD, this internal clock may not adjust properly to the changing seasons, making it harder for their bodies to adapt and self-regulate.

Additionally, in the winter, people with SAD may produce less Vitamin D as a result of less sunlight exposure.[6] Vitamin D is thought to influence serotonin activity, and low levels have been linked to depressive symptoms in several studies. While the exact connections between serotonin, melatonin, circadian rhythms, Vitamin D, and SAD aren’t fully understood, researchers are exploring these relationships to better grasp how they contribute to seasonal mood challenges that resemble major depression.

Are there other seasonal-based conditions?

While there are no other official DSM-5 diagnoses that categorize mental disorders around the seasons, that’s not to say that people don’t struggle with seasonal-related issues:

• Anxiety: While anxiety disorders are not specifically categorized as seasonal in the DSM-5, many individuals may experience heightened anxiety during certain seasons. Seasonal changes, such as transitions from summer to fall or winter, can bring about shifts in routine, weather-related concerns, or even anticipation of upcoming holidays. Additionally, the reduced exposure to sunlight, as seen in the winter months, may contribute to feelings of unease in some individuals, not to mention the potential stressors of the holiday season.
• Increased stress: Seasonal transitions can introduce increased stress for various reasons. Changes in weather, holiday preparations, and the adjustment to daylight saving time are just a few factors that can contribute to heightened stress levels. Individuals may find themselves overwhelmed by the demands associated with specific seasons, leading to stress-related symptoms.
• Insomnia or other sleep disruptions: Disruptions in sleep patterns can be influenced by seasonal changes. For example, the decrease in daylight hours during the fall and winter months may impact circadian rhythms, contributing to difficulties falling or staying asleep (and impacting your overall health).
• Summer depression: While seasonal affective disorder is commonly associated with the fall and winter months, some individuals may experience a form of depression during the summer. This may manifest as feelings of sadness, irritability, and low energy during the warmer months.
• Addiction and substance abuse: People struggling with addiction may find certain seasons or holidays difficult, leading to an increased risk of substance use or relapse (for those in recovery). These associations can be complex and highly individualized and are often intertwined with emotional triggers, societal expectations, and environmental factors.

What Are My Treatment Options For Seasonal-Based Issues?

If you or someone you know is struggling, experiencing symptoms of seasonal depression, or experiencing other mental health-related issues, it’s important to seek the advice of a professional for an accurate diagnosis and to access the appropriate treatment. Early intervention has been linked to better treatment outcomes overall,[7] and seeking help is an excellent proactive step to take towards improved mental well-being. Here are some common methods used to treat SAD and other mental health conditions:

Light therapy

Light therapy, where individuals are exposed to a bright light that mimics natural sunlight, is a common treatment for SAD.[8] Additionally, psychotherapy and medications, such as antidepressants, may be recommended in some cases.

Vitamin D

As referenced above, there is some evidence to suggest that vitamin D may play a role in SAD and mood regulation. If you suspect a vitamin D deficiency or are experiencing symptoms of SAD, it’s important to consult with a healthcare professional. They can conduct tests to determine your vitamin D levels and provide appropriate guidance on supplementation if needed. It’s important not to self-prescribe high doses of vitamin D without proper medical supervision, as excessive intake can also lead to adverse effects.

Taking good care of yourself

It’s important to focus as best you can on positive routines and behaviors during challenging times. This can include:

• Sleep hygiene: Establishing a consistent sleep routine is vital for mental well-being. Aim for 7-9 hours of quality sleep per night, and try to go to bed and wake up at the same time each day. Limiting screen time before bedtime can also improve the quality of your sleep.
• Nutrition: Eating a well-balanced diet is essential for overall health, including mental health. Ensure that your diet includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats. Although it may be difficult, try to avoid eating too much starchy and sweet foods
• Physical activity: Regular exercise can have positive effects on mood and can be a valuable component of managing seasonal issues. Aim for at least two hours of moderate-intensity exercise per week, such as brisk walking, jogging, or cycling. Outdoor activities can be particularly beneficial, as they expose you to natural light and the potential mood-boosting effects of being in nature.
• Mind-body practices: Meditation, mindfulness, and yoga can help reduce stress and improve overall well-being. These techniques may be especially beneficial for individuals dealing with seasonal mood changes, providing tools to cope with stressors and enhancing emotional resilience.

Getting professional help

Therapy can be a valuable component in the overall treatment of Seasonal Affective Disorder (SAD) and other mental health challenges:

• Collaboratively developing new coping strategies: Therapists can help individuals develop coping strategies to manage the specific challenges associated with SAD. This may include talk therapy, developing routines, setting realistic goals, working to maintain social connections, and adapting lifestyle habits to mitigate the impact of seasonal shifts on mood.
• Cognitive Behavioral Therapy (CBT): CBT is a type of psychotherapy that focuses on identifying and challenging negative thought patterns and behaviors. A therapist can work with you to identify and change negative thought patterns related to seasonal changes and develop healthier ways of thinking.
• Addressing any underlying or co-occurring issues: Therapy provides a supportive space to explore and address any underlying issues that may contribute to or exacerbate SAD. This could include exploring past experiences, relationships, or stressors that may influence an individual’s response to seasonal changes.
• Goal setting: SAD can lead to a lack of motivation and decreased interest in activities. Therapists can work collaboratively with individuals to set realistic goals, break them down into manageable steps, and provide support and motivation to help clients stay engaged in activities that bring joy and fulfillment.
• Being assessed for medications: A mental health professional can evaluate the severity of symptoms and, if necessary, prescribe antidepressant medications like selective serotonin reuptake inhibitors to help regulate mood and alleviate the impact of SAD. Medication, when combined with other therapeutic approaches, can be a valuable component in a comprehensive treatment plan, providing individuals with additional support in managing the challenges associated with seasonal depression.

Getting Help For Seasonal Depression and Other Mental Health Concerns

If you or someone you know is grappling with seasonal affective disorder or other challenges this holiday season, then seeking support from mental health professionals can be a crucial stride towards a brighter and more balanced life. Connecting with providers can guide you to a personalized treatment plan designed to address your unique challenges.

Remember, you don’t have to face this alone—there are resources and mental health treatments available to assist you in finding the right path toward emotional wellness. Give Clear Behavioral Health a call today to take the next step towards a healthier, happier you.

References:

1. National Institute of Mental Health. (2020). Seasonal Affective Disorder. Www.nimh.nih.gov; National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder on November 14th, 2023
2. Psychiatry.org – Seasonal Affective Disorder (SAD). (n.d.). Psychiatry.org. https://www.psychiatry.org/Patients-Families/Seasonal-Affective-Disorder on November 14th, 2023
3. Seasonal Affective Disorder. (n.d.). Www.hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/seasonal-affective-disorder on November 15th, 2023
4. Rosenthal, N. E. (2009). Issues for DSM-V: Seasonal Affective Disorder and Seasonality. American Journal of Psychiatry, 166(8), 852–853. https://doi.org/10.1176/appi.ajp.2009.09020188
5. Melrose, S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression Research and Treatment, 2015, 1–6. https://doi.org/10.1155/2015/178564 on November 15th, 2023
6. Seasonal Affective Disorder. (n.d.). NCCIH. https://www.nccih.nih.gov/health/seasonal-affective-disorder on November 15th, 2023
7. Mental Health America. (2011). Prevention and Early Intervention in Mental Health | Mental Health America. Mhanational.org. https://www.mhanational.org/issues/prevention-and-early-intervention-mental-health on November 16th, 2023
8. Campbell, P. D., Miller, A. M., & Woesner, M. E. (2017). Bright Light Therapy: Seasonal Affective Disorder and Beyond. The Einstein Journal of Biology and Medicine : EJBM, 32, E13–E25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746555/ on November 16th, 2023