It's official - the clock's have gone back, the days are getting shorter, and the winter blues have well and truly arrived. For most people, the winter blues are just a fact of life - you might feel a little down a little more often than usual, but it's nothing more than that. However, for some people, it hits much harder: about 3% of the population experience seasonal affective disorder (SAD), also known as 'seasonal depression'.
What Is Seasonal Affective Disorder?
Seasonal Affective Disorder is a type of depression, categorised in the DSM as 'major depressive disorder with a seasonal pattern'. It most commonly affects people during the winter months, although there are some people who experience it during summer. As mentioned above it is more than just the winter blues - its symptoms can be incredibly distressing and interfere with day-to-day life.
Symptoms include:
Feeling low or sad consistently
Feeling irritable
Feeling tearful or more sensitive than usual
Feelings of despair, worthlessness, or hopelessness
Feeling stressed, anxious, or overwhelmed
Lack of energy during the day
Wanting to sleep more than normal
Loss of interest in activities previously enjoyed
Finding it difficult to concentrate
Becoming less sociable or more withdrawn
Reduced sex drive
Increased food cravings (especially for carbohydrates)
What Causes Seasonal Affective Disorder?
There is no definitive answer for what causes SAD- it is thought to be a combination of high levels of melatonin, reduced serotonin production due to lack of sunlight, and the body clock being disrupted by the change in daylight hours.
There may be a genetic predisposition, as it sometimes seems to run in families. Women are four times more likely to suffer from SAD than men, and it is much more likely to occur in people who have other mental health issues, such as major depressive disorder, bipolar disorder, anxiety disorders or eating disorders.
How Is Seasonal Affective Disorder Treated
There are few different ways that SAD can be effectively treated, including:
Light therapy
Although there is mixed evidence regarding the effectiveness of light therapy, many people find it helpful for short-term relief from SAD symptoms. It involves sitting in front of a light box (a very bright light designed to mimic sunlight) for 30 minutes every day, ideally in the early morning. Light therapy is not available on the NHS, so to try it, you need to buy your own light box - however many manufacturers will allow you to try it out and get your money back if it doesn't work for you.
Talking Therapy
This can take the form of cognitive behavioural therapy (CBT), counselling, or psychotherapy - all of which are commonly used to treat all sorts of mental health difficulties, including depression. CBT can help change the way you feel and think about different situations, whereas counselling and psychotherapy provide you with a space to vent, and speak about how you are feeling.
Medication
Anti-depressant medications, such as SSRIs, are sometimes used to treat severe cases of SAD. Patients start taking them at the beginning of winter (most anti-depressants take 4-6 weeks to be effective), and continue taking them until spring.
Self-Care For Seasonal Affective Disorder
If you are struggling with the winter blues or suspect that you have SAD, here are some suggestions for things that you can do to feel better:
Try to get as much natural sunlight as you can - going out for a lunch-time walk can make a big difference
Make your day-time environment (whether at home or at work) as light as possible - one way to do this is by sitting next to a window
Exercise as much as you can - especially if you can do it outdoors during daylight
Eat a healthy, balanced diet
Take steps to avoid stressful situations, and manage your stress levels
Lucy* is one of the 2 million people in the UK who live with SAD and has agreed to share her story for the purposes of this blog post.
Lucy's Story
It took me quite a long time to really notice my SAD - like most people with SAD, I have other mental health issues as well, so it's quite normal for me to have periods of time when I feel very low, and periods of time when my anxiety gets worse. I call them my 'flare ups' and it's just a part of life for me.
Because I'm used to having flare ups every now and then, it took a while for me to notice that I consistently started struggling at the same time every year - usually about mid-October; and that when this happened, my mental health usually stayed bad for months, rather than weeks.
The year that I got diagnosed was particularly difficult: I was in my final year of university and I just felt so tired all of the time. I was sleeping through events that I had organised, I was struggling to find the motivation to complete my work and apply to graduate jobs, and I was crying at everything (the John Lewis advert was just too much for me that year).
Luckily, I had a very good relationship with my GP at the time, and he noticed that I'd come to him with worsening mental health symptoms around the same time, 3 years in a row. He floated the idea that I might have SAD.
I had already had a lot of talking therapies and had developed a lot of skills to help me cope with my mental health difficulties, so his suggestion was increasing the dosage of my SSRI for the duration of the winter period. We did this, but it unfortunately backfired. The side effects I got from increasing my dosage were far worse than my original symptoms and didn't settle down within the normal time period, so I had to cut it back down again.
After this, I purchased a light box (not cheap) and that was definitely worth it. In my experience, light therapy does not directly help with my low mood, but it helps a lot with my energy levels and I find that I don't need to sleep anywhere near as much. In turn, this does help my low mood, because I feel better about myself when I am able to be productive, meet deadlines, and participate in my normal day to day activities. I also find it very helpful to sit near windows and I try to go for walks or runs during daylight hours. I would say that SAD is something that is a big struggle for me every year, but it's helpful to know that it's coming, know what it is. I think it's also a big help for my family to understand that I'm going to need a bit more support at this time of I just try to be extra kind and gentle with myself when it comes.
A big thanks to Lucy for sharing her story with us!
*Lucy is a pseudonym as the woman in this story wishes to remain anonymous.
Do you find your mental health dips at this time of year? Did you find this blog post helpful? Share it with your friends and family to help raise awareness for SAD, or leave a comment to help us start an open discussion about mental health and wellbeing!
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