Is Seasonal Affective Disorder Real?

Lots of us get the winter blues. In the U.S., they hit people who live further north a bit harder than they hit people who live in the south. The days get shorter and the nights get longer. Some of us go to work before the sun comes up in the morning – whether we drive, walk, or use public transportation – and return home from work after the sun sets in the evening.

In between, we may be inside all day, working in an office with little natural light. When we do get a break to get outside, we might have 30 minutes to grab a bite to eat. Then we hustle back to the office. For many of us, that’s more of a tease than a remedy – and during the winter, the short days and long nights have a cumulative negative effect on our wellbeing.

In non-clinical terms, we get moody, cranky, and irritable.

And this year – because of COVID-19 – consumption of alcohol and drugs is on the rise. We may turn to alcohol or drugs to relieve the stress of the season and the pandemic, but that ultimately exacerbates the problems, rather than helps them. In addition, rates of binge-drinking and overdose have increased during the pandemic.

This problematic increase in alcohol and drug use is compounded by the fact that in clinical terms, many of us experience what’s known as Seasonal Affective Disorder, a.k.a. SAD. First identified by psychiatrist Norman Rosenthal in 1984, SAD is, indeed – contrary to what some people believe – a real psychiatric disorder.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5), SAD is a mental health condition that spikes during a specific season and wanes at the end of the season. The Mayo Clinic defines SAD as “a type of depression that’s related to changes in seasons.” Statistics indicate major SAD affects six percent of people in the U.S., while minor SAD affects 14 percent.

That means the answer to the question posed in the title of this article is a direct and affirmative yes. Seasonal Affective Disorder is real and affects – according to the stats above – more than 50 million people in our country every year.

Who Gets SAD?

Anyone can experience the symptoms of Seasonal Affective Disorder. However, there are some factors that increase the risk of getting SAD. Research shows the following all contribute:

Location: Relative distance from equator impacts the chance of developing SAD. The further north or south you are, the more likely you are to develop SAD.
Age: Older people report experiencing SAD less often than younger people.
Mental Health Disorders: Individuals diagnosed with depression or bipolar disorder are at increased risk of developing SAD.
Family: A family history of SAD increases your risk of developing SAD.
Gender: Both men and women can develop SAD. Women experience the disorder more often, while men who develop SAD report more intense/extreme symptoms.
Vitamin D Deficiency: People with low levels of vitamin D are at increased risk of developing SAD.

Let me clarify this: meeting all those criteria doesn’t necessarily mean you will develop SAD. It means you’re at increased risk. Therefore, if you do meet the criteria and you get cranky, moody, and irritable during the winter, you should consider the possibility that what you experience is not just an aversion to cold weather, short days, and long night. You might have an emotional disorder that you can take steps to improve.

I need to mention another thing. SAD is not specific to winter. Some people experience the symptoms of SAD during the summer. For them, long days, warm weather, and short nights have a negative effect on their emotional and psychological wellbeing. This article, though, is for people who experience the symptoms during the winter.

What are the Symptoms of SAD?

People with both mild and severe SAD experience symptoms beyond being cranky and moody. When symptoms hit their peak, individuals with SAD:

Have lower energy, compared to the rest of the year
Have problems sleeping
Feel sluggish or slow
Feel depressed most days, for most of the day
Gain or lose weight
Experience in increase or decrease in appetite
Have problems concentrating
Feel hopeless or worthless
Experience suicidal ideation

In addition, people with winter SAD:

Often oversleep
Crave high-carb foods
Gain weight
Feel tired all the time

One thing about winter SAD that can exacerbate the symptoms is the fact that the peak of winter SAD season coincides with the biggest holiday season in the U.S., the winter holidays. From Thanksgiving to New Year’s, people get festive. They throw parties (when we’re not in the middle of COVID), put on the ugliest sweaters, decorate the outside and inside of their houses.

And they smile, smile, smile – for almost six weeks.

A person with an emotional disorder characterized by low mood and irritability may feel alienated and out of place in the midst of all the holiday cheer. Feeling alienated often leads to self-isolation, which can, in turn, exacerbate the symptoms of SAD. Depression can deepen, sadness can increase, and irritability can increase to anger. And the overt joy – which often feels mandatory – of the holiday season can make a person who doesn’t feel joyful feel guilty for not feeling joyful – which can trigger another cascade of negative emotions.

If everything I’ve described already – or most of it – describes your emotional experience during wintertime, I’m here to tell you I understand. And so does the mental health community. What’s happening with you is a mental health condition that responds positively to specific clinical treatments and behavioral adjustments.

Coping With SAD: Proactive Steps

Evidence shows that people with SAD benefit from a combination of treatment approaches. If you have SAD, I recommend seeking the support of a mental health professional such as a psychologist or psychiatrist. They’ll most likely recommend a course of treatment that includes Cognitive Behavioral Therapy (CBT), light therapy, and/or medication. In addition, the psychiatrist who first described SAD recommends several behavioral and lifestyle steps to take that research indicates can mitigate the symptoms of SAD. These are:

Get Out in the Sunlight. Mental health professionals say that a lack of sunlight contributes to SAD. That’s why light therapy is often part of a treatment regimen. That’s also why taking advantage of the greatest resource for light we have – the sun – is an important way to deal with SAD. You can accomplish this by making sure you spend time in the sun every day – a few minutes will help – or arranging your workspace to allow you to at least see the sun for hours at a time. If you see a professional and receive a diagnosis for SAD, you may be able to get a doctor’s note for an office with windows – it may not be the VPs corner office, but any amount of sunlight can make a difference for people with SAD.
Get Out and Exercise. This pairs with another recommendation that’s not on this list: learn to manage stress efficiently. Stress exacerbates emotional and mood disorders like SAD. Exercise helps reduce symptoms of mood disorders. That’s both clinical fact and common knowledge. It follows, therefore, that exercise can help with SAD. And if you exercise outdoors, then you get the advantage of light and stress reduction simultaneously: a double bonus.
Socialize with Friends. You can do this now, during all the shelter-in-place and stay-home orders related to COVID-19, because the kind of socializing we mean is active and outdoors. We suggest meeting a friend for a walk in a park, or depending on where you live, a walk on the beach, by a lake, next to a river – you get the idea? Meet friends in a natural setting – greenspace in a city definitely counts – and walk and talk. You can also make a day of it and meet them at a nearby state park, and make it a hike. Bundle up!
Travel to a Warm Location. This is a recommendation for the future, of course, in light of the CDC’s recent travel recommendations. To avoid SAD next winter – or later this winter when restrictions could be lifted – plan a trip to a sunny, warm climate. You don’t have to be an uber-rich jet-setter to make this happen. People on the east coast can head to Florida, people on the west coast can head to sunny southern California, and people in the Midwest can drive to the peaceful desert climates found in places like Arizona or New Mexico.
Relocate to a Warmer Climate. This may seem like an extreme solution, but hear me out: if SAD makes every winter a miserable experience, you should seriously consider this option if you’re able to do so. Moving to a warmer climate means you create a set of default conditions that work to prevent SAD: the closer to the equator you get, the warmer and longer the days are in winter. That doesn’t mean you have to move to Costa Rica or an island in the Caribbean. Within the U.S., for instance, there’s great variation. Key West, Florida, is 1,500 miles south of New York City. Los Angeles is 1,350 miles south of Seattle. And Gulf Shores, Alabama, is 1,200 miles south of Minneapolis, Minnesota. In terms of climate, a thousand miles makes a difference – and it could make a difference for your emotional life every winter, too.

In addition to these five, I’d like to add one of my own:

Practice Mindfulness. Research shows that maintaining a mindfulness practice improves the ability to cope with stress. For those new to mindfulness practice, the book “Mindfulness for Beginners,” by Jon Kabat-Zinn is a great place to start learning. A brief daily practice can help increase time being in the moment instead of letting our thoughts get caught up in shame and anger about past events or fear about an uncertain future.

The important thing to realize about these suggestions is that, aside from the last two, you can implement them immediately. If you binge-watch your favorite shows as a form of self-care when you experience the symptoms of SAD, open the blinds and let the sun shine in – starting now. It will make a difference. You can also reach out to a friend and set up a meet for a hike or a walk in the park – right now. That, too, will make a difference – and I bet your friends are itching for a good reason to get out of the house.

Seasonal Affective Disorder: It’s Real If you take one thing away from this article, let it be this: SAD is a real thing. It’s in the DSM-V, which is the go-to diagnostic manual used by mental health providers. If you get depressed, sad, cranky, and irritable every winter, then it’s likely you have SAD – and all these years you may have thought you just always got a bad case of the winter blues. Now, you can plan ahead, and take steps to prevent the worst of the symptoms next year. And as far as this year goes, try our tips above, because we know they work. One last thing: in addition to the tips above, I recommend seeking the support of a mental health professional. They’ll confirm all the clinical details we shared with you above – and then they’ll tell you to get outside in the sunlight.