Seasonal Depression

The winter months can be very challenging for individuals struggling with seasonal depression. While it’s normal for many people to feel a bit down or sluggish during the colder, darker months, for some people, these feelings can become more intense and disruptive to daily life. Around this time of the year, that is, in the late fall and early winter, feeling down or experiencing what is commonly called the “winter blues” as it gets darker earlier, and people tend to feel stuck inside. This is a mild form of what is called Seasonal Affective Disorder (SAD) in mental health parlance.

Understanding Seasonal Depression

Seasonal Affective Disorder is a form of depression. The American Psychiatric Association in the DSM-V classifies it as major depressive disorder with seasonal pattern. It is estimated that about 5% of Americans experience this condition which tends to start between ages 18 and 30. Being able to recognize the symptoms of seasonal depression is important to avoid confusing it with the milder winter blues. It is also important to note that seasonal depression is not restricted to the winter months. There is a summer version of it. Also, for someone to be diagnosed as having seasonal depression, the person must have experienced the symptoms for at least two consecutive years. Care should also be taken not to confuse the winter-pattern SAD with “holiday blues” which involves feelings of sadness or anxiety brought on by stress at certain times of the year.

The symptoms of the winter-pattern SAD include:

• Persistent sad, anxious, or empty mood most of the day, nearly every day, for at least two weeks
• Feelings of hopelessness and pessimism
• Feelings of irritability, frustration, or restlessness
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest in usually pleasurable activities, including withdrawing from social activities
• Decreased energy, fatigue, or feeling slowed down
• Difficulty concentrating, remembering, or making decisions
• Changes in sleep (usually oversleeping)
• Changes in appetite (typically carbohydrate craving leading to weight gain)
• Physical aches or pains, headaches, cramps, or digestive problems that do not have a clear physical cause and do not go away with treatment

The additional symptoms of the summer-pattern SAD include:

• Trouble sleeping (insomnia)
• Poor appetite, leading to weight loss
• Restlessness and agitation
• Anxiety
• Violent or aggressive behavior

Whether it is the winter-pattern or the summer-pattern, the symptoms are severe enough to impact daily functioning and well-being.

What Causes Season Depression?

Research regarding the causes of seasonal depression is still emerging. However, there is more evidence for the winter-pattern of SAD than there is for the summer-pattern. Some of the theoretical suggestions about the possible causes include: 

• Biological clock change where the internal clock that regulates mood, sleep and hormones get disrupted due to less sunlight.
• Serotonin, a neurotransmitter (or chemical) in the brain has been found to be generally lower than normal in people who are prone to the winter-pattern. This is further decreased because of the insufficient amount of sunlight during shorter daylight days of winter.
• Vitamin D is believed to promote serotonin activity. The body produces vitamin D when exposed to sunlight on the skin apart from the one we get from food. Insufficient exposure to daylight in the winter means that people with SAD may have lower vitamin D levels, further reducing serotonin activity.
• Melatonin, a hormone needed for maintaining the normal sleep-wake cycle may also be a factor. People with the winter-pattern SAD tend to produce too much melatonin, which can increase sleepiness and lead to oversleeping. In contrast, people with summer-pattern SAD may have reduced melatonin levels, consistent with long, hot days worsening sleep quality and leading to depression symptoms.
• Negative thoughts and feelings about the winter or summer which come with associated limitations and stresses are also common among people with SAD (as well as others).

How to Help Clients with Seasonal Depression

The therapeutic approaches that can help individuals experiencing seasonal depression include:

• Psychoeducation: This involves providing information to help clients understand their condition
• Psychotherapy: Cognitive-Behavioral Therapy (CBT) and other therapies which promote emotional regulation including mindfulness, relaxation techniques, and learning different coping skills. 
• Medication options: This would involve collaborative decision-making with healthcare professionals.
• Encouraging a proactive approach where clients who are prone to seasonal depression take preventative action as the seasons approach. This includes educating clients on recognizing early signs of seasonal depression and implementing ongoing self-care practices.
• Encouraging clients to engage their support system.

Lifestyle Changes provide powerful intervention for helping with seasonal depression. These include:

• Light therapy: Harnessing the benefits of natural light. There are different ways to do this including using technology, but caution must be taken by people who have other conditions that may be affected.
• Exercise: Enhancing mood through physical activity
• Sleep hygiene: Establishing healthy sleep patterns.
• Nutrition: Diet rich in vitamin D and other ingredients that promote mental wellness

Conclusion

Recognizing the symptoms of season depression as distinct from the winter blues is an important first step toward helping clients with seasonal depression. Knowing the possible causes would also help in taking necessary proactive actions and in guiding toward appropriate intervention. Following a comprehensive and individualized approach is of importance. Clients are encouraged to seek support and collaborate with mental health professionals. At HopeNation Counseling, we provide care and support for clients experiencing seasonal depression.