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Diseases & Conditions
1. Diseases & Conditions
SEASONAL AFFECTIVE DISORDER (SAD)
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* Symptoms &
causes
* Diagnosis &
treatment
ON THIS PAGE
* Overview
* Symptoms
* When to see a doctor
* Causes
* Risk factors
* Complications
* Prevention
--------------------------------------------------------------------------------
OVERVIEW
Seasonal affective disorder (SAD) is a type of depression that's related to
changes in seasons — seasonal affective disorder (SAD) begins and ends at about
the same times every year. If you're like most people with SAD, your symptoms
start in the fall and continue into the winter months, sapping your energy and
making you feel moody. These symptoms often resolve during the spring and summer
months. Less often, SAD causes depression in the spring or early summer and
resolves during the fall or winter months.
Treatment for SAD may include light therapy (phototherapy), psychotherapy and
medications.
Don't brush off that yearly feeling as simply a case of the "winter blues" or a
seasonal funk that you have to tough out on your own. Take steps to keep your
mood and motivation steady throughout the year.
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SYMPTOMS
In most cases, seasonal affective disorder symptoms appear during late fall or
early winter and go away during the sunnier days of spring and summer. Less
commonly, people with the opposite pattern have symptoms that begin in spring or
summer. In either case, symptoms may start out mild and become more severe as
the season progresses.
Signs and symptoms of SAD may include:
* Feeling listless, sad or down most of the day, nearly every day
* Losing interest in activities you once enjoyed
* Having low energy and feeling sluggish
* Having problems with sleeping too much
* Experiencing carbohydrate cravings, overeating and weight gain
* Having difficulty concentrating
* Feeling hopeless, worthless or guilty
* Having thoughts of not wanting to live
FALL AND WINTER SAD
Symptoms specific to winter-onset SAD, sometimes called winter depression, may
include:
* Oversleeping
* Appetite changes, especially a craving for foods high in carbohydrates
* Weight gain
* Tiredness or low energy
SPRING AND SUMMER SAD
Symptoms specific to summer-onset seasonal affective disorder, sometimes called
summer depression, may include:
* Trouble sleeping (insomnia)
* Poor appetite
* Weight loss
* Agitation or anxiety
* Increased irritability
SEASONAL CHANGES AND BIPOLAR DISORDER
People who have bipolar disorder are at increased risk of seasonal affective
disorder. In some people with bipolar disorder, episodes of mania may be linked
to a specific season. For example, spring and summer can bring on symptoms of
mania or a less intense form of mania (hypomania), anxiety, agitation and
irritability. They may also experience depression during the fall and winter
months.
--------------------------------------------------------------------------------
WHEN TO SEE A DOCTOR
It's normal to have some days when you feel down. But if you feel down for days
at a time and you can't get motivated to do activities you normally enjoy, see
your health care provider. This is especially important if your sleep patterns
and appetite have changed, you turn to alcohol for comfort or relaxation, or you
feel hopeless or think about suicide.
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CAUSES
The specific cause of seasonal affective disorder remains unknown. Some factors
that may come into play include:
* Your biological clock (circadian rhythm). The reduced level of sunlight in
fall and winter may cause winter-onset SAD. This decrease in sunlight may
disrupt your body's internal clock and lead to feelings of depression.
* Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter)
that affects mood, might play a role in SAD. Reduced sunlight can cause a
drop in serotonin that may trigger depression.
* Melatonin levels. The change in season can disrupt the balance of the body's
level of melatonin, which plays a role in sleep patterns and mood.
--------------------------------------------------------------------------------
RISK FACTORS
Seasonal affective disorder is diagnosed more often in women than in men. And
SAD occurs more frequently in younger adults than in older adults.
Factors that may increase your risk of seasonal affective disorder include:
* Family history. People with SAD may be more likely to have blood relatives
with SAD or another form of depression.
* Having major depression or bipolar disorder. Symptoms of depression may
worsen seasonally if you have one of these conditions.
* Living far from the equator. SAD appears to be more common among people who
live far north or south of the equator. This may be due to decreased sunlight
during the winter and longer days during the summer months.
* Low level of vitamin D. Some vitamin D is produced in the skin when it's
exposed to sunlight. Vitamin D can help to boost serotonin activity. Less
sunlight and not getting enough vitamin D from foods and other sources may
result in low levels of vitamin D in the body.
--------------------------------------------------------------------------------
COMPLICATIONS
Take signs and symptoms of seasonal affective disorder seriously. As with other
types of depression, SAD can get worse and lead to problems if it's not treated.
These can include:
* Social withdrawal
* School or work problems
* Substance abuse
* Other mental health disorders such as anxiety or eating disorders
* Suicidal thoughts or behavior
--------------------------------------------------------------------------------
PREVENTION
There's no known way to prevent the development of seasonal affective disorder.
However, if you take steps early on to manage symptoms, you may be able to
prevent them from getting worse over time. You may be able to head off serious
changes in mood, appetite and energy levels, as you can predict the time of the
year in which these symptoms may start. Treatment can help prevent
complications, especially if SAD is diagnosed and treated before symptoms get
bad.
Some people find it helpful to begin treatment before symptoms would normally
start in the fall or winter, and then continue treatment past the time symptoms
would normally go away. Other people need continuous treatment to prevent
symptoms from returning.
Request an appointment
--------------------------------------------------------------------------------
By Mayo Clinic Staff
December 14, 2021
Print
Show References
1. Specifiers for depressive disorders: With seasonal pattern. In: Diagnostic
and Statistical Manual of Mental Disorders DSM-5. 5th ed. American
Psychiatric Association; 2013. https://dsm.psychiatryonline.org. Accessed
July 15, 2021.
2. Seasonal affective disorder. National Institute of Mental Health.
https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder/.
Accessed July 15, 2021.
3. Seasonal affective disorder (SAD). American Psychiatric Association.
https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder.
Accessed July 15, 2021.
4. Seasonal affective disorder: More than the winter blues. American
Psychological Association.
https://www.apa.org/topics/depression/seasonal-affective-disorder. Accessed
July 15, 2021.
5. Major depressive disorder with a seasonal pattern. National Alliance on
Mental Illness.
https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Depression/Major-Depressive-Disorder-with-a-Seasonal-Pattern.
Accessed July 15, 2021.
6. Galima SV, et al. Seasonal affective disorder: Common questions and
answers. American Family Physician. 2020;102:668.
7. Haller H, et al. Complementary therapies for clinical depression: An
overview of systematic reviews. BMJ Open. 2019;
doi:10.1136/bmjopen-2018-028527.
8. Light therapy. Natural Medicines.
https://naturalmedicines.therapeuticresearch.com. Accessed July 15, 2021.
9. Seasonal affective disorder and complementary health approaches: What the
science says. National Center for Complementary and Integrative Health.
https://www.nccih.nih.gov/health/providers/digest/seasonal-affective-disorder-and-complementary-health-approaches-science.
Accessed July 15, 2021.
10. Safe use of complementary health products and practices. National Center
for Complementary and Integrative Health.
https://www.nccih.nih.gov/health/safety. Accessed July 19, 2021.
11. Depression. National Institute of Mental Health.
https://www.nimh.nih.gov/health/topics/depression/. Accessed July 19, 2021.
12. Depression. National Institute of Mental Health.
https://www.nimh.nih.gov/health/publications/depression/. Accessed July 19,
2021.
13. Rosenthal SJ, et al. Seasonal effects on bipolar disorder: A closer look.
Neuroscience and Biobehavioral Reviews. 2020;
doi:10.1016/j.neubiorev.2020.05.017.
14. Gitlin MJ. Antidepressants in bipolar depression: An enduring controversy.
International Journal of Bipolar Disorders. 2018;
doi:10.1186/s40345-018-0133-9.
15. Sawchuk CN (expert opinion). Mayo Clinic. Sept. 2, 2021.
Diagnosis & treatment
1. Diseases & Conditions
2. Seasonal affective disorder (SAD) symptoms & causes
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NEWS FROM MAYO CLINIC
* Mayo Clinic Q and A: Light therapy for seasonal affective disorder
* Mayo Clinic Minute: Light therapy can help with seasonal affective disorder
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MORE INFORMATION
* Seasonal affective disorder treatment: Choosing a light box
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ASSOCIATED PROCEDURES
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