For some, the change in season from fall to winter is a welcome one––the air is crisp, the snow is beautiful, winter sports season begins, the world quiets. Others experience a shift in their mood, perhaps feeling sadder or more tired or more withdrawn than usual. And for some, the intensity and severity of the downshift in their mood becomes overwhelming. This may be a sign of seasonal depression.
Living in a cold locale, we often hear people say that they feel blue during the winter months, and sometimes the term seasonal affective disorder (SAD) is used to describe the experience. While feeling a bit down with the change of seasons is common, true seasonal depression is a serious mental health concern. SAD is not simply the “winter blues.” It is officially classified by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) as major depressive disorder with seasonal pattern.
What is seasonal depression?
According to the DSM-5-TR (2022), seasonal depression falls under the diagnostic category of Major Depressive Disorder. These are some of the symptoms associated with the diagnosis:
- Depressed mood (feeling sad, empty, or hopeless), most of the day nearly every day
- Lack of interest in all, or most activities, that you used to enjoy
- Lack of motivation to complete tasks or activities
- Fatigue, loss of energy, or sluggishness
- Change in sleep patterns, i.e. sleeping more than usual
- Difficulty concentrating or making decisions
- Withdrawing socially
- Suicidal thoughts
- The shift in symptoms is observable during a particular time of year (i.e. fall or winter) and these symptoms are not present during other times of the year (i.e. spring or summer)
With seasonal depression, there is a temporal relationship between the onset of symptoms and a particular time of the year, most commonly fall or winter. The symptoms also disappear at a characteristic time of the year (e.g. in the spring) (APA, 2013).
In order to qualify for the diagnosis, symptoms must cause significant distress or impair functioning in various areas of a person’s life. The disorder can present itself as social isolation, decreased activity levels, and/or increased irritability. It can include a lack of motivation to complete work tasks or difficulty focusing. Symptoms can become so severe that a person experiences suicidal thinking (APA, 2013).
In contrast, “winter blues” are more temporary, less severe, and do not impair one’s ability to function. People may hold negative opinions and associations with fall and winter because of how these seasons can limit certain activities; there may also be an increase in stress around the holidays, but ultimately with winter blues there isn’t a bigger, deeper psychological struggle.
What is the science behind seasonal depression?
During the fall and winter, the amount of daylight that our body receives is reduced. As it starts to get dark earlier, our exposure to sunlight is significantly decreased. This can impact the functioning of our hypothalamus, an organ in the body that plays a vital role in our mood, sleep, and appetite. If the hypothalamus is not functioning the way it’s supposed to, this can lead to a decrease in our body’s production of serotonin, an increase in our body’s production of melatonin, and an overall shift in our circadian rhythm. An increase in production of melatonin can lead to increased feelings of tiredness or fatigue. A decrease in production of serotonin can lead to low mood (USDHHS, n.d.).
These changes can disturb our overall circadian rhythm, which is our body’s internal clock, or our body’s way of regulating various functions. When the circadian rhythm is disrupted, mood and energy levels may be impacted. Moreover, the lack of sunlight during the fall/winter months can also lead to a decrease in vitamin D levels. Serotonin production is linked to vitamin D levels, so if there is a decrease in vitamin D levels there is a possibility of associated decrease in serotonin levels. In order to check vitamin D levels, it can be helpful to visit your doctor who can order a blood test (USDHHS, n.d.).
What can you do to help?
One of the things that can make a difference in your symptoms of seasonal depression is utilizing a light box. You can find some recommendations here. Lightboxes are shown to alleviate certain symptoms of seasonal depression, including overall mood, energy level, and sleep quality. This being said, benefits can vary from person to person. Research conducted by the National Institute of Mental Health shows that light box therapy can increase serotonin production and help regulate your circadian rhythm (USDHHS, n.d.). Before you use a light box, make sure you talk to a doctor, and read the instructions provided so that it is being used appropriately.
Another option is to see a physician to discuss options such as starting medication or taking supplements. If the doctor determines that the seasonal depression is due to a vitamin D deficiency, they may prescribe a vitamin D supplement. Correcting your low vitamin D levels might help regulate serotonin levels. The doctor will also determine whether you would benefit from an antidepressant such as selective serotonin reuptake inhibitors (SSRI’s) (USDHHS, n.d.).
Preparing for winter in the fall can be a helpful preventative for some of the symptoms of seasonal depression. Setting a routine for yourself so that you’re sleeping/waking up at the same time each day will keep your body regulated. Prioritizing social interactions – whether that be in person or through video/phone calls – is also important for your overall mood. Other strategies include taking time to prepare for the cold weather, or thinking about how you can modify the activities that are enjoyable to you so that they can still be enjoyed during the winter season.
Additionally, it can be helpful to talk with a psychotherapist about how you’re feeling and obtain assistance in creating and maintaining steady routines and effective coping tools. Some clinicians utilize Cognitive Behavioral Therapy (CBT), which according to the U.S. Department of Health and Human Services (n.d.), has been shown to help alleviate symptoms of seasonal depression. One of the techniques used in CBT entails engaging in behavioral activation, which is about using helpful behaviors to “activate” various emotions. CBT also focuses on addressing negative cognitions that may be contributing to the maintenance of your symptoms.
Concluding thoughts
My hope is that this information will provide you with some assurance and help you feel less alone in this struggle. Seasonal depression is something that can and should be managed with professional support. It is important to create a comprehensive treatment plan to help prevent and alleviate the distressing symptoms of this condition. This will enable you to discover and celebrate some of the joys of the changing seasons.
Sources:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Dsm-5.
American Psychiatric Association Publishing. (2022). Diagnostic and statistical manual of mental disorders: Dsm-5-Tr.
U.S. Department of Health and Human Services. (n.d.). Seasonal affective disorder. National Institute of Mental Health. Retrieved October 28, 2022, from
https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder
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