Seasonal Affective Disorder Symptoms and Treatment

Winter brings short days and frequent cloud covers, leading to prolonged periods of reduced sunlight. This weather pattern can give rise to Seasonal Affective Disorder (SAD) among adults, adolescents, and children.

Initially identified as a medical condition in the 1980s, SAD is likely a familiar concept for many. However, what might be less known is that SAD is not a standalone diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). Instead, it serves as a specifier for recurrent major depressive disorder.

The criteria for major depressive disorder must be met first, and then the specifier, indicating a seasonal pattern, is added. To fulfill the major depressive disorder criteria, an individual must exhibit at least five of nine symptoms during the same two-week period, representing a change from their previous state. One of these symptoms must include either a depressed mood or a loss of interest or pleasure in daily life experiences.

For children and adolescents, the DSM notes that an irritable mood may also satisfy the depressed mood criterion.

Additional symptoms of Seasonal Affective Disorder include:

• Changes in weight, encompassing both loss and gain, along with decreased or increased appetite. In younger individuals, it may present as a failure to achieve expected weight gain suitable for their age and stage of development.
• Insomnia or hypersomnia occurring almost daily.
• Psychomotor agitation or slowing evident nearly every day.
• Persistent fatigue or a daily loss of energy.
• Regular experiences of feelings of worthlessness or an overwhelming, inappropriate sense of guilt.
• Marked difficulty in thinking, concentrating, or making decisions on a nearly daily basis.
• Recurrent thoughts of death, contemplation of suicide, or the formulation and execution of a suicide plan.

Once again, it’s crucial to note that a majority, though not necessarily all, of these symptoms must be present to justify a formal diagnosis. Additionally, these symptoms must significantly distress the individual or impair their social, occupational, or other vital aspects of daily functioning. The clinician needs to ascertain that these symptoms do not stem from normal responses to substantial losses such as bereavement, severe medical issues, or other life circumstances.

In the case of children and adolescents, these circumstances might involve distress related to a relationship breakup, concerns about academic performance, unsettling experiences at school, worries about issues at home, among various others.

Only after satisfying these criteria can the specifier with a seasonal pattern be incorporated, and further criteria include:

Several conditions must be met to establish the specifier with a seasonal pattern:

1. There should be a distinct occurrence during a specific time of the year, commonly in fall or winter.
2. The depressive symptoms must alleviate or resolve at a different time of the year, usually in spring.
3. These seasonal episodes must have occurred over the past two years, with no nonseasonal depressive episodes within that timeframe.
4. Over the individual’s lifetime, seasonal episodes must significantly surpass nonseasonal episodes in frequency.

While meeting these comprehensive criteria is necessary for a clinical diagnosis, some individuals may occasionally exhibit certain symptoms at a subclinical level. Detecting the presence of symptoms in children and adolescents, whether clinically or subclinically, can be challenging, as they might not always express their feelings verbally or through behavior.

Nevertheless, most parents tend to be attuned to their children’s moods and may identify some signs of Seasonal Affective Disorder (SAD). In my perspective, if a parent observes two or three persistent symptoms over a span of two or more weeks, taking proactive measures should be considered.

Here are some recommended steps when Seasonal Affective Disorder is suspected:

1. Maximize exposure to sunlight. Even on cloudy days, encourage outdoor activities when sunlight is available.
2. When indoors, promote spending ample time near windows to benefit from available ambient light, even on overcast days.
3. Explore the use of various devices, such as light therapy lamps, boxes, and eyeglasses, in addition to natural sunlight.
4. Emphasize good sleep hygiene, including bedtime routines, limiting electronic device use before bedtime, maintaining an optimal sleep environment in terms of temperature and humidity, and adhering to a consistent bedtime and wake-up schedule throughout the week.
5. Encourage regular exercise, recognizing that winter weather and shorter days may necessitate extra effort to find suitable activities.
6. Ensure a healthy diet, recognizing the heightened importance when SAD is suspected.
7. If symptoms persist for more than two or three weeks, consider seeking guidance from a healthcare professional.

Frequently Asked Questions (FAQ) on Seasonal Affective Disorder (SAD)

Q1: What is Seasonal Affective Disorder (SAD)?

A1: Seasonal Affective Disorder, commonly known as SAD, is a type of depression that occurs at specific times of the year, typically during fall and winter when there is less sunlight. It is characterized by a recurring pattern of depressive symptoms.

Q2: What are the common symptoms of Seasonal Affective Disorder?

A2: Symptoms of SAD may include persistent low mood, loss of interest or pleasure, changes in sleep patterns, weight gain or loss, fatigue, feelings of worthlessness, and difficulty concentrating.

Q3: How is SAD different from regular depression?

A3: SAD is a subtype of major depressive disorder, and its distinctive feature is the seasonal pattern of occurrence. Symptoms typically start and resolve around the same time each year.

Q4: Who is at risk for developing SAD?

A4: SAD can affect people of all ages, but it is more prevalent in women and those living farther from the equator. Individuals with a history of depression or a family history of mood disorders may also be at a higher risk.

Q5: How is SAD diagnosed?

A5: Diagnosis involves a thorough evaluation by a healthcare professional. The individual must meet specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), including a seasonal pattern of depressive episodes.

Q6: Can children and adolescents have SAD?

A6: Yes, children and adolescents can experience SAD. However, it may manifest differently, and they may find it challenging to express their feelings verbally or behaviorally.

Q7: What are some self-help strategies for managing SAD?

A7: Strategies include maximizing exposure to natural sunlight, utilizing light therapy lamps, practicing good sleep hygiene, engaging in regular exercise, maintaining a healthy diet, and seeking professional help if symptoms persist.

Q8: How is light therapy used in treating SAD?

A8: Light therapy involves exposure to a bright light, simulating natural sunlight, for a specified duration each day. This can help regulate mood and improve symptoms of SAD.

Q9: Are medications prescribed for SAD?

A9: In some cases, healthcare professionals may recommend antidepressant medications, especially for individuals with severe symptoms. Consultation with a healthcare provider is crucial for appropriate treatment decisions.

Q10: When should I seek professional help for SAD?

A10: If you experience persistent symptoms of depression for more than two weeks, interfere with daily functioning, or worsen over time, it is advisable to seek guidance from a healthcare professional for an accurate diagnosis and tailored treatment plan.