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The Winter Blues: Seasonal Affective Disorder is Real


written by Dr. Christine Bishara - Dec 2, 2024

Photo Credit: by Pexels.com, Pixabay
Photo Credit: by Pexels.com, Pixabay

As the days grow shorter and the crispness of winter settles in, many of us may feel a bit more down than usual. This is a common occurrence known as Seasonal Affective Disorder (SAD), a type of depression that typically emerges during the fall and winter months when sunlight becomes harder to come by. It’s not uncommon to feel a dip in energy, a touch of sadness, or even a desire to retreat from social activities, but don’t worry—understanding SAD is the first step toward brighter days ahead. This article explores the fascinating link between melatonin and serotonin, uncover factors contributing to SAD, and share effective treatments to lift your spirits during these colder months.

UNDERSTANDING SAD

Seasonal Affective Disorder (SAD) frequently occurs when daylight hours are shorter. Symptoms often begin in autumn, peak during December to February, and improve with the arrival of spring. While commonly associated with winter, some individuals may experience SAD in the summer.

Prevalence and Demographic Factors

SAD affects about 5% of adults in the U.S., with higher prevalence at higher latitudes due to reduced daylight. It is more common in women and typically begins between ages 18 and 30. SAD prevalence

SYMPTOMS OF SADM

Low energy: Persistent fatigue and lack of motivation.

Changes in sleep patterns: Often characterized by oversleeping or difficulty waking up.

Increased appetite: Cravings for carbohydrates, leading to weight gain.

Difficulty concentrating: Trouble focusing on tasks or making decisions.

Persistent low mood: Sadness or hopelessness that lasts throughout the season.

Irritability: Increased frustration or mood swings.

Feelings of despair and worthlessness: A pervasive sense of hopelessness.

While SAD shares many symptoms with major depression, it is important to note distinctions that define it as a seasonal disorder and NOT major depressive disorder. Recognizing these differences can aid in accurate diagnosis and treatment.

Seasonal pattern: Symptoms typically emerge during specific seasons (fall/winter) and improve in spring/summer.

Duration: Symptoms are often more pronounced during the affected months and do not usually persist year-round.

Triggers: SAD is closely linked to changes in daylight exposure, whereas major depression can occur independently of seasonal changes.

Response to treatment: Light therapy is often effective for SAD, while major depression may require different therapeutic approaches.

BIOLOGICAL FACTORS

The Role of Melatonin in Sleep Regulation

Melatonin is a hormone released by the pineal gland in response to darkness, signaling the body that it is time to sleep. It regulates circadian and seasonal rhythms by adjusting the sleep-wake cycle according to changes in day length. In Seasonal Affective Disorder, melatonin secretion may be prolonged and disrupt the circadian rhythm cycle, further contributing to symptoms.

https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder?t&utm

Impact of Serotonin on Mood

Serotonin is a neurotransmitter crucial for mood regulation. In SAD, reduced sunlight can also lower serotonin levels, leading to depressive symptoms. This reduction disrupts normal daily rhythms and impairs mood regulation, contributing to the onset of SAD during shorter daylight periods.

https://pmc.ncbi.nlm.nih.gov/articles/PMC3202491/?t&utm

Understanding the relationship between melatonin and serotonin is important as it highlights the circadian misalignment in SAD. The phase shift hypothesis (PSH) suggests that SAD is often due to a delay in circadian rhythms relative to the sleep/wake cycle, and bright light exposure in the morning is recommended to correct this misalignment.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2768314/?t&utm

Additionally, research indicates that circadian misalignment increases mood vulnerability, particularly in contexts like shift work.

https://www.nature.com/articles/s41598-020-75245-9?t&utm

ENVIRONMENTAL TRIGGERS

Reduced sunlight exposure during fall and winter is a key environmental trigger for SAD. Geographically, SAD is more prevalent in regions farther from the equator. This is because these areas experience more significant seasonal variations in daylight. For instance, people living in northern latitudes are more likely to develop SAD due to the extended periods of darkness during winter months.

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/seasonal-affective-disorder-not-just-the-winter-blues?t&utm

TREATMENT OPTIONS

Here’s a list of lifestyle modifications/ natural therapies for SAD. As you can see, there are many options available. These options are typically favored as early interventions since they are straightforward and effective.

Light Therapy: Use a light box that mimics natural sunlight for 20-60 minutes to help regulate mood-related chemicals. Red light therapy has been shown to be effective.

Cognitive Behavioral Therapy (CBT): Focuses on changing negative thought patterns and behaviors, specifically adapted for SAD.

Increased Sunlight Exposure: Spend more time outdoors or near windows early in the day to increase natural light exposure.

Create a Bright Environment: Use bright lights indoors and open curtains during the day to maximize natural light exposure.

Exercise: Engage in regular physical activity, especially outdoors, to boost mood and alleviate symptoms.

Diet: Follow a balanced diet rich in omega-3 fatty acids, vitamin D, and whole foods while limiting refined carbohydrates. Vitamin D, in particular, is effective because it plays a role in serotonin production. Eating foods rich in the amino acid tryptophan can also have profound effects. Tryptophan is the precursor for serotonin and can help increase its production. Foods include walnuts, bananas, pineapples, and eggs.

Social Activities: Engage in social interactions and activities to combat isolation and improve mood.

Gut Health: Consume fermented foods and probiotics to maintain a healthy gut microbiome, which can also influence serotonin production.

MEDICATIONS

Medication for Seasonal Affective Disorder (SAD) is typically considered when other treatments and lifestyle changes are insufficient in alleviating symptoms. Medication may be used alone or alongside other therapies, depending on individual needs and the severity of symptoms.

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While this article provides suggested solutions for SAD, always speak to your doctor before starting any treatment or medication. If you have thoughts of suicide or would like to talk to someone, you can call the crisis/suicide hotline at 988.

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