First described in 1984 by Norman Rosenthal and his colleagues, Seasonal Affective Disorder (SAD) is a depression condition with a seasonal component.
SAD isn’t a distinct diagnosis on its own but acts as a specifier within the diagnosis of major depressive disorder and bipolar disorder. If you have depression or bipolar disorder that follows a seasonal pattern, it might be diagnosed as SAD (Jacobson et al., 1987).
It’s crucial to understand that, like all mental health diagnoses, there can be confusion due to overlapping symptoms. Some professionals even doubt its existence. However, from my own experience in practice, I firmly believe in its validity. Recognizing this component is essential as it might guide the approach of the therapist or doctor treating you.
One clear definition of seasonal affective disorder is a form of clinical depression that recurs annually, starting in the fall and winter and concluding in the spring and summer (Rohan, 2009).
What is the Criteria for Seasonal Affective Disorder?
While everyone exhibits seasonal variations in behavior and mood – feeling sluggish or blue in the winter, for instance, and more energized in spring and summer – these patterns don’t necessarily equate to SAD. To be diagnosed with SAD, you must first have depression or bipolar disorder. It’s also worth noting that many experience sub-clinical symptoms (significant but not enough for a diagnosis), often termed “Winter Blues.” If this resonates, seeking help is advisable. Early therapy can be more effective!
When will a doctor tell you you have a Seasonal Affective Disorder?
How Patterns Help Us Determine Seasonal Affective Disorder
Typically, seasonal depressive disorder manifests as winter depression, starting in the fall/winter. However, there’s another form known as summer depression, which begins in the spring and early summer. Each type has its distinct symptom set.
Winter SAD often presents with symptoms not common in general depression: daytime drowsiness, cravings for carbohydrates, weight gain, fatigue, and excessive sleepiness (Jacobson et al., 1987).
Common signs and symptoms of SAD include anxious feelings, guilt, irritability, difficulty concentrating, constant bad mood, decreased libido, increased appetite, social isolation, and even suicidal thoughts. It is more prevalent in women and living further from the equator may increase the risk of developing SAD, according to research.
What Causes Seasonal Affective Disorder?
Theories regarding the causes of SAD revolve around melatonin, serotonin, vitamin d, and alterations in the circadian rhythm (Jacobson, 1987). The success of light therapy in treating SAD points toward specific mechanisms that should be studied to ascertain the condition’s origins.
Risk Factors of Seasonal Affective Disorder
Seasonal Depression Risk Factors include:
Facts About Seasonal Affective Disorder
Relationship between ADHD and Seasonal Affective Disorder:
Individuals with ADHD may be more susceptible to Seasonal Affective Disorder. This susceptibility could be attributed to shared neurobiological mechanisms, particularly disruptions in the pathways of dopamine and serotonin (Biederman J, et al., 1998). When it comes to treatment, those diagnosed with both ADHD and SAD require a diverse range of therapeutic approaches. Light therapy, commonly used for SAD, might also benefit some individuals with ADHD by improving alertness and regulating sleep patterns. The reduced exposure to natural light during winter months can intensify Seasonal Affective Disorder symptoms. Lastly, disruptions in circadian rhythms have implications for both ADHD and Seasonal Affective Disorder. The shorter days of winter can disrupt the body’s internal clock, which is a factor in SAD. Similarly, ADHD has been associated with disruptions in circadian rhythms, with some individuals displaying symptoms of delayed sleep phase syndrome (Coogan AN, McGowan NM, 2017).
Effective treatments include light therapy, antidepressants, and cognitive behavioral therapy. Practicing self-compassion and stress reduction can help prepare for difficult seasons and seeking extra support is always a good idea. Ask your doctor about light therapy, it can be helpful.
References for ADHD and Seasonal Affective Disorder:
Biederman J, et al. (1998). Attention-deficit/hyperactivity disorder and comorbid disorders: issues of overlapping symptoms. American Journal of Psychiatry.
Rohan KJ, et al. (2004). Randomized trial of cognitive-behavioral therapy versus light therapy for seasonal affective disorder: Acute outcomes. American Journal of Psychiatry.
Melrose S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression Research and Treatment.
Coogan AN, McGowan NM. (2017). A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder. *Attention Deficit and Hyperactivity Disorders
Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.
References for Seasonal Affective Disorder:
Rohan, Kelly J. Coping with the Seasons: A Cognitive Behavioral Approach to Seasonal Affective Disorder, Workbook, Oxford University Press, 2009. ProQuest Ebook Central, https://ebookcentral.proquest.com/lib/cmlibrary-ebooks/detail.action?docID=415211.
Jacobsen, F. M., Wehr, T. A., Sack, D. A., James, S. P., & Rosenthal, N. E. (1987). Seasonal Affective Disorder: A Review of the Syndrome and Its Public Health Implications. American Journal Of Public Health, 77(1), 57-60.
Lam, et al. (2004). Seasonal mood symptoms in bulimia nervosa and seasonal affective disorder Comprehensive Psychiatry, 32(6),552-558.
Leu SJ et al, “Immune-inflammatory markers in patients with seasonal affective disorder: effects of light therapy”, J Affect Disord. 2001 Mar; 63(1-3): 27-43.
Mersch, P. P. A., Middendorp, H. M., Bouhuys, A. L., et al (1999) Seasonal affective disorder and latitude: a review of the literature. Journal of Affective Disorders, 53, 35 -48.
Portella AT, Haaga DA, Rohan KJ.The association between seasonal and premenstrual symptoms is continuous and is not fully accounted for by depressive symptoms. J Nerv Ment Dis. 2006 Nov;194(11):833-7.
Taylor-Walker, C. (2011). Clinical: The basics – Seasonal affective disorder. GP: General Practitioner, 24.
Wehr TA, Giesen HA, Schulz PM, Anderson JL, Joseph-Vanderpool JR, Kelly K, Kasper S, Rosenthal NE. (1991). Contrasts between symptoms of summer depression and winter depression J Affect Disord. 1991 Dec;23(4):173-83.
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Medical information obtained from this website is not intended as a substitute for professional care. If you have or suspect you have a problem, you should consult a healthcare provider.
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