Seasonal Affective Disorder: When Winter Depression Is More Than the Blues

Owen: The National Institute of Mental Health estimates that millions of Americans experience SAD. It often begins in young adulthood, and it's much more common in women than in men.

Claire: Thanks for joining us. You're listening to Between Visits, sponsored by Hope Health Network, a network of medical practices serving South Carolina. We dig into the medical and mental health topics that matter most to patients and the public.

Claire: I'm Claire, and this is episode 9. I'm going to quickly play our disclaimers, and then we'll get started!

Recorded disclaimer: This show is for entertainment, education and general information only. It's not medical advice, and listening doesn't make you a patient. Our hosts and guests are not real people, medical doctors or healthcare providers. We do our best, but we can be wrong, and our content can have errors and omissions. Talk with a licensed medical provider in your state before you make any decisions about your health or medical care.

Claire: Joining me today is Owen, from our digital entertainment team. Today's topic is an important one: Seasonal Affective Disorder: When Winter Depression Is More Than the Blues.

Claire: This can be a heavy subject. If it ever starts to feel like too much, at any point today, it's okay to step away. And help is always just a call away, any time, day or night. In an emergency, call 911. In a crisis, call or text 988.

Claire: Okay, Owen. Thanks for being here today.

Owen: Thanks, Claire. I'm glad we're talking about this.

Claire: Me too, Owen.

Claire: Let's dig into seasonal affective disorder. Some people call it winter depression. And I think a lot of people just tell themselves, it's winter, everybody feels this way.

Owen: A lot of people do. But shorter days do not have to mean a lost winter. Seasonal affective disorder, or SAD, is a type of depression that comes back around the same time each year. And it can be treated.

Claire: So it's a real kind of depression, not just being a little down in January?

Owen: Right. The National Institute of Mental Health describes it as a type of depression with a seasonal pattern that keeps coming back. Symptoms last about 4 to 5 months of the year.

Claire: So doctors see it as a kind of depression, not its own separate thing?

Owen: That's right. The American Psychiatric Association says its diagnostic manual calls it major depressive disorder with a seasonal pattern.

Claire: Okay. And 4 to 5 months is a big part of the year. When does it usually start?

Owen: The more common form is called winter-pattern SAD. It usually starts in late fall or early winter. It lifts in spring and summer.

Claire: So is that the same as the holiday blues? Because the timing sounds about the same.

Owen: It isn't the same. That institute describes the holiday blues as sadness or anxiety brought on by stress at certain times of the year. SAD is tied to daylight, not the calendar.

Claire: Tied to daylight, not the calendar. Okay. You said winter is the more common form. Is there another one?

Owen: Yes. There's a less common summer pattern. It brings symptoms in spring and summer instead.

Claire: I had no idea. So what does this feel like? How would someone know?

Owen: SAD includes the signs of depression. That can mean a sad, anxious or empty mood most of the day, for at least 2 weeks. You might feel hopeless, irritable, guilty or worthless.

Claire: What else?

Owen: Losing interest in things you used to enjoy. Low energy. Trouble concentrating. Changes in sleep or appetite. Aches or pains with no clear physical cause. And thoughts of death or suicide.

Claire: That last one is serious. If someone listening is having those thoughts right now, what do they do?

Owen: Call or text 988, any time. The 988 Suicide and Crisis Lifeline is free and confidential. And if you are in immediate danger, call 911.

Claire: Thank you. So those are the signs of depression in general. Is there anything special about the winter kind?

Owen: Yes. Winter-pattern SAD often adds three more signs. The first is oversleeping.

Claire: Okay. And the second?

Owen: Overeating, with weight gain and cravings for carbohydrates. Those are starchy and sugary foods, such as bread, pasta and sweets.

Claire: And the third?

Owen: Social withdrawal. That means pulling away from friends and family.

Claire: So sleeping more, eating more, and pulling back from people. I can see how someone might brush those off as just winter.

Owen: They might. That's why it helps to notice if it comes back at the same time each year.

Claire: And the summer kind? Is it the same?

Owen: It looks different. Summer-pattern SAD can bring trouble sleeping, poor appetite with weight loss, restlessness, agitation and anxiety. It can also bring violent or aggressive behavior.

Claire: So almost the opposite on sleep and appetite. Who's more likely to get this?

Owen: The National Institute of Mental Health estimates that millions of Americans experience SAD. It often begins in young adulthood, and it's much more common in women than in men.

Claire: Does it go along with other conditions?

Owen: It can. It's more common in people with depression or bipolar disorder, especially bipolar two disorder. It's also more common in people with A D H D, eating disorders, anxiety or panic disorder. And it sometimes runs in families.

Claire: Here's what I want to ask, though. We're in South Carolina. It's not exactly Alaska. Does this even apply here?

Owen: That's a fair question. Where you live does matter. SAD is more common farther north, where winter days are shorter. People in Alaska or New England are more likely to develop it than people in Texas or Florida.

Claire: So down here, we're in the clear?

Owen: Less likely is not never. Our days in South Carolina get shorter too. So if your mood follows the seasons, it's worth a conversation.

Claire: Okay. So let's say someone goes in and brings this up. How does a provider figure out if it's SAD?

Owen: Your provider may ask you to fill out a short questionnaire. And according to the National Institute of Mental Health, a diagnosis of SAD means three things.

Claire: Go ahead.

Owen: First, you have symptoms of depression, or the seasonal symptoms we just went over. Second, your depression episodes have come during a specific season for at least 2 years in a row.

Claire: So one rough winter doesn't make it SAD.

Owen: Right. It takes that pattern. Although not everyone has symptoms every single year. And third, those seasonal episodes happen more often than episodes at other times of year.

Claire: Okay. Same season, 2 years in a row, and more often than other times. Could something else be causing it, though?

Owen: It could. Certain medicines and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression. A provider can rule these out with a physical exam, an interview and lab tests.

Claire: That makes sense. So let's get to it. What helps?

Owen: The National Institute of Mental Health names four main treatments, used alone or together. Light therapy, antidepressant medicine, talk therapy and vitamin D.

Claire: Let's start with light therapy. Is that just sitting by a window?

Owen: Not quite. It's used for winter-pattern SAD. It usually means sitting in front of a 10,000 lux light box for about 30 to 45 minutes a day. That's most often first thing in the morning, from fall to spring.

Claire: What's a lux?

Owen: Lux is a measure of how bright a light is.

Claire: So a very bright box, every morning, for months. Can anybody do that?

Owen: If you have certain eye diseases, or you take medicines that make you more sensitive to sunlight, ask your provider first.

Claire: What about medicine?

Owen: Antidepressants usually take 4 to 8 weeks to work, and you may need to try more than one. One common type, called selective serotonin reuptake inhibitors, is sometimes used.

Claire: So you'd need some patience. It's not a quick fix.

Owen: Right. There's also a medicine called bupropion, in an extended-release form. That means the medicine is let out slowly. The institute notes that the Food and Drug Administration has approved it. For many people, it can prevent seasonal episodes when taken daily from fall through early spring.

Claire: So you'd start before it gets bad. Interesting. Does that work for everybody?

Owen: It says for many people, not everyone. So ask your provider whether planning ahead fits you.

Claire: And talk therapy?

Owen: The institute describes a form of cognitive behavioral therapy made for SAD. You may hear it called C B T for SAD. It's a kind of talk therapy. In one direct comparison, it and light therapy worked about equally well.

Claire: About equally well. So talking can do about as much as the light box, at least in that comparison.

Owen: In that one comparison, yes. Talk with a provider about whether it fits you.

Claire: Now, vitamin D. I feel like people would hear that and just go buy some. Should they?

Owen: I'd slow down there. Many people with winter-pattern SAD are low in vitamin D, so supplements may help. But study results are mixed. And vitamin D can interact with some medicines. So check with your provider first.

Claire: Good to know. So people have a few choices, and your provider helps you decide.

Owen: Yes. Treatment can include medication, counseling or both. Your provider can help you decide what fits.

Claire: For someone who feels like they're the only one going through this, is there anything you'd say?

Owen: You are far from alone. The Substance Abuse and Mental Health Services Administration has a national survey. It estimates that in 2025, nearly 20 million U.S. adults had a major depressive episode in the past year. That's about 7 in every 100 adults.

Claire: Nearly 20 million. And that's depression in general, not just the seasonal kind?

Owen: Right. It's depression in general.

Claire: What could someone say to their provider, if they think this is them?

Owen: Here's one to bring along. Do my symptoms follow a seasonal pattern, and should we plan my treatment before the days get shorter next fall?

Claire: I like the planning ahead part. You're not waiting for it to hit.

Owen: Right. Knowing the signs lets you and your provider plan ahead.

Claire: Okay, before we wrap up. If people only remember a few things from today, what should they be?

Owen: First, SAD is a type of depression tied to daylight. It's more than the winter blues, and it can be treated.

Claire: Okay. What else?

Owen: Second, watch for the pattern. If your mood drops in the same season, year after year, tell your provider.

Claire: And one more?

Owen: If you are having thoughts of suicide, call or text 988, any time. It's free and it's confidential. And call 911 if you are in immediate danger.

Claire: Thank you for saying that. This has been really helpful.

Owen: Thanks for having me, Claire. I hope it helps someone.

Claire: This episode is sponsored by Hope Health Network. Its member practices all have providers experienced in managing seasonal affective disorder, or can refer you to a network provider who is. Hope Health Network medical practices provide evidence-based medical care and include Hope Integrative Medicine, Hope Medical Associates, Hope Behavioral Medicine and Hope Addiction Medicine. To learn more, go to Hope Health Network dot com. That website, along with appointment links for all four practices, is in the description of this episode.

Claire: One last reminder. In an emergency, call 911. In a crisis, call or text 988.

Claire: This podcast is a production of Hope Health Network Media.

Claire: You've been listening to episode 9 of Between Visits, Seasonal Affective Disorder: When Winter Depression Is More Than the Blues. Thanks for hanging out with us. See you next time!