If I look up from my office computer in southeast Portland I see a patchwork of brick buildings interspersed by evergreen patches of forest, all pushing up against a lead-coloured sky. It’s winter in the Pacific Northwest, and we’re a couple months into a rainy season that will probably last until April. Lucky me, I love the rain and cold—as long as I get enough kung fu and yoga, I’m happy all winter. Yes please, I’d love to wear my striped sweater for six more months. Bring on the cider.
But in the spring, when the benevolent sun appears over my city and the rest of the world rejoices, I start to feel unaccountably depressed. The sun hurts my eyes, the bustle on the streets overwhelms me, and I find myself crying for no real reason. I struggle to sleep; basic functions are too much to face. Farmer’s markets and movies in the park? Nope. You’ll find me huddled in the basement re-watching season four of Buffy the Vampire Slayer.
What’s going on? If my sadness and depressive symptoms occurred in the winter, I’d quickly self-analyse: SAD, or Seasonal Affective Disorder. Michael Barness M.D., a licensed psychiatrist and founder of Mindful Medicine, in New Jersey, says, “We have noticed that certain people with a major depressive disorder have recurring sadness at specific types of the year. Interestingly, 9-10% of people in Alaska are affected by SAD, while closer to the equator, it’s more like 1%.”
Though often diagnosed as a separate disorder, the DSM, or Diagnostic and Statistical Manual of Mental Disorders (known to layfolk as the Psychiatry Bible) has recently been revised to include Seasonal Affective Disorder as a subset of a major depressive disorder. Folks who suffer from depression may find themselves sadder at certain times of the year, every year.
If my opening paragraph about the Portland sky made you feel bleary and dread the months of winter you might be facing if you're in the Northern Hemisphere, you might be at risk for classic SAD. Dr. Sanam Hafeez, a New York-based neuropsychologist and faculty member of Columbia University, says, “Winter SAD sufferers tend to sleep and eat more, effectively ‘hibernating’ through the season.” Other symptoms include feeling sad most of the time, at the same time every fall or winter; having difficulty concentrating; weight gain; tiredness; and low energy. This type of mood disorder has received plenty of coverage in the media, and Dr. Barness says he approaches it as with any other aspect of major depression with his clients, using a mix of treating the symptoms, talk therapy, and medication.
Reverse SAD has slightly different symptoms
What about sadness and depression in the summer, or reverse Seasonal Affective Disorder? Dr. Hafeez points out that the symptoms of reverse SAD are often opposite those of SAD. “People with summer SAD are likely to have insomnia, need less sleep or get less sleep, and they are likely to eat less and lose weight. They are often agitated instead of being lethargic. Disturbingly, they express more suicidal ideations. Because of insomnia, they can find it hard to perform simple everyday tasks like washing clothes or doing the dishes. Some people find that there is so much light that they always feel as if they have had sleep stolen from them.”
According to Dr. Hafeez, summer and winter SAD differ in their symptoms; individuals with reverse SAD may feel manic, while those with wintertime SAD lack energy. She adds that researchers have identified two-thirds of patients with SAD have a relative with a major mood disorder, so it may be genetic.
What causes these types of Seasonal Affective Disorder?
Scientists are still learning, says Dr. Barness, but what’s thought to be happening is an imbalance in the amounts of serotonin, a neurotransmitter in the brain and other places. “We know when we increase [serotonin], people feel less depressed and anxious.” He adds that the body’s melatonin system is also an important player in depression; released by the pineal gland, melatonin regulates the body’s circadian rhythms. According to Dr. Hafeez, “As the seasons change, our brain physiology adapts from winter mode to the warmer spring weather, and those with [SAD] likely have trouble transitioning.”
Interestingly, summer SAD and winter SAD seem to be prevalent in areas that are particularly prone to warmer summers. In other words, people in the southern U.S. tend to experience summer SAD more than those in the north, and vice versa.
When should you see a professional?
If you suspect you are experiencing SAD—noticeable, recurring sadness at the same time of year every year—don’t hesitate to discuss it with a professional. SAD has been largely destigmatisd, and as with any mood disorder, professional help may make a great difference for you. Seeing a professional is always the best step, immediately.
If you suspect you are experiencing mild (non-debilitating) SAD and don’t want or are unable to see a professional for help, try dealing with the symptoms to help the underlying depression.
For autumn and winter SAD, regular exposure to a melatonin-regulating light is commonly recommended to time your circadian rhythms and help you sleep better. Dr. Barness says he usually begins by helping his patients with their sleeping patterns, then inquires about diet and exercise. “It’s intuitive—diet, exercise, what are you eating? Are you consuming too much alcohol, are there other things going on? Sometimes it’s almost so obvious that people don’t notice. Those two bottles of wine probably aren’t helping your seasonal depression.” Regular exercise, healthy food, enough sleep, limiting screen time, and plenty of socialising are all ways to improve your quality of life during the low months of fall and winter.
When it comes to improving your quality of life during the summer, Dr. Hafeez recommends staying inside during the heat of the day; cooling down with showers, swimming and air conditioning; taking afternoon naps; and trying to stay busy. She points out that many people have “fear of missing out” during the summer, especially on the weekends, which only serves to increase anxiety and depression. As during the winter, focus on not getting isolated, and always being gentle to yourself.
Dealing with SAD at work can be rough as well. Try following the above tips as well as improving the comfort of your immediate surroundings. If you sit near a window and the summer sun is hurting your eyes, lower the shades. Dim the lights if you can during the summer or brighten them during the winter. Speak to your doctor about medication during the season when your depression is the strongest, and experiment with tapering off as you exit that time of the year. If you tend to overheat, bring a portable fan. If time and finances make it possible, take a vacation somewhere that will give you a break from the conditions negatively impacting you.
If the bright blue skies of summer make you flinch, take heart: You’re not alone. Seasonal Affective Disorder affects a large number of individuals who already suffer from mood disorders and can occur at any time in the year. I, along with many other SAD sufferers, will be right there with you, sunglasses firmly in place.