Now that sunshine is at a premium, with shorter daylight hours, longer nights and cold weather, many of us know that the onset of “winter blues” is around the corner. Compounding this common condition, the isolation that many of us have experienced due to COVID-19 can exacerbate and intensify the symptoms of seasonal affective disorder.

Seasonal affective disorder (SAD) is a form of depression associated with seasonal patterns, and it is not always clear whether the symptoms are part of a more serious depression, which would require intensive treatment.

SAD shows up during the fall and winter months, when there are fewer hours of sunlight, and improves when daylight increases as we approach spring. It is estimated that five percent of the population experience SAD symptoms. Some individuals may experience depression symptoms that extend to other times of the year; this may not be seasonal affective disorder, but rather some other type of health issue.

Signs and symptoms of seasonal affective disorder

Feeling depressed most of the day, almost every day

Feelings of worthlessness, helplessness, and/or hopelessness

Low energy and fatigue

Low mood

Loss of interest in previously enjoyable activities

Difficulty sleeping or sleeping too much (hypersomnia)

Overeating and weight gain  

Irritability

Difficulty concentrating  

Isolation and social withdrawal  

Carb cravings

If you are experiencing depression symptoms year-round, your doctor will likely consider a diagnosis of major depression.

During the winter months, people with SAD show symptoms more than at any other time of the year. The reason why some people get SAD is unknown; however, researchers describe decreased levels of serotonin—one of the neurotransmitters affecting your moods—and an increase in melatonin, leading to more daytime sleepiness. This condition is more prevalent in northern locations of the U.S. as compared to southern states.    

Some symptoms of SAD

People can experience a wide range of symptoms that can wax and wane as the winter and early spring progress. Adults often present to their doctor with complaints of lethargy, irritability, or complaint of sleep disruption—either they are unable to sleep or are experiencing excessive sleepiness. Children and teens can also be affected by SAD, but the presentation may differ from adults. Children might show significant fussiness, clinginess or emotional outbursts. [For the full list, see sidebar.]

Non-pharmacological ways of improving SAD symptoms

There are many approaches and activities you can try as part of an overall treatment plan to moderate symptoms. These include:  

Maintain a regular exercise program and follow a healthy diet. Do not tempt yourself with fast food carryout or snacks. Gaining weight does not help your self-image.

Even though you may not feel like it, continue to participate in your favorite personal activities and volunteering.  

Many of us now use virtual interactive tools such as Zoom. Remain in frequent touch with friends and family during the months when the weather prevents us from venturing out.

Because of COVID restrictions, many of us have developed a “bubble” of friends and family for periodic get-togethers. This should also be maintained, following COVID guidelines (especially receiving a vaccination with a booster). Become creative.

For more severe and persistent SAD symptoms, professional help should be sought. Many of our health plans provide for telephone interviews with mental health professionals. Because people are still hesitant in going out due to our pandemic, using teletherapy can be a valuable resource.

Light therapy has been utilized for many years. There are many types of devices available, but first, try opening your blinds and increasing the amount of natural light in your living space during these winter months.  

Your doctor may feel that an antidepressant may be helpful, along with some form of talking therapy. Combining both approaches has been shown to be more effective than either alone.

The pandemic, SAD and depression

How will our continuing pandemic impact vulnerable people with SAD and underlying depression? Because we are now in our second year of the pandemic and going into the third, most of us are aware that limiting social interactions because of COVID-19 leads to varying amounts of anxiety and depression in all of us. Exacerbating this is the effect of job disruptions and changes in our educational systems.

We also need to be aware that individuals who have contracted COVID-19 can have persistent psychological effects, including depression and “brain fog.” If you notice changing behaviors in family members and friends who have had COVID-19, encourage them to seek out professional help.