- Seasonal Depression (SAD): Symptoms & Treatments
- Can people get summer depression?
- How common is seasonal affective disorder (SAD)?
- Who is at risk for seasonal affective disorder (SAD)?
- What are the symptoms of seasonal affective disorder (SAD)?
- What tests will I need to diagnose seasonal affective disorder (SAD)?
- What are the criteria for a seasonal affective disorder (SAD) diagnosis?
- How does light therapy work?
- What time of day should I use light therapy?
- How long will it take light therapy to work?
- How long do I use light therapy for?
- Is light therapy safe?
- Can I use a tanning bed instead of light therapy to treat seasonal affective disorder (SAD)?
- What type of antidepressants can help with seasonal affective disorder (SAD)?
- Can seasonal affective disorder (SAD) come back?
- When should I see my healthcare provider about seasonal affective disorder (SAD)?
- When should I go to the emergency room?
- What should I ask my healthcare provider?
- Light Treatment for Seasonal Affective Disorder
- What is the best light box to buy?
- Can I just put special bulbs into my light fixtures at home?
- How much light exposure is enough?
- 8 Golden Rules For Buying A Light Box for SAD
- 2. Look for a lamp specifically designed to treat seasonal affective disorder
- 3. Buy a clinically tested light box
- 4. Buy a lamp with the right KIND of light
Seasonal Depression (SAD): Symptoms & Treatments
More than just «the winter blues,» seasonal depression, often called seasonal affective disorder (SAD), occurs at the same time each year. Fortunately, treatment is available.
Seasonal affective disorder (SAD) is depression that gets triggered by a change in seasons, usually when fall starts.
This seasonal depression gets worse in the winter before ending in the spring.
Some people may get a mild version of SAD known as the “winter blues.” It’s normal to feel a little down during colder months. You may be stuck inside, and it gets dark early.
But full SAD goes beyond that — it’s a form of depression. Un the winter blues, SAD affects your daily life, including how you feel and think. Fortunately, treatment can help you get through this challenging time.
Can people get summer depression?
Some people get a rare form of SAD called “summer depression.” It starts in the late spring or early summer and ends in the fall.
How common is seasonal affective disorder (SAD)?
About 5% of adults in the United States experience SAD. It tends to start in young adulthood. SAD affects women more than men, though researchers aren’t sure why. About 75% of people who get seasonal affective disorder are women.
About 10% to 20% of people in America may get a milder form of the winter blues.
Who is at risk for seasonal affective disorder (SAD)?
SAD is more common in younger people and women. You’re also at higher risk if you:
- Have another mood disorder, such as major depressive disorder or bipolar disorder.
- Have relatives with other mental health conditions, such as depression or schizophrenia.
- Live at high latitudes (farther north of the equator), such as Alaska or New England.
- Live in cloudy regions.
People with seasonal affective disorder may also have other mental conditions, such as:
Researchers don’t know exactly what causes seasonal depression. The lack of sunlight may trigger the condition in people who are prone to getting it. The theories suggest:
- Biological clock change: When someone has less exposure to sunlight, their biological clock shifts. This internal clock regulates mood, sleep and hormones. When it changes, people may have trouble regulating their moods.
- Brain chemical imbalance: Brain chemicals called neurotransmitters send communications between nerves. These chemicals include serotonin, which contributes to feelings of happiness. People at risk of SAD may already have less serotonin activity. Since sunlight helps regulate serotonin, the lack of winter sun can make the situation worse. Serotonin levels can fall further, leading to mood changes.
- Vitamin D deficit: Serotonin also gets a boost from vitamin D. Since sunlight helps us produce vitamin D, less sun in the winter can lead to a vitamin D deficiency. That change can affect serotonin and mood.
- Melatonin boost: Melatonin is a chemical that affects sleep patterns. The lack of sunlight may stimulate an overproduction of melatonin in some people. They may feel sluggish and sleepy during the winter.
- Negative thoughts: People with SAD often have stress, anxiety and negative thoughts about the winter. Researchers aren’t sure if these negative thoughts are a cause or effect of seasonal depression.
What are the symptoms of seasonal affective disorder (SAD)?
SAD is a type of depression, rather than a separate disorder. So people who have seasonal affective disorder may have signs of depression, including:
- Carbohydrate cravings and weight gain.
- Extreme fatigue and lack of energy.
- Feelings of hopelessness or worthlessness.
- Inability to concentrate.
- Limbs feeling heavy.
- Loss of interest in usual activities, including withdrawing from social activities.
- Sleeping more.
- Thoughts of death or suicide.
People who have summer SAD may experience:
- Agitation and restlessness.
- Decreased appetite and weight loss.
- Episodes of violent behavior.
- Trouble sleeping.
If you have symptoms of SAD, don’t try to diagnose yourself. See a healthcare provider for a thorough evaluation. You may have a physical issue that’s causing depression. But many times, seasonal affective disorder is part of a more complex mental health issue.
Your provider may refer you to a psychiatrist or psychologist. These mental health professionals talk to you about your symptoms. They consider the pattern of symptoms and decide if you have seasonal depression or another mood disorder. You may need to fill out a questionnaire to determine if you have SAD.
What tests will I need to diagnose seasonal affective disorder (SAD)?
There’s no blood test or scan to diagnose seasonal depression. Still, your provider may recommend testing to rule out other conditions that cause similar symptoms.
What are the criteria for a seasonal affective disorder (SAD) diagnosis?
Your provider may diagnose you with SAD if you have:
- Symptoms of major depression.
- Depressive episodes that occur during specific seasons for at least two consecutive years.
- Depressive episodes that happen more frequently during a specific season than during the rest of the year.
Your provider will talk to you about treatment options. You may need a combination of treatments, including:
- Phototherapy: Bright light therapy, using a special lamp, can treat SAD.
- Cognitive behavioral therapy (CBT): A type of talk therapy called CBT can also effectively treat SAD. Research has shown that CBT produces the longest-lasting effects of any treatment approach.
- Antidepressant medication: Sometimes, providers recommend medication for depression, either alone or with light therapy.
- Spending time outdoors: Getting more sunlight can help improve symptoms. Try to get out during the day. Also increase the amount of sunlight that enters your home or office.
- Vitamin D: A vitamin D supplement may help improve symptoms.
How does light therapy work?
To use light therapy, or phototherapy, you get a special lamp. It has white fluorescent light tubes covered with a plastic screen to block ultraviolet rays. The light is about 20 times brighter than regular indoor light. The intensity of light emitted should be 10,000 lux.
To use phototherapy, don’t look directly into the light. Place the lamp about 2 or 3 feet away while you read, eat or do other activities.
What time of day should I use light therapy?
When you use light therapy may impact how effective it is. Morning light therapy seems to work better. Plus, using it later in the day may cause insomnia. Many health professionals recommend 10,000 lux for 15 to 30 minutes every morning.
How long will it take light therapy to work?
People who use a lamp for SAD often see results within two to four days. It may take about two weeks to reach the full benefits.
How long do I use light therapy for?
Healthcare providers often recommend using light therapy through the entire winter. SAD symptoms can return quickly after stopping light therapy. Continuing to use the therapy can help you feel your best throughout the season.
Is light therapy safe?
Light therapy is typically safe and well-tolerated. But you may need to avoid light therapy if you:
- Have diabetes or retinopathies: If you have diabetes or a retina condition, there’s a potential risk of damaging the retina, the back of your eye.
- Take some medications: Certain antibiotics and anti-inflammatories can make you more sensitive to sunlight. Light therapy can then cause harm.
- Have bipolar disorder: Bright light therapy can trigger hypomania or mania, uncontrolled boosts in mood and energy level. People with bipolar disorder need medical supervision to use light therapy.
You may experience:
Can I use a tanning bed instead of light therapy to treat seasonal affective disorder (SAD)?
Don’t use tanning beds to treat SAD. Tanning beds do generate enough light, but they can cause other harm. They produce a high amount of UV rays that can hurt your skin and eyes.
What type of antidepressants can help with seasonal affective disorder (SAD)?
Medications called selective serotonin reuptake inhibitors (SSRIs) can treat SAD. They improve mood by regulating serotonin levels in your body.
Another approved antidepressant called bupropion comes as an extended-release tablet. It can prevent seasonal depression episodes when people take it daily from fall to early spring.
You may not be able to prevent the first episode of SAD. But once your provider has diagnosed you with seasonal depression, you can take steps to help keep it from coming back:
- Use your light box: Start using light therapy at the beginning of fall, before you feel SAD symptoms.
- Get out: Spend time outside every day, even if it’s cloudy. Daylight can help you feel better.
- Eat a well-balanced diet: Even though your body may crave starchy and sweet foods, stick to nutritious choices. A healthy diet with enough vitamins and minerals can give you the energy you need.
- Exercise: Try to get 30 minutes of exercise, three times a week.
- See friends: Stay involved with your social circle and regular activities. They can provide support during the winter months.
- Find help: Consider seeing a mental health professional who’s trained in CBT. This treatment can be very effective for seasonal affective disorder.
- Consider medications: Talk to your healthcare provider about taking an antidepressant. Medications can help if your symptoms are severe or if they continue after other treatments. In some cases, taking the medication before SAD begins can prevent episodes.
Talk to your healthcare provider to find out if starting treatment early, as a preventive measure, is right for you.
The outlook is positive. Treatments are available for SAD. People who get the right diagnosis and combination of treatments can find relief from symptoms. Talk to your healthcare provider to figure out the treatment that will work best for you.
Can seasonal affective disorder (SAD) come back?
People who are prone to seasonal affective disorder can get it every year. But you can take steps to prevent or lessen symptoms.
Talk to your healthcare provider. By planning ahead, you can manage your symptoms and feel your best.
- Stick to your treatment plan: If you have medications or a lamp for SAD, use them as directed. Follow up with your healthcare provider if you don’t see an improvement in your symptoms.
- Care for yourself: Eat a well-balanced diet. Get enough sleep. Exercise regularly. Try to manage stress, perhaps by talking to a counselor or therapist.
- Plan ahead: Make a plan for what you’ll do if your symptoms get worse. If you notice signs of depression, take action. It might help to plan a lot of activities during these months. Having a busy schedule keeps you from hunkering down at home.
- Start treatment early: Talk to your healthcare provider about preventive treatment. If you know your symptoms start in October, consider starting treatment in September.
- Isolate yourself: Being alone can make your symptoms worse. Even though you may not feel going out or being social, try to reach out to friends and loved ones.
- Use alcohol or drugs: They might make symptoms worse. And they can interact negatively with antidepressants.
When should I see my healthcare provider about seasonal affective disorder (SAD)?
If you think you have symptoms of seasonal depression or another mood disorder, see your healthcare provider. Your provider will want to rule out another condition or illness that may be causing these symptoms.
When should I go to the emergency room?
If you or a loved one has suicidal thoughts, get help. Call your provider, go to an emergency room, call 911 or call the National Suicide Prevention Lifeline, at 800.273.8255. This national network of local crisis centers provides free, confidential emotional support to people in suicidal crisis or emotional distress. It’s available 24/7.
What should I ask my healthcare provider?
If you have SAD, ask your provider:
- What treatment is best for me?
- How can I prevent depressive episodes?
- Will light therapy work?
- Should I take an antidepressant?
- When should I start treatment?
- How long should my treatment continue?
- What can I eat (or should avoid eating) to improve my symptoms?
- What else can I do to feel better?
A note from Cleveland Clinic
Seasonal affective disorder (SAD) is a type of depression that happens every year during a specific season, usually winter. Symptoms can include a lack of energy and feelings of hopelessness. Fortunately, there’s treatment for seasonal depression.
Talk to your healthcare provider. The provider may recommend a special lamp for SAD. The lamp emits bright light to improve symptoms. Antidepressants and talk therapy can also provide relief.
If you’ve had seasonal depression in the past, talk to your provider about starting treatment before symptoms begin.
Last reviewed by a Cleveland Clinic medical professional on 12/07/2020.
Light Treatment for Seasonal Affective Disorder
Do you find in the depths of winter you don’t feel yourself? Your energy level might be lower. You might feel irritable. Maybe you have difficulty sleeping. If you find yourself experiencing the symptoms of depression but only during wintertime, you could have seasonal affective disorder (SAD).
SAD is a mood disorder in which a person’s depression occurs repeatedly in a particular season of the year – most often people with SAD get depressed in winter when days are short. SAD is a form of depressive disorder and has the usual symptoms.
What is unique to the specific SAD diagnosis is the seasonal timing. Evidence-based treatments for SAD include light therapy. This requires the use of a specific type of light box to mimic some features of natural sunlight. Janis L.
Anderson, PhD, Department of Psychiatry, Brigham and Women’s Hospital, offers some tips for choosing the right type of light box to treat SAD.
What is the best light box to buy?
Many products have been developed since the 1980s, and several have been used in clinical research studies where they were demonstrated to be effective. However, no one type of bulb or device has been demonstrated superior to all others. The main considerations are cost and safety.
In the absence of FDA regulation, it is up to the consumer to look into claims made by vendors. Some wavelengths of light can be hazardous to eyes or skin, so major research centers have avoided ultraviolet-containing “full-spectrum” bulbs and have used blue light only after careful examination of safety data for the specific device.
In general, cool-white fluorescent or some LED bulbs have been used successfully by many clinical research centers.
Can I just put special bulbs into my light fixtures at home?
It is difficult to safely construct an effective light treatment device on your own.
The high level of light required for daytime use is achieved by using specific reflectors, ballasts, and other components that the average household would not have on hand.
Simply putting brighter bulbs into existing light fixtures is ly to be a waste of money. In addition, electrical safety and wavelengths of the lights are important technical concerns affecting safety that many users are not equipped to evaluate.
One form of light treatment that has been studied to some extent is called “dawn simulation.” This treatment uses less intense light in the bedroom as a person is waking up. However, the light needs to gradually increase in intensity so special equipment is used to produce the gradual increase over a period of an hour or so. Also, it must be acceptable to bed partners.
How much light exposure is enough?
The “dose” of a light for affecting SAD is determined by the intensity and wavelengths of light coming from the device, the distance of the user from the device, the time of day relative to the user’s normal schedule, and the length of time the exposure goes on.
It is possible to get too much light, which can produce discomfort including feeling “wired,” such as after consuming too much caffeine. Working with an experienced clinician, and starting with general guidelines, many SAD patients arrive at a “dose” that works well for them.
Some patients benefit from regularly increasing their exposure to outdoor sunlight after awakening, but the cold weather makes that a challenge.
Here at the Brigham, we are exploring ways to use input from smartphones to inform decisions on when to begin light treatment, and to aid users in selecting the most helpful dose.
For many individuals with SAD, the shorter days of fall and winter bring early changes in functioning, such as difficulty getting up in the morning, which can be effectively addressed by starting properly-timed supplemental light exposures.
In summary, light therapy is one proven treatment for controlling symptoms of seasonal affective disorder during fall/winter months. Specialized lights are recommended for therapy to be effective, and prices can approach $200 or more. Some specific features to consider:
- UV light – Look for lights that block or filter UV light.
- Illumination “dose”– The recommended dose depends on your distance from the light device and the time of day you are using it. It is important to not wake up extra early in order to get a strong dose of light, as that can upset your daily body rhythm.
- Light type – White light has been more widely studied.
- Physician recommendation – Consult with your physician or health care professional. They can help determine whether you are suffering from seasonal affective disorder and evaluate your eyes to make sure that light exposure will be safe for you.
Janis L. Anderson, PhD
Janis L. Anderson, PhD, is a psychologist at Brigham and Women’s Hospital and an assistant professor of psychology at Harvard Medical School.
8 Golden Rules For Buying A Light Box for SAD
There are a lot of other medical conditions that could be causing the same symptoms that often accompanies SAD. If you have not been diagnosed by a medical professional, or been advised to use light therapy by your doctor, you could end up doing more harm than good.
Some of the symptoms that come hand in hand with the winter blues include fatigue, which is caused by a whole bunch of other medical complaints, plus loss of appetite which could also be caused by something more sinister. If the problem that you’re suffering from isn’t SAD, the lamp is going to prove to be a complete waste of your time and money.
Plus if you use the lamp unnecessarily, you could end up causing half the problems you are trying to avoid such as nausea, headaches, and even feelings of agitation.
Precautions have to be made in persons suffering from eye and skin conditions, because the exposure to light could affect them in various ways. By using light therapy, you could be causing further damage so buying an over-the-counter SAD lamp is not a good idea.
Conditions bipolar depression can be agitated by inappropriate use of light therapy. The light rays can actually cause episodes of mania within bipolar patients so as you can probably imagine, using one is not the best idea.
Essentially, if you haven’t been diagnosed or you have any doubts or questions, always check with your doctor before you starting self-treating yourself with light boxes!
2. Look for a lamp specifically designed to treat seasonal affective disorder
There are quite a few different types of light therapy devices on the market, and each of them are used for different things. This is why you should get advice from a doctor – they know what they are doing and what you need. By guessing, you run the risk of getting it wrong.
Lot of the light therapy devices are designed to treat skin conditions or to help with wound healing. You need to make sure you are not buying these as they will not help with your Seasonal Affective Disorder.
Even if you are looking at products specifically designed to help treat the winter blues symptoms you will find that some are less effective than others.
There are things called light caps or light visors which you can buy that are worn on the head. Again, these come in varying strengths and intensities, and are designed for longer-term use.
Reviews about the efficacy of these products are mixed, but in general these are considered only as supplementary options to a regular light box.
You also have dawn simulators which can help you get a brighter start to your day.
These wake you up in the morning gradually, as the sun would, and have been shown to be very effective for those that suffering during the darker winter nights and mornings.
They work by helping to decrease the levels of melatonin in the body in the morning. When you wake up to natural light, you are woken up slowly and naturally rather than being screeched awake by a loud alarm clock in an almost-black room.
With LED lamps and traditional bulk light boxes as well as daylight bulbs and full spectrum lamps, picking the right one is important to getting the best treatment. Dawn simulators help with the sleeping and waking patterns of a SAD sufferer, for example, but it won’t do the job that a full-on light box can do for you.
3. Buy a clinically tested light box
The good thing about being able to buy your light boxes on the internet is the fact that you can get a lot of information on your side before you choose to buy. Amazon, for example, gives you the opportunity to read the reviews and specifications before you part with your cash, and you should check out the smaller details of information such as whether it has been clinically tested.
4. Buy a lamp with the right KIND of light
Light boxes or rather the light they emit come in different colors.
Blue light boxes aren’t ideal for those with bipolar depression. They can help by suppressing melatonin, shifting circadian rhythm and by making you feel more.
These light boxes have been shown in studies to have a much better effect than red light boxes, with the blue one showing a faster decrease in SAD symptoms with regular usage.
The efficacy of blue lights is backed up by research, some researchers however warn about possible toxicity to the eye. Red lights are pretty much useless now, especially with the technology that full spectrum, blue and white lights have to offer.
Full spectrum light boxes generally tend to be a little bit more expensive but the light they give off appeals to many. These lamps are considered to be the best at effectively mimicking sunlight. Then again, it is not sure you need to get a light that is similar to the sun to help with winter blues, but if you find the quality of light better, go for one of these boxes!
White lights are considered by some people as too bright but are meant to give off a powerful enough light for battling SAD. These white boxes have been around for the longest time and are generally considered as safe and effective.
See – speaking with your doctor about the TYPE of light box you need isn’t such a bad idea now, is it?