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Patient education: Seasonal affective disorder (The Basics)

Patient education: Seasonal affective disorder (The Basics)

What is seasonal affective disorder? — Seasonal affective disorder (often called "SAD") is a form of depression that comes and goes depending on the time of year. There are 2 main types:

Fall-onset SAD – This type of SAD starts in late fall and goes away in the spring and summer. Some people call it "winter depression." It is the most common form of SAD.

Spring-onset SAD – This type of SAD starts in the spring and goes away in the fall and winter. Spring-onset SAD is much less common than fall-onset SAD.

What are the symptoms of SAD? — The symptoms are the same as in regular (non-seasonal) depression.

Depressed people feel down most of the time for at least 2 weeks. They also have at least 1 of these 2 symptoms:

They no longer enjoy or care about the things that they used to like to do.

They feel sad, down, hopeless, or cranky most of the day, almost every day.

Depression can also make you:

Lose or gain weight

Sleep too much or too little

Feel tired or like you have no energy

Feel guilty or like you are worth nothing

Forget things or feel confused

Move and speak more slowly than usual

Act restless or have trouble staying still

Think about death or suicide

However, the symptoms are different depending on which form of SAD a person has.

People with fall-onset SAD tend to:

Sleep more than usual

Have a bigger appetite than usual, especially for sweet or starchy foods, like pastries or rice

Gain weight

People with spring-onset SAD have symptoms that are more like those of typical depression. They tend to:

Sleep less than usual

Have a smaller appetite

Lose weight

Should I see a doctor or nurse? — Yes, if you have symptoms of SAD, see a doctor, nurse, or counselor.

Get help right away if you are thinking of hurting or killing yourself! — Sometimes, people with depression think of hurting or killing themselves. If you ever feel like you might hurt yourself, help is available:

In the US, contact the 988 Suicide & Crisis Lifeline:

To speak to someone, call or text 988.

To talk to someone online, go to www.988lifeline.org/chat.

Call your doctor or nurse and tell them that it is an emergency.

Call for an ambulance (in the US and Canada, call 9-1-1).

Go to the emergency department at your local hospital.

If you think your partner might have depression, or if you are worried that they might hurt themselves, get them help right away.

How is SAD treated? — Treatment options include the following:

Light therapy – Light therapy involves sitting in front of special, bright lamps during the day. This form of therapy can help people with fall-onset SAD. It must be done with help of a doctor or counselor who knows how to give the therapy. It's not something people should try to do on their own.

Medicines called antidepressants – The same medicines used to treat depression can help people with SAD. There are many different antidepressant medicines that doctors can prescribe. The medicines work in different ways and can cause different side effects. If 1 medicine causes problems or does not work, there are often others to try. If the medicines work well, some patients stop and start the medicines every year, while other patients take the medicines all year round. The best plan for you will depend on your situation and preferences.

Counseling (also called "psychotherapy") – Counseling can help with SAD. In addition, people with SAD who get counseling might be less likely to have their SAD come back in the following years.

Experts think that light therapy plus antidepressant medicines is often the best treatment to try first for fall-onset SAD. Some people with SAD are treated with only light therapy, but only if they are not severely depressed or thinking about suicide. For people who are severely depressed or thinking about suicide, antidepressant medicines might be a better option.

You and your doctor, nurse, or counselor can decide which treatment is best for you.

Whatever treatment you try, keep in mind that it sometimes takes patience to find a treatment that works. In some cases, people who take medicines have to try a few different medicines before they find one that works for them. Plus, most treatments take some time before they start working. The key is to work with your doctor, nurse, or counselor, and to keep them informed about any problems.

Is there anything I can do on my own to feel better? — Yes. Some people feel better if they exercise. Even you do not feel like it, try to do something active for at least 30 minutes on most days of the week.

Also, if you have fall-onset SAD, make sure you get exposed to as much light as possible. Here are some ways you can do that:

Follow good sleep habits:

Sleep only long enough to feel rested and then get out of bed.

Go to bed and get up at the same time every day.

Do not try to force yourself to sleep. If you can't sleep, get out of bed and try again later.

Have coffee, tea, and other foods that have caffeine only in the morning.

Avoid alcohol in the late afternoon, evening, and bedtime.

Avoid smoking, especially in the evening.

Keep your bedroom dark, cool, quiet, and free of reminders of work or other things that cause you stress.

Solve problems you have before you go to bed.

Exercise several days a week, but not right before bed.

Avoid looking at phones or reading devices ("e-books") that give off light before bed. This can make it harder to fall asleep.

Take walks outside during the day, so that you get some sun.

In your bedroom, put a lamp on a timer and have it turn on in the early morning, even before the sun comes out.

Get a "dawn-simulating" lamp, which brightens gradually and turns on before the sun comes out.

More on this topic

Patient education: Depression in adults (The Basics)
Patient education: Medicines for depression (The Basics)
Patient education: Suicide prevention (The Basics)

Patient education: Depression in adults (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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