What is Seasonal Affective Disorder (SAD)?

Seasonal Affective Disorder (SAD) represents a significant mental health concern affecting approximately 5% of adults in the United States. This specific form of depression follows a predictable seasonal pattern, with symptoms generally persisting for 4-5 months yearly. Most cases happen during late fall as daylight hours diminish. Many people in the United States—between 10 and 20%—experience a milder version commonly called the “winter blues.”

Seasonal Affective Disorder (SAD) Definition

Seasonal Affective Disorder (SAD) represents a distinct clinical subtype of depression defined by its predictable seasonal pattern. Unlike standard depression, SAD follows a cyclical course where symptoms emerge and subside at consistent times throughout the year. This temporal regularity distinguishes SAD from general depression, which may appear without warning and persist indefinitely.

When Does Seasonal Affective Disorder Start​?

While the timing can vary, SAD commonly begins during the colder, darker months of the year. Here’s a breakdown of when it usually starts:

• Winter-pattern SAD: Symptoms typically start in late fall or early winter (October to December). The condition worsens as daylight decreases, reaching its peak during the darkest months (December to February). Symptoms often improve in spring (March or April) as daylight increases.
• Summer-pattern SAD: This rare form of SAD begins in late spring or early summer. Symptoms may last through the warmer months and improve in fall as days shorten.

What Causes SAD?

While the exact mechanism behind Seasonal Affective Disorder (SAD) is not fully understood, research suggests several biological factors contribute to its development. Reduced exposure to sunlight disrupts the body’s internal clock (circadian rhythm), which regulates sleep-wake cycles and mood. This disruption may lead to imbalances in key brain chemicals, such as serotonin, which affects mood, and melatonin, which regulates sleep patterns, potentially triggering depressive symptoms.

What Are Symptoms of Seasonal Affective Disorder (SAD)?

Identifying Seasonal Affective Disorder (SAD) early is key to getting the right treatment and managing the condition effectively.

Here are some of the common symptoms of SAD, which often overlap with those of major depression:

• Depressed mood most of the day, nearly every day
• Loss of interest in activities you once enjoyed
• Changes in appetite or weight
• Sleep problems
• Sluggishness or agitation
• Low energy
• Feelings of hopelessness or worthlessness
• Difficulty concentrating
• Frequent thoughts of death or suicide

In addition to the general depressive symptoms, winter-onset SAD comes with specific signs that are often linked to the colder months:

• Despite getting plenty of sleep, those with winter-pattern SAD often feel unusually tired or sluggish.
• A strong craving for carb-rich foods can lead to weight gain.
• Many individuals with SAD feel the need to “hibernate,” withdrawing from social activities and isolating themselves.

How Does a Primary Care Doctor Diagnose Seasonal Affective Disorder (SAD)?

A primary care doctor uses several tools and methods to diagnose Seasonal Affective Disorder (SAD). Here’s how they typically approach the diagnosis:

Symptom Screening

Primary care physicians often start by asking about the patient’s symptoms. They’ll focus on the seasonality of the mood changes, a key characteristic of SAD. Doctors may use structured questionnaires to assess these symptoms, such as:

• Seasonal Pattern Assessment Questionnaire (SPAQ): This tool helps identify whether the patient’s depression follows a seasonal pattern and is fundamental in diagnosing SAD.
• Patient Health Questionnaire-9 (PHQ-9): While not specific to SAD, this tool screens for symptoms of depression and helps the doctor assess their severity and impact on daily life.

Medical and Mental Health History

The doctor will review the patient’s medical history, asking about any previous mental health conditions, family history of depression or mood disorders, and whether symptoms occur year-round or only during certain seasons. This helps rule out other conditions.

Physical Exam and Blood Tests

The doctor may perform a physical exam to rule out other potential causes for the symptoms, such as thyroid function tests and a vitamin D level checkup.

Mental Health Screening Tools

Besides the PHQ-9, a doctor may use other mental health screening tools to evaluate mood disorders, such as:

• Beck Depression Inventory (BDI): Another self-report tool to help assess the severity of depression symptoms.
• Generalized Anxiety Disorder 7 (GAD-7): To evaluate anxiety levels, which often coexist with SAD.

How Can Primary Care Doctors Treat Seasonal Affective Disorder (SAD)?

Primary care doctors play a key role in diagnosing and managing Seasonal Affective Disorder (SAD). Treatment often includes a combination of therapeutic approaches, medications, and lifestyle changes. Here’s how primary care providers can help treat SAD:

1. Seasonal Affective Disorder Light Therapy

One of the most common and effective treatments for winter-pattern SAD is light therapy, which primary care doctors often recommend. Your primary care doctor may advise using a light box that emits 10,000 lux (about 20 times brighter than regular indoor lighting) for 20-30 minutes daily, preferably within the first hour after waking. Most patients notice improvements within 2-4 days, and full benefits typically occur after about two weeks of consistent use.

Please note: If you have certain medical conditions like diabetes, retinal disorders, or bipolar disorder, it’s vital to consult your primary care doctor before starting light therapy, as it may need to be adjusted to avoid any complications.

2. Cognitive Behavioral Therapy (CBT) for SAD

Primary care doctors may recommend Cognitive Behavioral Therapy (CBT), specifically designed for SAD, known as CBT-SAD. This type of therapy helps individuals identify negative thought patterns and develop coping strategies to replace unhelpful responses to the lack of sunlight and colder months with more adaptive behaviors.

3. Seasonal Affective Disorder Medication

Primary care providers may recommend medication, such as antidepressants, to help manage the symptoms of Seasonal Affective Disorder (SAD). Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to regulate serotonin, a neurotransmitter that plays a key role in mood regulation.

4. Lifestyle Changes to Support Recovery

Primary care doctors can advise you on lifestyle changes to support SAD recovery. Spending time outdoors for natural light exposure helps regulate your circadian rhythms and improve mood. Regular exercise—at least 3x a week for 30 minutes—reduces stress and boosts mood. Staying connected with loved ones combats isolation, while a balanced diet supports mental well-being.

Behavioral Health & Seasonal Affective Disorder (SAD) Treatment at AllCare

AllCare provides behavioral health services to support your management of SAD, including talk therapy. Talk therapy can help identify and challenge negative thought patterns triggered by seasonal changes. We also offer ongoing medication management to ensure your treatment is effective and adjusted as needed. If your symptoms are more severe or you need urgent care, (remove link here) we can refer you to specialized mental health professionals to provide the appropriate care.

Don’t let Seasonal Affective Disorder interfere with your life. Schedule an appointment at AllCare today for a professional diagnosis and personalized treatment plan.