Seasonal affective disorder (SAD) - Diagnosis and treatment (2023)

Diagnosis

Even with a thorough evaluation, it can sometimes be difficult for your health care provider or mental health professional to diagnose seasonal affective disorder because other types of depression or other mental health conditions can cause similar symptoms.

To help diagnose SAD, a thorough evaluation generally includes:

  • Physical exam. Your health care provider may do a physical exam and ask in-depth questions about your health. In some cases, depression may be linked to an underlying physical health problem.
  • Lab tests. For example, your health care provider may do a blood test called a complete blood count (CBC) or test your thyroid to make sure it's functioning properly.
  • Psychological evaluation. To check for signs of depression, your health care provider or mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may fill out a questionnaire to help answer these questions.

Treatment

Treatment for seasonal affective disorder may include light therapy, psychotherapy and medications. If you have bipolar disorder, tell your health care provider and mental health professional — this is critical to know when prescribing light therapy or an antidepressant. Both treatments can potentially trigger a manic episode.

Light therapy

In light therapy, also called phototherapy, you sit a few feet from a special light box so that you're exposed to bright light within the first hour of waking up each day. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood.

Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to a few weeks and causes very few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving SAD symptoms.

Before you purchase a light box, talk with your health care provider about the best one for you, and familiarize yourself with the variety of features and options so that you buy a high-quality product that's safe and effective. Also ask about how and when to use the light box.

(Video) Understanding Seasonal Affective Disorder (SAD)

Psychotherapy

Psychotherapy, also called talk therapy, is another option to treat SAD. A type of psychotherapy known as cognitive behavioral therapy can help you:

  • Learn healthy ways to cope with SAD, especially with reducing avoidance behavior and scheduling meaningful activities
  • Identify and change negative thoughts and behaviors that may be making you feel worse
  • Learn how to manage stress
  • Build in healthy behaviors, such as increasing physical activity and improving your sleep patterns

Medications

Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe.

An extended-release version of the antidepressant bupropion (Wellbutrin XL, Aplenzin) may help prevent depressive episodes in people with a history of SAD. Other antidepressants also may commonly be used to treat SAD.

Your health care provider may recommend starting treatment with an antidepressant before your symptoms typically begin each year. He or she may also recommend that you continue to take the antidepressant beyond the time your symptoms normally go away.

Keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try different medications before you find one that works well for you and has the fewest side effects.

More Information

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(Video) Seasonal Affective Disorder (SAD) Symptoms and Treatment

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Lifestyle and home remedies

In addition to your treatment plan for seasonal affective disorder:

  • Make your environment sunnier and brighter. Open blinds, trim tree branches that block sunlight or add skylights to your home. Sit closer to bright windows while at home or in the office.
  • Get outside. Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning.
  • Exercise regularly. Exercise and other types of physical activity help relieve stress and anxiety, both of which can increase SAD symptoms. Being more fit can make you feel better about yourself, too, which can lift your mood.
  • Normalize sleep patterns. Schedule reliable times to wake up and go to bed each day. Especially for fall-winter-onset SAD, reduce or eliminate napping and oversleeping.

More Information

  • Seasonal affective disorder treatment: Choosing a light box
(Video) Seasonal affective disorder - an Osmosis Preview

Alternative medicine

Certain herbal remedies, supplements or mind-body techniques are sometimes used to try to relieve depression symptoms, though it's not clear how effective these treatments are for seasonal affective disorder.

Herbal remedies and dietary supplements aren't monitored by the U.S. Food and Drug Administration (FDA) the same way medications are, so you can't always be certain of what you're getting and whether it's safe. Also, because some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions, talk to your health care provider or pharmacist before taking any supplements.

Make sure you understand the risks as well as possible benefits if you pursue alternative or complementary therapy. When it comes to depression, alternative treatments aren't a substitute for medical care.

Coping and support

These steps can help you manage seasonal affective disorder:

  • Stick to your treatment plan. Follow your treatment plan and attend therapy appointments when scheduled.
  • Take care of yourself. Get enough sleep to help you feel rested, but be careful not to get too much rest, as SAD symptoms often lead people to feel like hibernating. Participate in an exercise program or engage in another form of regular physical activity. Make healthy choices for meals and snacks. Don't turn to alcohol or recreational drugs for relief.
  • Practice stress management. Learn techniques to manage your stress better. For example, you may try relaxation techniques such as yoga, tai chi and meditation. Unmanaged stress can lead to depression, overeating, or other unhealthy thoughts and behaviors.
  • Socialize. When you're feeling down, it can be hard to be social. Make an effort to connect with people you enjoy being around. They can offer support, a shoulder to cry on or shared laughter to give you a little boost.
  • Take a trip. If possible, take winter vacations in sunny, warm locations if you have winter SAD or to cooler locations if you have summer SAD.

Preparing for your appointment

You may start by seeing your health care provider or a mental health professional such as a psychiatrist or psychologist.

Here's some information to help you get ready for your appointment.

(Video) S.A.D: Seasonal Affective Disorder Symptoms and Treatments | This Morning

What you can do

Before your appointment, make a list of:

  • Your symptoms, such as feeling down, having a lack of energy, excess sleeping and appetite changes
  • Your depression patterns, such as when your depression starts and what seems to make it better or worse
  • Any other mental or physical health problems you have — both can affect mood
  • Any major stressors or life changes you've had recently
  • All medications, vitamins, herbs or other supplements you're taking, including dosages
  • Questions to ask your health care provider or mental health professional

Some basic questions to ask may include:

  • Are my symptoms likely caused by SAD, or could they be due to something else?
  • What else could be causing or worsening my symptoms of depression?
  • What are the best treatment options?
  • Would using a light box help my symptoms?
  • Are there any restrictions that I need to follow or steps I should take to help improve my mood?
  • Should I see a psychiatrist, psychologist or other mental health professional?
  • Are medications likely to improve my symptoms?
  • Is there a generic alternative to the medication you're prescribing me?
  • Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your health care provider or mental health professional is likely to ask you a number of questions, such as:

  • What are your symptoms?
  • When did you first begin having symptoms?
  • Have your symptoms been continuous or occasional?
  • How do your symptoms impact your daily activities?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Do you have any other physical or mental health conditions?
  • Are you taking any medications, supplements or herbal remedies?
  • Do you use alcohol or recreational drugs?
  • Do any of your blood relatives have SAD or another mental health condition?

Your health care provider or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your appointment time.

By Mayo Clinic Staff

(Video) What is Seasonal Affective Disorder? (SAD)

Dec. 14, 2021

FAQs

What is the typical treatment for seasonal affective disorder? ›

Treatment for seasonal affective disorder may include light therapy, psychotherapy and medications. If you have bipolar disorder, tell your health care provider and mental health professional — this is critical to know when prescribing light therapy or an antidepressant.

What is the most effective treatment for seasonal affective disorder? ›

Selective serotonin reuptake inhibitors (SSRIs) are the preferred type of antidepressant for treating SAD. They increase the level of the hormone serotonin in your brain, which can help lift your mood.

What treatment is used for SAD? ›

Seasonal affective disorder (SAD) is a type of depression that typically occurs each year during fall and winter. Use of a light box can offer relief. But for some people, light therapy may be more effective when combined with another SAD treatment, such as an antidepressant or psychotherapy, also called talk therapy.

How do you diagnose SAD? ›

Confirming a diagnosis of SAD

It may take some time before you and a GP realise that your symptoms are forming a regular pattern. A diagnosis of SAD can usually be confirmed if: your depression occurs at a similar time each year for at least 2 years. the periods of depression are followed by periods without depression.

What happens if SAD is not treated? ›

Untreated clinical depression is a serious problem. Untreated depression increases the chance of risky behaviors such as drug or alcohol addiction. It also can ruin relationships, cause problems at work, and make it difficult to overcome serious illnesses.

How long does SAD disorder last? ›

Seasonal Affective Disorder (SAD) is a type of depression that occurs at the same time each year. Although it can occur in spring or summer, it typically begins in late fall and lasts through the end of winter.

What happens if seasonal affective disorder goes untreated? ›

Left untreated, SAD can cause problems at work or school, at home, and in relationships. SAD can also complicate your treatment for other conditions including bipolar disorder, substance use disorder, anxiety, and depression.

What triggers seasonal affective disorder? ›

The reduced level of sunlight in fall and winter may cause winter-onset SAD . This decrease in sunlight may disrupt your body's internal clock and lead to feelings of depression. Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in SAD .

Can you get rid of seasonal affective disorder? ›

SAD can be effectively treated in a number of ways, including light therapy, antidepressant medication, talk therapy or some combination of these. While symptoms will generally improve on their own with the change of season, symptoms can improve more quickly with treatment.

Is seasonal affective disorder a real diagnosis? ›

Seasonal affective disorder* is a form of depression also known as SAD, seasonal depression or winter depression. In the Diagnostic Manual of Mental Disorders (DSM-5), this disorder is identified as a type of depression – Major Depressive Disorder with Seasonal Pattern.

What happens in the brain with seasonal affective disorder? ›

In people with SAD, lack of sunlight and a problem with certain chemicals in the brain prevents the hypothalamus working properly. The lack of light is thought to: affect the production of the hormone melatonin. affect the production of the hormone serotonin.

How does light therapy work for SAD? ›

People with SAD may want to sleep more and be less active. Scientists believe that it's because of how sunlight affects the brain. “Light may stimulate the parts of the brain that control mood, appetite and sleep, which can contribute to how a person feels,” says Dr. Alcera.

Can vitamin D help with seasonal depression? ›

Low levels of vitamin D, caused by low dietary intake of the vitamin or not enough exposure to sunshine, have been found in people with SAD. However, it's unclear whether vitamin D supplementation can help to relieve SAD symptoms. Very little research has been done on dietary supplements other than vitamin D for SAD.

At what age does SAD start? ›

How common is seasonal affective disorder (SAD)? About 5% of adults in the U.S experience SAD. It tends to start in young adulthood (usually between the ages of 18 and 30). SAD affects women more than men, though researchers aren't sure why.

Can you get tested for SAD? ›

Talk to your GP if you think you might have SAD and you're finding it difficult to cope. Your GP can carry out an assessment to check your mental health. They may ask you about your mood, lifestyle, eating habits and sleeping patterns, plus any seasonal changes in your thoughts and behaviour.

What is the most specific screening tool for SAD? ›

The Seasonal Pattern Assessment Questionnaire (SPAQ) is perhaps the most widely studied tool. It has been reported to have a high specificity (94 percent) for SAD but a low sensitivity (41 percent).

What does SAD do to a person? ›

Otherwise known as seasonal depression, SAD can affect your mood, sleep, appetite, and energy levels, taking a toll on all aspects of your life from your relationships and social life to work, school, and your sense of self-worth.

Can SAD be serious? ›

The nature and severity of SAD varies from person to person. For some, it may be mild while for others it can be severe and have a significant impact on their day-to-day life.

What happens in your brain when you are SAD? ›

Sadness is associated with increased activity of the right occipital lobe, the left insula, the left thalamus the amygdala and the hippocampus. The hippocampus is strongly linked with memory, and it makes sense that awareness of certain memories is associated with feeling sad.

Why do people get SAD? ›

Stress, Health, and Hormones

Things like stress, using alcohol or drugs, and hormone changes also affect the brain's delicate chemistry and mood. Some health conditions may cause depression-like symptoms. For example, hypothyroidism is known to cause a depressed mood in some people. Mono can drain a person's energy.

Can SAD cause anxiety? ›

(WHSV) - Seasonal Affective Disorder (SAD) causes fatigue, anxiety and sadness for many people, often in winter months. SAD, also called Seasonal Depression, is a form of depression that occurs one season of the year.

How long do you have to be SAD for it to be classified as depression? ›

To be diagnosed with depression, an individual must have five depression symptoms every day, nearly all day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in almost all activities. Children and adolescents may be irritable rather than sad.

What month is seasonal affective disorder The worst? ›

The most common period for the onset of a SAD episode is late October through November. January and February are the worst months overall, and the symptoms don't fully subside until early May.

Is seasonal affective disorder permanent? ›

Dr. Rohan: SAD can be effectively treated but the status of the research in the field is unfortunately not at the point where we can say we have a “cure” for SAD. The good news is that research in the field shows effective treatments are available, including light therapy, medications and CBT.

Is seasonal affective disorder a form of bipolar? ›

Description. Seasonal affective disorder is a mental health condition that is triggered by the changing of the seasons. This condition is a subtype of major depressive disorder and bipolar disorder.

Who is most at risk for seasonal affective disorder? ›

SAD is more common in people who live either far north or far south of the equator. Young people are more likely to develop SAD. The risk decreases with age. A family history of SAD or other forms of depression increases risk.

Who is most affected by seasonal affective disorder? ›

SAD is four times more common in women than in men. Although some children and teenagers get SAD, it usually doesn't start in people younger than age 20. Your chance of getting SAD goes down as you get older. SAD is also more common the farther north you go.

Is being SAD genetic? ›

Depression does not have a clear pattern of inheritance in families. People who have a first-degree relative (for example, a parent or sibling) with depression appear to have a two to three times greater risk of developing the condition than the general public.

How can you tell the difference between seasonal depression and affective disorder? ›

What's the difference between SAD and general depression? By definition, seasonal affective disorder is a subtype of major depression. The main difference is that while depressive episodes can occur anytime during the year, SAD occurs in seasonal patterns.

What hormone causes SAD? ›

Researchers have found that people with SAD may have an imbalance of serotonin, a brain chemical that affects your mood. Their bodies also make too much melatonin, a hormone that regulates sleep, and not enough vitamin D.

Does insurance cover light therapy for SAD? ›

Prior authorization review is not required. Phototherapy for the treatment of seasonal affective or other depressive disorders is a non-covered service. Phototherapy for the treatment of seasonal affective or other depressive disorders may be considered medically necessary.

How long does it take for a SAD lamp to work? ›

How long does it take a SAD lamp to start working? The University of British Columbia found that people can start to respond to light therapy within a few days and you should see improvements within 2 weeks. Be sure to speak to your doctor if your body does not respond to a SAD lamp after 2 weeks.

What color light helps with sadness? ›

Background. Bright white light has been successfully used for the treatment of depression. There is interest in identifying which spectral colors of light are the most efficient in the treatment of depression. It is theorized that green light could decrease the intensity duration of exposure needed.

What vitamins should I take for seasonal depression? ›

Vitamin D is possibly the most studied vitamin for the treatment of SAD, and it's an essential hormone for bodily processes, especially mood management. Vitamin D appears to play an important role in SAD since levels drop during the winter as sun exposure decreases.

What supplements are good for seasonal affective disorder? ›

Vitamin D, melatonin and St. John's Wort are recommended for seasonal depression. Omega-3 fatty acids, magnesium and vitamin C may also help with depression. Vitamins are not a replacement for medical treatment but may improve its effectiveness.

What vitamin D should I take for SAD? ›

Take a Vitamin D3 supplement. Most vitamin D supplements come in 500-1,000 IU capsules. By taking 1,000-2,000 IU per day, you can ensure that your body is getting enough vitamin D even on days when you don't go outside or eat enough vitamin D rich foods.

What are 4 treatments and or therapies for mental illness? ›

Some people find complementary and alternative therapies helpful to manage stress and other common symptoms of mental health problems. These can include things like yoga, meditation, aromatherapy, hypnotherapy, herbal remedies and acupuncture.

How long does it take for a therapist to diagnose you? ›

The duration of a psychiatric evaluation varies from one person to another. The amount of information needed helps to determine the amount of time the assessment takes. Depending on the situation, a mental health evaluation can last anywhere from 20 to 90 minutes long, and in some cases longer.

What are the two main types of treatment for mental disorders? ›

Cognitive behavioral therapy (CBT) is a form of psychotherapy. It focuses on helping you change negative behaviors and thought patterns. Alternative therapies: Some mental illnesses, such as depression, may improve with alternative therapies. Examples include herbal remedies, massage, acupuncture, yoga and meditation.

Can a therapist diagnose you? ›

Therapists require master degrees and approval of their licensing boards to practice in the mental health field. Therapists provide mental health diagnosis and develop a treatment plan.

How do you prove mental disability? ›

To prove your mental disability, you will need to have medical documentations, records and notes from any physicians you are seeing to show that your mental disability makes it impossible for you to work full time. The more medical evidence you have, the easier it is to prove your mental disability.

How do psychiatrist diagnose depression? ›

To diagnose depression, a doctor performs a physical exam, asks about your symptoms, and recommends a blood test to determine if another condition, such as hypothyroidism, is causing your symptoms. If the doctor does not find an underlying cause of your symptoms, he or she performs a psychological evaluation.

Which is the most widely used treatment today for mental disorders? ›

There are several different types of drugs available to treat mental illnesses. Some of the most commonly used are antidepressants, anti-anxiety, antipsychotic, mood stabilizing, and stimulant medications.

What is the most effective mental health treatment? ›

Psychotherapy combined with medication is the best method for advancing recovery. Various types of psychotherapy are available that include: Individual therapy.

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