Seasonal Affective Disorder: symptoms, causes and treatment

Find out what seasonal affective disorder is, as well as the symptoms, causes and treatment options. Also learn how to recognise the most common signs in autumn and winter, and when you should seek medical help.

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Seasonal Affective Disorder

In the months when days get shorter and sunlight decreases, many people feel more fatigue and less energy. However, in some cases, this impact can develop into a condition called seasonal affective disorder — a type of depression that recurs at certain times of the year and has a major effect on wellbeing and quality of life. Persistent fatigue, mood swings and sleep disorders are some of the most common signs. In this article, we explain what seasonal affective disorder is, how to identify the symptoms and when you should seek medical help.

 

What is seasonal affective disorder?

Seasonal Affective Disorder (SAD) usually occurs in autumn and winter, when daylight decreases, although it can also happen at other times of the year.

This condition is not a “seasonal melancholy”, and can significantly affect wellbeing, interfering with sleep, appetite, energy and mood. Specialists like the psychiatrist Nassir Ghaemi note that seasonal affective disorder shares characteristics with atypical depression — tendency to sleep more, larger appetite (especially for carbohydrates) and persistent fatigue — and, in some cases it may be related to bipolar disorder, especially type II.

What are the symptoms of seasonal affective disorder?

The signs vary from person to person, but they tend to recur every year and can last several months.

General symptoms of seasonal affective disorder

  • Persistent sadness or low mood.

  • Intense fatigue.

  • Loss of interest in usual activities.

  • Sleep disruptions (insomnia or sleeping excessively).

  • Changes in appetite or weight.

  • Difficulty concentrating.

  • Frequent irritability and anxiety.

Specific symptoms of winter-pattern seasonal affective disorder 

  • Sleeping excessively (hypersomnia).

  • Craving carbohydrates and sweets.

  • Weight gain.

  • Social withdrawal.

 

Specific symptoms of summer-pattern seasonal affective disorder

  • Insomnia or trouble sleeping.

  • Loss of appetite and weight loss.

  • Constant agitation.

  • Greater irritability.

Difference between seasonal affective disorder. diagnoses 

The treatment for this condition should be personalised in order to address each patient’s diagnosis.  

Seasonal affective disorder (SAD) 

Recurs at certain times of the year, especially in autumn and winter. 

Atypical depression 

Shares symptoms with Seasonal Affective Disorder (SAD) (oversleeping, overeating, constant fatigue). 

Bipolar disorder 

In some cases, seasonal affective disorder can be part of a bipolar pattern (type II). 

Causes and risk factors associated with seasonal affective disorder 

Seasonal affective disorder results from an interaction between biological, genetic and environmental factors. 

  • Less daylight: in autumn and winter months, shorter days can alter the circadian rhythm, thereby affecting mood.  

  • Altered levels of melatonin: the body produces more of this hormone when there is less daylight. In winter, high levels of melatonin can cause drowsiness, while in summer, low levels can cause insomnia. 

  • Vitamin D deficiency: less exposure to sunlight can reduce the body’s natural production of vitamin D. This risk is higher in women, young adults, people with a family history of depression or bipolar disorder, people who suffer from other mood disorders (such as anxiety, depression or ADHD) and individuals with low levels of vitamin D. 

 

How is SAD diagnosed? 

Seasonal affective disorder is a clinical diagnosis and it should be performed by a psychiatrist, who assesses the symptoms and their frequency. It’s essential to distinguish between unipolar seasonal affective disorder, atypical depression and bipolar disorder, to determine the correct treatment and avoid unsuitable therapeutic choices. 

How is seasonal affective disorder treated?

The treatment for seasonal affective disorder is personalised and can combine different approaches, defined according to each patient’s diagnosis. 

  • Phototherapy

  • Psychotherapy

  • Antidepressant medication

  • Vitamin D

Joaquim Chaves Saúde, specialised support to help battle seasonal affective disorder 

If you recognise symptoms that recur at certain times of the year, don’t delay your assessment any longer. An early diagnosis makes all the difference. At Joaquim Chaves Saúde, you can count on specialised support from our Psychiatry and Psychology units, whenever necessary in collaboration with other fields such as General Practice/Family Medicine, Endocrinology and Nutrition, guaranteeing comprehensive and integrated care. 

An early diagnosis is crucial: if you notice recurring mood swings at certain times of the year, don’t hesitate to get help. Schedule your consultation now. 

 

Clinical Team

We have a team of doctors and health professionals, specialists in various areas, available to give you the support you need.

Inês Fonseca
Medic
Inês Fonseca
Speciality/Service
Psychiatry
Key areas of expertise
Neurocognitive Disorders/Dementias, Obsessive-Compulsive Disorder, Mood Disorders, Anxiety Disorders, Psychotic Disorders, Attention Deficit Hyperactivity Disorder
Healthcare Units
Clínica de Sintra, Clínica Cirúrgica de Carcavelos, Clínica de Miraflores, Clínica de Cascais
Rui Ribeiro
Medic-coordinator
Rui Ribeiro
Speciality/Service
Psychiatry
Key areas of expertise
Mood disorders - bipolar disorder, Depression and anxiety resistant to therapy, Adult attention deficit hyperactivity disorder, Pain psychiatry
Healthcare Units
Clínica de Entrecampos, Clínica de Miraflores
Maria João Avelino
Medic
Maria João Avelino
Speciality/Service
Psychiatry
Key areas of expertise
Mood Disorders (Depression and Bipolar Disorder), Anxiety Disorders, Mental Illness and Parenting (pregnancy and postpartum), Mental Illness in Adolescence and Early Adulthood (early intervention), Early stages of psychosis
Healthcare Units
Clínica de Sintra, Clínica Cirúrgica de Carcavelos, Clínica de Miraflores, Clínica de Cascais

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Sources

Ghaemi, N. S. A Clinical Guide to Depression in Bipolar Disorder. Cambridge University Press, 2018. 

Ghaemi, N. S. Seasonal Mood Disorders and Bipolar Spectrum Illness. Journal of Affective Disorders, 2001. 

American Psychiatric Association. Practice Guideline for the Treatment of Patients With Major Depressive Disorder. 

 

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