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Seasonal Affective Disorder - Causes, Symptoms, Diagnosis, and Treatment

Written by
Dr. Lochana
and medically reviewed by Dr. Ruhi Satija

Published on Jun 01, 2020   -  5 min read



Seasonal affective disorder is a type of mood disorder that includes depression. Read this article to know about its causes, symptoms, diagnosis, and treatment options.

Seasonal Affective Disorder - Causes, Symptoms, Diagnosis, and Treatment

What Is Seasonal Affective Disorder?

Seasonal affective disorder is known to occur in a climate where there is low sunlight during certain times of the year. Seasonal affective disorder (SAD) is one type of depression that is known to begin and end during the same period every year.

What Are the Causes?

Climate: Usually, all the species are known to go through a phase called hibernation. During this period, changes in behavior are observed. Normal activity is reduced during the winter months and they are known to remain dormant. There will be a reduction in food that is available and a reduction of sunlight. The diurnal animals have difficulties surviving in cold weather. There is a usual tendency towards low mood during the winter months. This characteristic is also seen in humans.

Lack of Serotonin: The probable cause is the lack of serotonin. Serotonin has to be converted to N-acetylserotonin by the enzyme serotonin N-acetyltransferase. If it does not get converted, there will be entry of depression due to the inadequate enzymes.

Lack of Melatonin: The change in season can disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood.

What Are the Symptoms?

Many patients with seasonal affective disorder might experience the symptoms only during winter. The symptoms may be less severe in summer and spring. Some people with the opposite type have symptoms that might begin in summer and spring. In both cases, symptoms may begin very mildly and become severe as the season progresses.

What Is GSS?

GSS is a Global Seasonality Score. It is a measure of different seasonal changes in sleeping length, social activity and well-being, mood variation, weight, appetite, and energy level.

What Is the Relationship Between Bipolar Disorder and Seasonal Affective Disorder?

In bipolar disorder, including type 1 and type 2, the pattern of seasonal affective disorder. Many people with seasonal affective disorder might experience a major depressive disorder. Some of the seasonal affective disorder patients may have a bipolar disorder. Gender plays an important role in exhibiting characteristics associated with seasonal patterns. Men are known to have depressive episodes. Women are known to have rapid cycling and eating disorders.

What Is the Relationship Between Personality Disorder and Seasonal Affective Disorder?

Personality disorders are the describing factors of a person’s identity and character. They are clusters A, B, and C.

Cluster A: Paranoid, schizoid, and schizotypal.

Cluster B: Antisocial, Borderline, Narcissism, and histrionic.

Cluster C: Obsessive-Compulsive disorder, Codependency, and avoidance attachment types.

Of all these types, schizotypal, histrionic, narcissistic, and obsessive-compulsive personality types were known to experience more traits of seasonal affective disorder. The seasonal affective disorder is more commonly known to be associated with patients with anxiety and depression.

Who Is More Prone to Seasonal Affective Disorder?

  • Gender: Women are more likely to get affected by seasonal affective disorder than men. Women usually have instability in emotions. This may be due to the hormonal changes they experience during menstruation. This change in emotion is contributing more to the varying conditions of mood and energy.

  • Relationship status: Seasonal affective disorder is more common in people who are single. People who are in committed and secure relationships are less likely to experience a seasonal affective disorder.

  • Financial status: People with a poor financial background or status tend to have a general insufficient feel.

  • Educational status: People who do not have good educational knowledge might be unaware to keep their mental state healthy. This is the reason for such a community to experience the more seasonal affective disorder.

  • Age: Age plays an important role in seasonal affective disorder. Young patients are known to be affected more by seasonal affective disorder.

What Are the Types of Seasonal Affective Disorder?

There are two types of seasonal affective disorder. They are winter depression and summer depression. The symptoms vary in each face:

The winter seasonal affective disorder symptoms include:

  • Altered appetite. There will be an enhanced carving for carbohydrates containing foods.

  • Gaining weight.

  • Sleeping too much.

  • Low energy and fatigue.

The Summer seasonal affective disorder symptoms include:

  • Insomnia (difficulty to sleep).

  • Loss of appetite.

  • Weight Loss.

  • Anxiety.

How Can It Be Diagnosed?

Many experts considered this condition skeptical, now it is diagnosed by the Diagnostic and Statistical Manual (DSM-5). A psychological evaluation will be done to see for the signs of depression and anxiety. You may be asked to fill out a questionnaire to help answer these questions.

What Is the Treatment?


  • Selective Serotonin Reuptake Inhibitors (SSRIs) are used for the treatment of seasonal affective disorder. There are few side effects for Selective Serotonin Reuptake Inhibitors. So, it is advisable to be taken in an appropriate dosage according to the doctor’s instructions.

  • Bupropion is another type of antidepressant used for the treatment of seasonal affective disorder.

Light Therapy:

Light therapy is the oldest treatment of choice. The idea behind light therapy is to replace natural sunshine. This replacement can be obtained by sitting in front of a light box in the morning. This should be done on a daily basis. The light boxes are known to filter out the ultraviolet rays. This might require 20-60 minutes of exposure to white fluorescent light. This is estimated to be 20 times greater than ordinary indoor lighting.

Tips to Use Light Therapy:

  • Confirm whether your light box is 10,000 lux.

  • Your light box should provide the complete spectrum of bright white light. It should also block ultraviolet rays.

  • Place the box at eye level or higher.

  • Position the light box about 2 feet away from your eyes.

  • Keep the light box at a particular angle to the left or right. It can be 2 o'clock or 10 o'clock.

  • Use the light box in the morning hours for 20 to 60 minutes, depending on your needs.

  • Consistency is important in light therapy.

  • Do not use light therapy if you are under medications that are highly photosensitive.

  • Monitor your mood changes to see your progress.

  • A combination of cognitive-behavioral therapy and light therapy is more advantageous.

Psychotherapy Treatment:

Cognitive-behavioral therapy (CBT) is a psychotherapy treatment that is very effective for seasonal affective disorder. Traditional methods of cognitive-behavioral therapy have been adapted for seasonal affective disorder. Behavioral activation seeks to help the person identify and change their activities that are engaging and very pleasurable. It can engage in many coping strategies.

Vitamin D Supplementation:

Vitamin D supplementation by itself is not regarded as an effective seasonal affective disorder. The reason behind its use is that low blood levels of vitamin D were found in people with seasonal affective disorder. The low levels of vitamin D are usually due to insufficient dietary intake or poor exposure to sunshine.

Experiencing changes in mood or any similar symptoms? Call a doctor online.


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Last reviewed at:
01 Jun 2020  -  5 min read


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