Seasonal Affective Disorder – Diagnosis and Treatment

Diagnosis

Providers diagnose Seasonal Affective Disorder (SAD) through several steps. They ask about feelings, behaviors, and mood changes that happen at certain times of the year.

Common symptoms include:

• Lasting sadness
• Low energy
• Social withdrawal
• Hopelessness
• Trouble focusing
• Changes in sleep or appetite

Doctors perform a physical exam to check for health issues that look like depression. They may order lab tests, such as a complete blood count (CBC) or thyroid function tests, to rule out other medical conditions that could mimic depressive symptoms.

Providers also do a mental health evaluation to look for depression patterns or other affective disorders. They ask about the duration and timing of symptoms—particularly if they occur in fall and winter and improve during spring or summer.

A diagnosis of SAD may be made if symptoms follow this seasonal pattern for at least two consecutive years and significantly interfere with daily functioning.

Mental health professionals may use diagnostic tools such as standardized questionnaires or criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to confirm the diagnosis and rule out other mood disorders, such as major depressive disorder or bipolar disorder.

Treatment

Using Bright Light as Treatment

Bright light therapy, or phototherapy, uses a special lamp called a light box. This lamp gives off strong, white light that mimics daylight.

People often use light therapy in the morning, especially within an hour after waking up. This helps balance brain chemicals like serotonin and melatonin, which affect mood and sleep.

Doctors often suggest light therapy first for winter-based seasonal sadness. Many people see results in a few days or weeks.

Most people have few side effects, but it is best to talk with a doctor before starting, especially for those with bipolar disorder.

When picking a light box, check for light intensity (about 10,000 lux), UV filtering, and timer settings. A healthcare provider can help choose a safe and effective model.

Tips for Light Box Use

• Sit 16 to 24 inches from the light
• Use in the morning for 20-40 minutes
• Avoid looking directly at the light

Counseling and Talk Therapies

Talk therapy, or psychotherapy, is another helpful option. Cognitive behavioral therapy (CBT) is often used for seasonal depression.

CBT helps people recognize and change negative thought patterns. It also teaches better coping skills.

Therapists support people in managing stress, finding positive activities, and keeping routines. Regular sessions can help build healthy habits like exercise and better sleep.

Technique	Purpose
Cognitive restructuring	Identify negative thoughts
Behavioral activation	Increase enjoyable, meaningful activity
Stress management	Handle daily challenges

Medications and Other Medical Care

Doctors may prescribe medicine for stronger or long-lasting symptoms. Antidepressants, such as bupropion, can be started before symptoms usually begin.

Other antidepressants, like serotonin reuptake inhibitors, may also help. It often takes several weeks for medication to work.

Some people need to try more than one type to find the best fit with the fewest side effects. Doctors closely monitor people, especially those with bipolar disorder, since some medicines can trigger mania.

Possible Side Effects:

• Headache
• Nausea
• Changes in sleep or appetite

Taking Care of Yourself

Self-care helps manage mood changes during seasons with less sunlight. Simple steps can improve well-being. Open blinds and keep windows clear to let in more light. Spend time near bright windows indoors.

Going outside, even briefly, can help. Try walking, eating lunch outside, or sitting on a sunny bench. Getting sunlight within two hours after waking is especially helpful.

Regular exercise, like walking, biking, or stretching, lowers stress and boosts mood. Eating healthy foods, such as fruits and vegetables, supports overall wellness.

Set a sleep routine by waking up and going to bed at the same time daily. Avoid oversleeping, especially during darker months.

Other Therapy Choices

Some people try herbal products, dietary supplements, or mind-body activities to manage low mood during certain times of year. Common examples include St. John’s wort, omega-3 fatty acids, and guided relaxation exercises.

These options may sound appealing, but experts have not proven their true benefit for seasonal affective symptoms. Supplements and herbal products do not have the same FDA regulation as regular medicine.

Coping and Getting Support

Managing mood and behavior changes during certain times of the year can be hard. Following a treatment plan from a mental health professional is important. Keeping therapy appointments and using recommended therapies can help.

Taking care of physical health also matters. Regular exercise, nutritious meals, and enough sleep boost mood and energy. People should avoid oversleeping, as too much sleep can make symptoms worse.

Healthy choices include avoiding alcohol and recreational drugs, which increase the risk of depression and substance misuse. Counselors can help if substance abuse is also a concern.

Reducing stress can keep symptoms from getting worse. Yoga, meditation, or tai chi help people relax and calm their minds.

Connecting with others is important. Spending time with family or friends gives emotional support and lifts spirits. Short trips to sunnier or milder places, when possible, may also help relieve symptoms.

Steps to Cope	Description
Stay on treatment plan	Attend therapy and follow advice
Self-care	Sleep, eat well, and exercise regularly
Avoid substances	Stay away from alcohol and drugs
Manage stress	Practice relaxation techniques
Social support	Stay connected with loved ones
Travel	Plan trips to preferred climates if possible

Getting Ready for Your Visit

Steps You Can Take Ahead of Time

Planning before meeting a healthcare provider or mental health professional can help. Organizing information makes the appointment smoother.

• Make a List of Concerns: Write your main symptoms, such as low mood, tiredness, excess sleep, or changes in appetite. Note when these feelings started and what makes them better or worse.
• Track Your Mood Patterns: Record when symptoms appear each year. Note if certain months are worse or if things like exercise or daylight help.
• Include Health History: Bring details about past or current health problems. List any previous diagnoses.
• Mention Life Changes: Note any major changes or stress, such as moving or loss.
• Prepare a Medication List: Write all medications, vitamins, and supplements you take, including names, dosages, and frequency.
• Create a List of Questions:
  Example questions:
  • Is my mood caused by seasonal changes, or is something else involved?
  • What could be making symptoms worse?
  • What treatment options do I have?
  • Would light therapy help?
  • Should I make lifestyle changes?
  • Should I see a psychiatrist, psychologist, or another expert?
  • Are there medicines that could help? Are there generic versions?
  • Where can I find more information?

• Consider a Symptom Diary:
  Bring a diary or chart showing your daily mood and symptoms. This can help your provider.

Example Table – Symptom Diary:

Date	Mood Level (1-10)	Sleep (hours)	Notable Symptoms	Notes (stress, events)
May 1	4	9	Low energy, overeating	Raining all day
May 2	6	8	Sad in morning, better PM	Went for a walk outside

Bringing a support person, like a family member or friend, can also help. They may notice symptoms you forget or help remember what the provider says.

Reminders:

• Be honest about symptoms and feelings.
• List all medications and supplements, even over-the-counter ones.
• Ask any questions you have, no matter how small.

What Your Healthcare Provider Might Ask

Your provider will likely ask questions to learn about your symptoms. Knowing what to expect can help you answer clearly.

• About Your Symptoms:
  • What symptoms do you have now?
  • When did you first notice these issues?
  • Are your symptoms always there, or only at certain times?
• Symptoms’ Effect on Life:
  • How does this affect your daily life?
  • Does it change your energy, sleep, eating, or social life?
• Making Connections:
  • What helps you feel better?
  • What makes you feel worse?
  • Do you notice a pattern with weather or seasons?
• Your Overall Health:
  • Do you have other health problems?
  • Are you taking any medicines or supplements?
  • Do you drink alcohol or use drugs?
• Family History:
  • Does anyone in your family have depression or another mental health condition?

Your provider may also ask if you have tried treatments like talk therapy, medication, or light therapy. They may ask about major life changes or recent stress.

They might ask about your lifestyle, such as exercise, sleep routine, and eating habits. If you do not know an answer, it is okay to say so. Honest answers help your provider understand how to help.

During the Appointment:

• The provider may use rating scales or questionnaires to measure symptoms.
• They may discuss treatment options, such as counseling, lifestyle changes, or medication.

If your provider needs more details, they may ask follow-up questions or suggest seeing a mental health specialist.

Preparing in these ways makes your appointment more helpful. Taking notes or having someone with you can help you remember important information.

More Information

People with seasonal affective disorder (SAD) often notice that symptoms begin and end around the same times each year. Symptoms can include persistent sadness, low energy, sleep changes, and changes in appetite or weight.

Common symptoms of SAD:

• Feeling down or hopeless
• Lack of interest in usual activities
• Tiredness or low energy
• Sleeping too much
• Difficulty focusing
• Craving foods high in carbohydrates

Possible treatment options:

• Light therapy with a special lamp
• Medication such as antidepressants
• Counseling, including cognitive behavioral therapy
• Lifestyle changes, like outdoor exercise and a regular schedule

If you experience these symptoms, reach out to a healthcare professional.