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What Is SAD (Seasonal Affective Disorder) and Is It Real?

author image Lauren Ditzian
Lauren Ditzian, LMFT, is a Licensed Marriage and Family Therapist in Northern California. Originally from Madison, CT, Ditzian studied philosophy at Brown University and earned a master's degree in somatic psychology at The California Institute of Integral Studies in San Francisco. For the last four years she has worked at expressive arts centers and community mental health agencies in Northern California.
Sad woman looking through a car window on a rainy day.
Sad woman looking through a car window on a rainy day. Photo Credit AntonioGuillem/iStock/Getty Images

Days are growing shorter, nights are longer, and it feels like you are slipping into that down-in-the-dumps feeling that strikes every winter. If this sounds familiar, you might be one of the estimated 4 to 6 percent of people living in the US who suffer from Seasonal Affective Disorder (SAD).

What is SAD?

SAD is a real condition officially known as “Major Depressive Disorder with Seasonal Pattern.” This psychological disorder is defined as periods of major depression that only occur seasonally. Generally, beginning in autumn and continuing through winter.

People with SAD feel depressed for at least two weeks and these feelings dissipate completely once spring arrives. Gloominess is accompanied by changes in diet, including increased appetite and carb cravings. People go into hibernation mode, feel lethargic, sleep excessively, and lose interest in their favorite activities.

While SAD is real, many people who think they have SAD are mistaken. Instead, you might be suffering from the “winter blues,” a milder form of depression experienced by 10 to 20 percent of the US population during winter time when healthy people naturally eat heavier foods, sleep more, and enjoy nesting down.

It’s also totally normal to be stressed around the holidays for a variety of reasons, such as endless to-do lists and unfriendly in-laws. While potentially distressing or depressing, these common experiences are not SAD.

Who Gets SAD?

It is not completely understood why certain people get SAD and others do not, but the most important factor is that the condition is substantially more common in geographic regions that are further from the equator because these areas receive less sunlight over the course of the year.

For reasons we do not yet understand, women make up the majority of people with SAD, outnumbering men 3-to-1. Typical onset is during early adulthood and risk seems to decrease after middle age.

Contributing Factors

Most research shows that lack of sunlight is the underlying cause of seasonal depression. People with depression tend to have lower levels of serotonin. Production of serotonin is triggered by sunlight and reduced serotonin levels lead to depression in some people. However, some researchers believe that changes in the production of melatonin, the hormone that regulates circadian rhythms, is primarily responsible for SAD.

There also seems to be a genetic component to SAD. A study conducted by the National Institute of Mental Health suggests that a gene variant lowering the retina’s ability to receive light might predispose some people to SAD. Although this gene seems closely linked to SAD, it still explains only a small percentage of cases.

Treatment Options

If you experience the symptoms of SAD, seek professional help. Treatment options include:

1) Light therapy ­– about thirty minutes of exposure to a light box every morning – is frequently used. Approximately 50 to 80 percent of people who try light therapy find significant relief. It is generally advised to be under the supervision of an experienced clinician.

2) Some people find melatonin supplements helpful but research shows that they are not as beneficial as light therapy and are best used in conjunction with other treatments.

3) Some people who do not find adequate relief from other options respond well to anti-depressants.

4) As with all forms of depression, talk therapy can be an integral aspect of treatment. I advise all patients to engage in talk therapy while taking anti-depressants. Make sure to discuss all treatment options, including over-the-counter supplements, with your doctor.

What You Can Do

Lifestyle changes can be an extremely important aspect of treatment to keep dark moods at bay. While it can be difficult to resist indulging during the holidays, it’s best to eat well-balanced nutritious meals. Exercise is also an effective mood regulator.

Don’t wait until depression sets in – begin exercising before the days begin to shorten to up your serotonin levels. While it can be wonderful to enjoy the coziness of the season, resist isolation and spend time outdoors everyday. Exposure to natural light, ideally in the morning, will help regulate melatonin and serotonin and can boost your mood.


Do not self diagnose. Tell your doctor or therapist if you’ve ever been diagnosed with bi-polar disorder or if you’ve experienced manic symptoms, such as sleeplessness or impulsivity. This may impact treatment options. If you experience suicidal thoughts seek professional help immediately.

What Do You Think?

Have you ever experienced a change in your mood during fall and winter? Have you heard of SAD before? Do you suffer from SAD? How do you stay physically healthy during the winter months? How do you make sure to take care of your mental health during the winter months? If you suffer from SAD, what treatment has been most effective for you? Have you suffered from any of these symptoms before?

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