Jennifer Agee: Hello, hello, and welcome to Sh*t You Wish You Learned in Grad School. I am your host, Jennifer Agee, licensed clinical professional counselor. Today we are going to be talking about seasonal affective disorder. We're going to go over what it is, the signs and symptoms, who's at increased risk, causes, and current treatments.
It's that time of year where the sun is just not out nearly as much as we wish it would be. And it's time for us to start talking to our clients about seasonal affective disorder and what they can do about it. Many people experience periods of time where they feel sad or not like their usual selves. When these mood changes begin and end when the seasons change, this is often referred to as seasonal affective disorder.
People may start to notice a decrease of energy or just start feeling down when the days get shorter in the fall and the winter, and they notice that they begin to feel better in the spring, which comes with longer daylight hours. Most people describe the beginning of seasonal affective disorder — we'll call it SAD; that's the acronym for the rest of the podcast — so people describe it as feeling a lack of energy, a lack of motivation.
And these mood changes can be more serious and begin to affect how a person feels, thinks, and handles their daily activities. If you have noticed, or your clients have started to notice changes in their mood, behavior, just around these seasonal changes, you may be suffering from seasonal affective disorder.
So, what are the signs of SAD? SAD does not have its own separate diagnosis. Rather it's a type of depression that follows a recurrent seasonal pattern. Symptoms typically last about four months out of the year. And before I share the symptoms, I want you to remember that because SAD is a type of depression, these symptoms may be seen with major depressive disorder as well.
If you find yourself identifying with several of the symptoms, please talk to your doctor, or make sure that you're talking to your mental health professional. With SAD, you may experience some or all of the following symptoms, feeling depressed most of the day, nearly every day; losing interest in activities you once enjoyed; experiencing changes in appetite, weight, especially overeating and craving carbs; having problems with sleep, especially oversleeping — they call that hypersomnia, that oversleeping — feeling sluggish or agitated; having low energy; feeling hopeless or worthless; having recurrent thoughts of death or suicide; having difficulty concentrating; low motivation to complete tasks; and isolation, just feeling like you wanna hibernate.
If you think you might be suffering from SAD, make sure that you talk to someone because there are treatments out there that are available, and you can get support with that. There are some groups of people that are at increased risk for developing seasonal affective disorder, and I wanna make sure that you understand what they, what groups they are, because if you're working with these populations, it's very important to check in on them this time of year.
So, SAD is common. It affects millions of Americans. And the research shows that SAD is actually more common in women, those that live farther north and experience shorelight, shorter daylight hours, and certain mental health diagnoses. And that's where I, I wanna go to next. SAD is more common in people with major depressive disorder, bipolar disorder, especially bipolar 2 disorder, attention deficit hyperactivity disorder, eating disorders, anxiety disorders, or panic disorders. So, if you have clients or if you yourself fall into any of these categories, please make sure you pay special attention to how you feel as the seasons change to into what's happening in your body with you.
Notice your mood and notice if you can feel any shifts that take place. Now as far as what causes SAD, scientists don't fully understand the causes, but the research indicates very strongly that serotonin, melatonin, and vitamin D are all key factors. Serotonin is extremely important in regulating mood, and both serotonin and melatonin are essential for maintaining the body's natural rhythm that's a part of the day-night cycle, that sleep, sleep-wake cycle.
So, getting a little further into this to understand, especially if your clients ask, low vitamin D promotes serotonin. That's why vitamin D is so important when people have seasonal affective disorder. It promotes serotonin so that when the body is low in vitamin D, the body is no longer in a healthy balance.
Vitamin D is absorbed through food, the skin, and eyes. Yes, you heard me, the eyes. And the shorter daylight hours decrease the opportunities for vitamin D absorption. I want you to think about it. In the summer, we go to work in the sunlight. We get home in the sunlight. Because it's light, we might feel more encouraged to go outside or to take a walk.
And in the winter months, we often go to work when the sun is coming up. So, it's still a little dark. We come home when it's already dark or getting dark. And our opportunities for vitamin D absorption just plummet. So, we just don't have as many opportunities for this absorption, and that lack of vitamin D has a rippling, uh, just a cascade effect with our melatonin and our serotonin that really affect our mood and affect our energy levels.
There are some really great treatments for seasonal affective disorder though, and I wanna go over those now so that you can speak to your clients about them, or if you yourself are struggling with this, like I do, you can have some ideas of things that you might be able to do and try. So, the main treatment for SAD is light therapy, psychotherapy, antidepressants, vitamin D and B12 injections, under your doctor's recommendation of course.
So, I wanna break down these treatments and tell you a little bit about what you need to know about each of them. Light therapy exposes people with SAD to a bright light every day to make up for the diminished natural sunlight in the darker months.
You're gonna use a, a unit that it looks kind of like a square. You can get it online at Amazon really inexpensively. But you're gonna use that for 30–45 minutes a day first thing in the morning. Again, we're gonna mimic the wake cycle, the natural sunshine that would happen at the beginning of a day.
The unit needs to be no more than 16–18 inches from your face for maximum benefit when you turn it on. And it's important that you choose a light box that has at least 10,000 lux, and it ha-, is both UV-filtering and UV-free. You're gonna wanna use that light thing, the light box, again, first thing in the morning. Mimic that natural sunlight.
Start this treatment late in the fall and throughout the winter months. Usually, when spring starts, most people no longer need their light box, but the consistency of doing that every day is so helpful. I actually have mine sitting on the kitchen table. When I have my coffee in the morning and eat breakfast, I've got it on, and by the time I finish coffee and breakfast and I'm ready to clean up, I put the light box away, and I'm, I'm good to go for the day. Talk therapy or psychotherapy is also very helpful. It's been researched specifically around CBT, cognitive behavioral therapy, and they found that that type of therapy, uh, really does help.
And although light therapy gets the fastest results, talk therapy, the research show, continue to have long-term positive effects lasting longer over time, which for those of us who are therapists, that is no surprise, right? Um, healing the mind and the body together is a powerful combination. There are medications that your doctor might prescribe if your symptoms get really severe.
If you do need medication, your doctor's likely gonna prescribe you an SSRI antidepressant because of the benefits of increasing serotonin. And like I mentioned earlier, that serotonin is very key in having a healthy mood balance. Vitamins D and B12 are also important. And because many people with SAD often have that vitamin D deficiency, it's highly likely your doctor's gonna recommend a vitamin D supplement.
They may even prescribe vitamin D. If you're really, really low, they'll do blood work, and they can let you know if you need, um, just an over-the-counter supplement or if you need a prescription for vitamin D. B12 may also be added because it's known for really helping to increase energy. But consult your doctor before starting any supplements.
Of course, I'm not a doctor. I didn't even stay at a Holiday Inn last night, so, um, I can't prescribe anything. But vitamin D, and light therapy, talk therapy... hugely beneficial. It's that time of year, y'all. Start talking to your clients and checking in with seasonal affective disorder. Go over the signs and symptoms. Let them know that there's something that they can do about it.
There is help. If you'd like to connect more with me, counselingcommunity.com. You can find me on social media on all of the major outlets and platforms, and I hope you get out there and live your best dang life.