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Seasonal Affective Disorder


Disease: Seasonal Affective Disorder Seasonal Affective Disorder
Category: Psychiatric diseases
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Disease Definition:

The type of depression that occurs at the same time every year is called SAD (seasonal affective disorder). Although in some rare cases SAD may cause depression in the spring or early summer, in most cases, its symptoms begin in the fall and sometimes continue into the winter months.
Light therapy (phototherapy), psychotherapy and medications are used in treating SAD.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


The signs and symptoms of SAD come back and go away at the same time every year, because it is a cyclic, seasonal condition. The problems of this disorder start out mild and become more severe as the season progresses. Usually, the symptoms start appearing during late fall or early winter and go away during the sunnier days of spring and summer. In some cases, the symptoms may begin with the onset of spring or summer.

Some of the signs and symptoms of winter-onset seasonal affective disorder are:


  • Depression
  • Oversleeping
  • Weight gain
  • Anxiety
  • Social withdrawal
  • Hopelessness
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Difficulty concentrating and processing information
  • Loss of energy
  • Loss of interest in activities that were once enjoyed


Some of the signs and symptoms of summer-onset seasonal affective disorder may be:


  • Insomnia (trouble sleeping)
  • Poor appetite
  • Irritability
  • Increased sex drive
  • Anxiety
  • Weight loss
  • Agitation

Spring and summer could bring on symptoms of mania or a less intense form of mania called hypomania in some people, such as rapid thoughts and speech, elevated mood and agitation. This disorder is considered to be one of the forms of bipolar disorder. Some of its signs and symptoms may be:


  • Hyperactivity
  • Unbridled enthusiasm out of proportion to the situation
  • Persistently elevated mood
  • Increased social activity

People should see a doctor in case they feel down for days at a time and just can't get motivated to do the activities that they normally enjoy. This is especially important in case they find themselves turning to alcohol for comfort or relaxation, notice that their sleep patterns and appetite have changed, or if they feel hopeless or think about suicide.


What exactly causes SAD is still not known, but probably genetics, age and the body's natural chemical makeup play a role in the development of this condition. Some other specific factors are:

A person’s circadian rhythm (biological clock):
The body's internal clock that lets a person know when they should sleep or be awake, may be disrupted due to the reduced level of sunlight in fall and winter. Feelings of depression could be caused by this disruption of circadian rhythm.

Melatonin levels:
The balance of the natural hormone melatonin, which plays a role in sleep patterns and mood, could be disrupted because of the change in season. To know whether taking melatonin supplements is a good option or not, a person should talk to a doctor.

Serotonin levels:
Seasonal affective disorder could be partly affected by a drop in serotonin, which is a brain chemical (neurotransmitter) that affects mood. In some cases, depression may result when serotonin levels drop due to reduced sunlight.

Some of the factors that could increase the risk of developing seasonal affective disorder may be:

Family history:
Just like the other types of depression, if someone has a blood relative with seasonal affective disorder, they will be more likely to develop the condition.

Even though men have more-severe symptoms of seasonal affective disorder than women, studies have shown that women are more often diagnosed with this disorder.

Because of the decreased sunlight during the winter, and the longer days of summer, people who live far north or south of the equator seem to be affected by seasonal affective disorder more often.



When left untreated, seasonal affective disorder could worsen and lead to problems. So people should take its signs and symptoms seriously. Some of the problems that could be caused by untreated seasonal affective disorder may be:


  • School or work problems
  • Social withdrawal
  • Substance abuse
  • Suicidal thoughts or behavior

When seasonal affective disorder is diagnosed and treated before symptoms get bad, treatment could help prevent complications.


Light therapy, medications and psychotherapy are some of the methods by which seasonal affective disorder could be treated.

Light therapy imitates outdoor light and seems to cause changes in the brain chemicals that are linked to mood. During light therapy, which is also called phototherapy, the patient will sit a few feet from a specialized light therapy box, so that he/she will be exposed to bright light. This method is easy and seems to have only a few side effects.
Despite the fact that light therapy is widely used and seems to be quite helpful, it's not entirely clear exactly how it works and how effective it is in treating seasonal affective disorder. However, to make sure that light therapy is suitable for a specific person and to make sure that he/she is getting a high-quality light therapy box, a doctor or mental health provider should be consulted before considering light therapy or purchasing a light therapy box.

When symptoms are severe, some people with SAD may benefit from treatment with antidepressants. Some of the medications that are commonly used to treat this disorder include:

In people with a history of seasonal affective disorder, an extended-release version of the antidepressant bupropion may help prevent depressive episodes.

Other antidepressants:
Sertraline, venlafaxine, paroxetine and fluoxetine are some of the antidepressants that are commonly used to treat seasonal affective disorder.
A person may be recommended antidepressants before their symptoms typically begin each year. They may also be recommended taking them beyond the time their symptoms usually go away.
Before finding the type of antidepressant that works well and has the fewest side effects, the patient may have to try several different types. People should also know that it may take several weeks before noticing full benefits from an antidepressant.

Someone’s mood and behavior could add to their symptoms of seasonal affective disorder, despite the fact that this disorder is thought to be related to biochemical processes. In psychotherapy, the patient could learn healthy ways to cope with SAD and manage stress. This therapy could also help identify and change negative thoughts and behaviors that may be making the person feel worse.


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