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Seasonal Affective Disorder: An Introduction

 

 

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Seasonal Affective Disorder: An Introduction

Suzanne Womack Strisik, Ph.D.

Seasonal Affective Disorder is a form of clinical depression. Also known by its acronym, SAD, Seasonal Affective Disorder varies with the seasons and can range from a mild depression (the winter blues) to a severe depression that requires medical treatment (Rosenthal, 2005; Spoont, Depue, & Krauss, 1991). Seasonal Affective Disorder is an aspect of the mood disorder, Major Depressive Disorder (DSM-IV-TR, 2000).

In this introduction to Seasonal Affective Disorder, the experience of SAD, the symptoms, and the relation of SAD to depression in general will be described. It is hoped that this introduction will be useful, especially to those people living far north of the equator who are most vulnerable to SAD.

Seasonal Affective Disorder (SAD) is a disorder of mood, which co-occurs with seasons of the year, particularly winter, when periods of daylight are short, or rainy seasons, when natural light levels are low. Approximately six percent of the people in the U.S., most of them clustered in the northern parts of the country, experience SAD, and an estimated 14% of the country’s population experience the mild form of SAD, the winter blues (Rosenthal, 2005). The seasonality of SAD occurs on a continuum: a person might not feel any change or feel only subtle changes across the seasons, may experience mild winter blues, or may suffer a moderate to severe winter depression (Flaskerud, J., 2012). SAD is similar to depression with some differences: people who suffer from SAD usually experience symptoms seasonally, and SAD can include anxiety and food cravings (Lansdowne & Provost, 1998). Think of SAD symptoms as supportive of primal, survival-oriented kinds of needs before and during winter, when the anticipation of a reduction in the food supply and daylight promotes calorie ingestion and periods of sleep and inactivity. Food cravings, especially for simple carbohydrates and sugars, and fatigue and drowsiness are congruent with hibernation.

Symptoms

Here is a checklist of symptoms for Seasonal Affective Disorder (DSM-IV, 2000; Magnuson & Partonen, 2005; Rosenthal, 2005):

• Feeling sad or blue
• Overeating with Weight Gain
• Over-Sleeping with grogginess upon awakening
• Poor Quality Sleep (e.g., disrupted, shallow)
• Daytime Drowsiness
• Lethargic (slow) physical movement
• Diminished interest or pleasure in enjoyable activities
• Poor concentration
• Decreased libido
• Anxiety
• Social discomfort

Major Depressive Disorder, as seen in the symptoms below (DSM-IV-TR, 2000), is essentially the same as Seasonal Affective Disorder, with some small differences.

• Feeling sad or blue
• Appetite disturbance with either loss of appetite or increase in appetite
• Sleep problems
• Fatigue
• Lethargic (slow) physical movement or physical agitation
• Diminished interest or pleasure in activities that are usually engaging
• Poor concentration or indecision
• Feeling worthless—or feeling guilty
• Thoughts of death or suicide

These symptoms should be used as a guide rather than a means to identifying the nature of yours or someone else’s mood. Identifying a depression is a complex process, and licensed professionals (including, but not limited to, psychiatrists and psychologists) are trained to make a diagnosis.

Experiencing SAD and Depression

Depression can act subtly and can be hard to detect on a subjective level. Symptoms can be felt so intimately that they can be experienced as and attributed to something undesirable in one’s self, which can be distressing. However, the symptoms of SAD are experiences; the person is not the problem. Concluding that one is out of sorts, because of a particular problem or stressor, and that the thoughts or feelings can be changed through will power or by changing the situation can provide a sense of control and a plan of action. But doing so may not be helpful in recognizing the presence of the depression, itself—something that is affecting thoughts and feelings.

So what can you do if you have symptoms of Seasonal Affective Disorder? Understanding the etiology—the causal factors—in SAD can take self-blame out of the equation and provide information, insight, and understanding. Forewarned is forearmed. If you believe you are experiencing SAD or depressive symptoms and want to start on alleviating them, consider seeking information (check your public library or bookstore for a list of books, such as Norman Rosenthal’s Winter Blues, Revised Edition) or look into professional help (for example, a case manager, a medical or psychiatric professional, a clergy person, or a psychotherapist).

SAD and Suicide

If you are having suicidal thoughts or thoughts of death, know that such thoughts are very serious. Suicidal thinking reflects more of a slippery or skewed thinking than a realistic assessment of your situation. Suicidal thinking can include a bias towards unpleasant appraisals and a limited perspective, like experiencing the world from a pit. Confused thinking and lack of clarity in thought is a feature of both SAD and depression. If you are tempted to draw conclusions on the order of something like, the world will be better off without me; I’m too tired to go on; or I can’t do anything right, so I should end my life, or other kinds of conclusions, then know you are not thinking clearly. The world, indeed, is best with you IN IT. This article is not a substitute for mental health treatment: Call the Anchorage Community Mental Health Crisis Line at 563-3200 if you are having thoughts of death or of killing yourself; if you are formulating a suicide plan or you are about to take action on a plan, get yourself (safely) to a local emergency room.

Helpful Resources

Depression with seasonal pattern (i.e., SAD) is a mood disorder, and moods change. That means that you will feel better than you do now. Get help. That may include an evaluation for medication, an improvement in self-care lifestyle, or therapy.

References

Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR,(4th Ed.). (Text Revision). (2000). American Psychiatric Association: Washington, DC.

Flaskerud, J. (2012). Seasonal affective disorders. Issues in Mental Health Nursing, 33, 266-268.

Lansdowne, A. & Provost, S.C. (1998). Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology, 135, pp. 319-323.

Magnuson, A. & Partonen, T. (2005). The diagnosis, symptomatology, and epidemiology of seasonal affective disorder. CNS Spectrum, 10, 8, 624-634.

Rosenthal, N. (2005). Winter Blues, Revised Edition: Everything you need to know to beat Seasonal Affective Disorder. Guilford Press: New York, NY.

Spoont, M., Depue, R., Krauss, S. (1991). Dimensional measurement of seasonal variations in mood and behavior. Psychiatric Research, 39, 269-284.
 

 


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