Mental Health Challenges: Seasonal Depression and Anxiety

As fall begins, many people may start to experience symptoms of seasonal depression. In fact, about 5% of Americans experience symptoms of seasonal depression every year. It is essential to recognize these symptoms and seek effective treatment options.

What is seasonal depression?

Seasonal depression, also known as seasonal affective disorder (SAD), is a type of depression associated with seasonal changes. In most people, symptoms appear in the fall and resolve in spring. A smaller number of individuals may experience the opposite, with mental health challenges starting in spring and resolving by fall.

People whose daily lives are not significantly hindered by their depressive symptoms may be experiencing a mild form of seasonal depression. Such “winter blues” affect about 10% to 20% of people in the U.S.

What are the symptoms of seasonal depression?

The most common signs and symptoms of seasonal depression include:

• Persistent feelings of sadness, hopelessness, worthlessness, or guilt
• Loss of interest in daily activities
• Not wanting to spend time with friends and family
• Struggle to maintain focus and concentrate
• Low energy levels
• Excessive or insufficient sleep
• Having physical health problems such as colds, infections, or other illnesses
• Sugar cravings, overeating, and weight gain
• Decreased sex drive
• Thoughts of not wanting to live

What are the causes of seasonal depression?

Although the exact cause of seasonal depression is unclear, the lack of sunlight might play an important role. Here are some possible ways in which low sunlight exposure may cause mental health challenges:

• Biological clock change. The lack of daily sunlight exposure may affect your internal biological clock. This regulates your mood, sleep, and hormones.
• Brain chemical imbalance. The level of serotonin, a brain chemical that helps you regulate mood and emotions, may be negatively affected by the lack of sunlight.
• Vitamin D deficiency. The lack of sunlight may decrease your production of vitamin D, a chemical that affects your production of serotonin.
• Melatonin boost. Your levels of melatonin, a chemical that promotes sleep, may increase with the lack of sunlight. This might make you sleep more and feel tired during the day.

Who is at risk for seasonal depression?

Seasonal depression affects young people and women more often than other groups of people. Other risk factors include:

• The presence of another mood disorder, such as major depressive disorder or bipolar disorder.
• Having relatives who experience seasonal depression or other mental health conditions.
• Living at latitudes far north or far south from the equator. This causes you to receive less sunlight during winter. 
• Living in cloudy areas.

When should you seek help?

It is normal to have days when you don’t feel your best. However, you should contact your healthcare provider if you experience the following symptoms:

• Feeling sad for an extended period of time
• Losing interest in everyday activities you normally enjoy
• A significant change in your sleep pattern and appetite
• Increased use of alcohol and other substances
• Starting to feel hopeless and thinking about suicide

Treatment Options

Various treatments may ease mental health challenges associated with seasonal depression. Your healthcare provider may suggest some of the following treatment options:

• Lifestyle changes.  Your provider might encourage you to get out and get as much natural sunlight as possible. Try to exercise regularly, walk more, and increase your overall activity levels. Your symptoms might improve if you maintain a healthy sleep schedule and eat a nutritious, well-balanced diet.
• Talk therapy.  A healthcare professional can assist you in changing the distorted views you may have of yourself and the environment around you. This may help you improve interpersonal relationship skills, identify stressors, and learn techniques to manage your stress levels. The most effective therapeutic approaches for seasonal depression might be cognitive behavioral therapy (CBT) and counseling.
• Light therapy.  Light therapy involves using a special lamp for 15 to 30 minutes every morning. It might take a couple of days or weeks to see the benefits of this treatment.
• Medications.  If needed, your healthcare provider can prescribe vitamin D supplements and/or anti-depressive medications. The most commonly prescribed antidepressants include:
  • Fluoxetine (Prozac®)
  • Escitalopram (Lexapro®)
  • Paroxetine (Paxil, Pexeva®)
  • Sertraline (Zoloft®)
  • Citalopram (Celexa®)
  • Bupropion (Wellbutrin®)