If you’ve ever lived with depression, you know how big of an impact it can have on all areas of your life, from relationships, to work, to sleep. For many people, this depressive state is cyclical and occurs throughout the year, depending on the season.
If this sounds familiar, you may be dealing with Seasonal Affective Disorder (SAD), or seasonal depression. What exactly is SAD, though? How does it impact sleep and energy levels? Perhaps most importantly, how can you get to feeling better? Here, we’ll answer these questions and more.
Chances are you have either heard of the term “Seasonal Affective Disorder” (with the fitting acronym, “SAD”) or the term “Seasonal Depression” before. SAD and seasonal depression are essentially two terms describing the same thing.
Seasonal Affective Disorder, a.k.a., seasonal depression, is a type of recurring depression with a seasonal pattern. As summer turns into fall and winter, the temperature drops, and the hours of sunlight decrease. For as many as 10 million Americans, these changes trigger symptoms of depression that aren’t present at other times during the year.
SAD is different from major depression in that it comes and goes at roughly the same time every year. These symptoms can be so severe that they interfere with daily life and may even increase the risk of suicide.
A milder form of the disorder, known as subsyndromal seasonal affective disorder (S-SAD), is also referred to as the “winter blues”. For this group of men, women, and even children, the winter blues may come and go but only cause small changes in things like mood, appetite, and energy.
Though most people experience SAD as the weather transitions into the colder months, some may experience this in the spring or early summer. While people who experience seasonal depression in the winter tend to get excessively sleepy, people who experience it in the warmer months tend to experience the opposite: insomnia.
For people living in northern climates, the winter blues are commonplace. While S-SAD can bring on small changes in mood and affect, the temporary symptoms are mild and can be managed with lifestyle changes like exercise, self-care, and meditation.
For those battling Seasonal Affective Disorder, the symptoms are similar to major depression, affecting nearly every aspect of life. The two most common symptoms of SAD are low energy and a depressed mood, regardless of which variation occurs.
Those experiencing a winter seasonal pattern may also have the following symptoms:
On the other hand, those experiencing the less common summer variation may have these symptoms:
Winter blues or not, getting adequate sleep in this cold and dark season can be a challenge. If you feel tired and lethargic, you may not be sleeping enough or getting the restorative rest you need. Here are some tips on how to sleep better in the long, winter months:
Light therapy using light boxes or specially designed LED lights has been shown in research to be very effective for improving depression, which could lead to better sleep. These boxes, most small enough to sit on the counter, emit full-spectrum rays, similar to sunlight. Using them for just 20 to 60 minutes a day each morning from early fall until spring can help lower the body’s melatonin levels and increase mood-boosting chemicals and hormones.
To date, light therapy has been the most widely studied treatment for seasonal affective disorder. In a review of studies of light therapy, early morning treatment with an average dosage of 2,500 lux daily for one week resulted in a significant amount of remissions in depression symptoms.
Artificial lights can be helpful, but natural sunlight is best. If you live in a place where there is sunlight during the day and temperatures are safe to be outside, spending time outside in the sun is a great way to boost your mood and get vitamin D, which helps battle depression. Similar to light therapy, this can help regulate depression symptoms as well as your body’s circadian rhythm.
Exercise has some amazing benefits for sleep. Working out triggers the release of endorphins and other chemicals that make you feel good, plus it can help you to sleep better at night. Bonus points if you can exercise outdoors in the natural sunlight!
Yoga, meditation, and deep breathing are all effective ways to calm the body and mind. In the morning, they can help you feel focused and more energized for the day. In the evening, they can clear the mind from all the worries of the day so you can focus on the most important task at hand – sleep.
One of the most underestimated yet effective ways to improve sleep is by sticking to a regular schedule when it comes to sleep and wake times. Going to bed and waking up at the same time every day, including weekends, helps to establish a pattern and balances the body’s internal master clock. Over time, maintaining this routine may help you to wake up feeling more alert and cut down on the time it takes to fall asleep at night.
Here are some good places to start:
Scientists are still trying to understand the complexities of mood changes over the winter months. They haven’t been able to pinpoint one distinct cause, but there are some biological explanations that they’ve been able to uncover. Blaming it all on the lack of sunshine may seem overly simple, but natural light exposure does play a huge role.
If you’ve ever taken an antidepressant, you may have heard the term “SSRI”. This stands for “Selective Serotonin Reuptake Inhibitors”. These medications work by increasing the amount of serotonin in the brain, thus helping to balance mood.
Serotonin is a neurotransmitter that's found in the brain and gut and is involved in regulating mood. Neurotransmitters are chemicals that act as messengers, relaying information from nerves to other nerves, muscles, or throughout the body.
Researchers have discovered that individuals with Seasonal Affective Disorder may have difficulty regulating serotonin. SERT is a protein that transports serotonin, and when there are higher levels of this protein, less serotonin is available, leading to depression. Sunlight plays an important role in keeping SERT levels low, so when fall and winter come, serotonin levels drop.
There’s been a lot of talk about the hormone melatonin and the important role it plays in regulating the sleep-wake cycle, aka the circadian rhythm. To understand how light controls melatonin production, we need to jump into the brain to look at a tiny pea-sized structure known as the pineal gland.
The pineal gland is responsible for creating melatonin, the hormone that makes you feel tired. The suprachiasmatic nucleus (SCN) is a tiny part of the brain in the hypothalamus that tells the pineal gland when and how much melatonin to make. The SCN does this based on the information it receives from receptors in the eyes.
Natural sunlight helps to regulate this master alarm clock, relaying information about whether it’s day or night. Unfortunately, according to the EPA, Americans spend over 90 percent of their time indoors, especially during the long and dark winter months.
Research has shown that individuals with seasonal affective disorder may produce excessive amounts of the hormone melatonin. This could explain why they feel excessively tired and sluggish during the winter months, often spending more time in bed.
Another downside to spending so much time indoors is that the skin misses out on the sun exposure it requires to produce vitamin D. You’ve probably heard of this sunshine vitamin and that it also acts as a hormone in the body. Vitamin D has many different functions, and one is its involvement in serotonin activity.
You only need 5 to 30 minutes of sun exposure to the face, arms, legs, or back without sunscreen between 10:00 a.m. and 3:00 p.m. twice a week to get sufficient vitamin D, but most people aren’t even getting this. A detailed examination of National Health and Nutrition Examination Surveys from 2001 to 2004 discovered that 77 percent of the U.S. population is deficient in vitamin D.
Many people living in northern climates have lower levels of vitamin D over the winter months, so much so that physicians often recommend a supplement between the months of November and March. Researchhas also discovered that people with SAD may produce less vitamin D, and a deficiency of this vitamin has been linked to depression.
The winter months bring less light exposure, which we’ve identified as a key factor in regulating the body’s circadian rhythm. Increased melatonin and decreased serotonin can have a huge impact on this internal 24-hour sleep-wake clock.
For this reason, people with SAD often have a circadian rhythm delay. Research has discovered that “the circadian signal that indicates a seasonal change in day length has been found to be timed differently, thus making it more difficult for their bodies to adjust3.”
In one study, individuals with seasonal affective disorder had circadian rest-activity rhythms that were delayed by up to 70 minutes compared to healthy controls.
Another study examined whether the circadian pacemaker in patients with SAD signals a change in day length after the transition from winter to summer. They discovered that “patients with seasonal affective disorder generate a biological signal of change of season that is absent in healthy volunteers and that is similar to the signal that mammals use to regulate seasonal changes in their behavior.”
The problem with this signal in humans is that we don’t hibernate like other mammals. Healthy individuals don’t have this signal, so it could be part of the reason people with SAD react differently to the change in season.
While most individuals with winter-onset SAD experience excessive fatigue and sleep, there are some who have the opposite problem. Several studies in Northern countries have found that the darker winter months are associated with poor sleep.
One study compared sleep and mood in people living in two drastically different areas of the world where there is a great variation in sunlight throughout the seasons. In Ghana, where the duration of daylight remains constant, there was hardly any difference in sleep or mood throughout the winter months. In Norway, where there is a lack of daylight over several winter months, individuals reported insomnia, fatigue, and depression.
More and more research is looking at the close connection between mood and sleep. Many people suffering from depression report insomnia and other sleep disturbances, and scientists have identified that the part of the brain that regulates sleep is also closely tied to mood. A review done in 2013 found that the majority of those with mood disorders also have circadian rhythm disturbances affecting their sleep and wake cycles.
Another factor that may play a role in winter insomnia is the great amount of time spent indoors. For most people, most of this time is spent in front of electronics like phones, computers, and televisions, all of which emit primarily blue light. This is one of many wavelengths of light that the sun naturally emits, but in our blue-lit 21st-century world, we’re being bombarded with round-the-clock blue light.
While some blue light is beneficial, too much of it could be negatively impacting our health. Research has shown that blue light directly inhibits our body’s melatonin flow, hurting our ability to fall asleep in addition to negatively impacting the quality of the sleep we get.
Twice a year every year, more than 70 countries and 1.6 billion people shift the clocks by one hour in a practice known as daylight savings. The practice that began in 1916 was designed to maximize exposure to daylight during the time that most people are active and outdoors.
Unfortunately, the practice of daylight savings causes disruptions to the circadian rhythm that have been shown to have multiple adverse effects. Research has found that daylight savings time transitions are associated with sleep disturbances, fatal car accidents, and increased heart attacks and strokes the day after the spring time change.
In a 2017 study, a team of international researchers looked at 185,419 Danish hospital intake records between 1995 to 2012 where there was a diagnosis of depression. These Danish scientists discovered that during the transition from summertime to standard time (known as “fall back”), there was an 11 percent increase in depressive episodes.
The researchers concluded that “the observed association is primarily related to the psychological distress associated with the sudden advancement of sunset from 6 PM to 5 PM, which marks the coming of winter and a long period of short days.” They believe that the majority of these individuals likely had suffered from seasonal depression in the past and that the sudden shift to less evening daylight served as an omen of the dark season ahead.
While the idea behind moving the clocks back in the fall is to provide more early morning sunlight, which should be beneficial for those with depression, the opposite may be true for those with SAD. Dr. Norman Rosenthal is a Psychiatrist and was one of the original doctors who first described seasonal affective disorder in 1984. He now speaks widely on the subject and is the best-selling author of a book entitled Winter Blues.
If you have the winter blahs, it may be tempting to just pack your bags and move south. Unfortunately, this type of major life change isn’t always feasible. Seasonal depression is a real disorder, and it’s important to seek treatment.
As we’ve seen in the research, it can impact every area of your life, including sleep. Thankfully, there are so many promising treatments that can help. If you’re struggling, remember that you’re not alone—find a friend, loved one, or trusted medical professional to speak with today so you can embark on your journey to feeling whole again.