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  • Depression blog

  • Nov. 17, 2008

    It's a SAD time of year

    By David Mrazek, M.D.

33 comments posted

Need more help?
  • National Suicide Prevention Lifeline
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  • National Alliance on Mental Illness
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    1-800-950-NAMI (6264)

Less daylight during the fall and winter causes depression in some people.

Other factors contributing to seasonal affective disorder (SAD) may include genetics and age. We know that neurochemicals are involved in the regulation of our mood and functioning.

Melatonin is a hormone that our brains produce during the hours of darkness. It is involved with regulation of sleep, body temperature and release of hormones. As with any hormone, the amount produced is important.

People with SAD produce too much melatonin. This disrupts our internal body clock leading to depressive symptoms. If you have had episodes of depression that clearly have an onset in fall or winter followed by remission of symptoms in the spring or summer, you may have SAD.

Symptoms of winter-onset seasonal affective disorder include:

  • Depressed mood
  • Irritability
  • Hopelessness
  • Anxiety
  • Loss of energy
  • Social withdrawal
  • Oversleeping (feeling like you want to hibernate)
  • Loss of interest in activities you normally enjoy
  • Appetite changes, especially a craving for foods high in carbohydrates such as pastas, rice, bread and cereal
  • Weight gain
  • Difficulty concentrating and processing information

Medications or light therapy (phototherapy) can be used to treat SAD. The type of light used, distance from the light, and amount of time, are very specific. The light should be of adequate intensity, 10,000 lux (lux is a measurement of light intensity). At 10,000 lux, the amount of time required in front of the light is 30 minutes.

If the light is 5,000 lux, then the amount of time will be 60 minutes. You need to have your eyes open, so that the light can reach the retina in the back of your eye. You do not have to look directly at the light. You can read, knit, etc. The light purchased should have information on exactly how to use the light effectively. The distance you sit from the light will range from about 12-18 inches. The light will not emit damaging UV rays.

Speak with your health care provider if you think you may have SAD. Treatment is available. There are possible side effects, such as eye strain and headaches. Typically, light therapy is done in the morning, as it can cause insomnia if done too late in the day. If you struggle with bipolar, a hypomanic or manic episode can be triggered by light therapy, so should be used with extreme caution.

You can purchase a phototherapy light without a prescription, but speak with your provider first. Some insurance companies may cover some of the cost. Treat SAD, so you can enjoy this beautiful time of year!

33 comments posted

blog index

  • February 3, 2012 10:01 a.m.

    For many years I go through a really difficult winter cycle. I live in a small mountain town in the California Redwoods and the sun is obscured by mountains and trees during Fall and Winter. I used to use a light box but it didn't seem to really have a lasting value. And it hurt my eyes. Am on anti-depressants and 3 month ago began taking Vitamin D. which has increased my energy quite a bit but anxiety has increased too! I exercise (walk) 3 times a week and I continue to have depression/anxiety. Thank goodness it only happens in the winter but it's really difficult to live like this. I think of moving to the tropics but how to earn a living is a big question? Talking with others and knowing that there are others who have this experience is helpful.

    - Marie

  • January 22, 2012 5:13 p.m.

    I recognized my SADS 25 years ago (I'm 72). For many years light boxes worked but not as much any more. What is a blessing is if I go to florida for the winter. Southern Florida snowbirds are mainly there for the sunlight. Age is a big factor in worsening SADS. My resources are limited but i manage to rent small kitchenette for $400/$500 month. This winter tho my husband needed open heart surgery so we came home (illinois). I got in touch with doctor and she prescribed stronger anti-depressants which are working. Husband had surgery at Mayo in Rochester 3 weeks agoo and is doing fine. I'm doing o.k. with te stronger meds.

    - Bicyclecruiser

  • January 14, 2012 9:00 p.m.

    I am new to this SAD but wondering if it can explain my loss of control and crying so often, everytime a grown child or grandchild and I have a confrontation/conversation. Our holidays were very stressful with lots of family conflict. We muddled thru but still nothing is resolved. My emotions are so close to the surface I can hardly carry on a conversation, I break down and my family looks at me like I am losing my mind, indeed, I feel like I am too at times. What is wrong with me. Sleep disturbances, very nervous and anxious. Am on no meds or have not seen a dr. can I handle this myself or what??

    - Mary

  • October 25, 2011 10:30 p.m.

    I've had a ''down'' period (including depression symptoms, sleepyness, sugar cravings, apetite variations, anxiety, mood swings, crying spells...)from Late August to March since my teenage years and I've always left all the lights open around me because I seemed to crave on light! My Doctor has suggested I try light therapy and it has given me a feeling of comfort and well being after 30 minutes of exposure. I usually read or eat in front of it and I am even reluctant to turn it off! Unfortunately, the effect are not permanent althrough the day. I am still loking into other ways to help me because Winter is long and everything is better from Spring to Fall...I am also taking an antidepressant whic helps some, Effexor, 75 mg. It helps mostly with anxiety.

    - Christiane

  • April 20, 2011 3:49 p.m.

    For several years i've noticed this depression that begins in April and dissapates sometime later, maybe June. I guess it feels good to put a name to it. I thought SAD only happened in the Winter. I read that May has the highest number of suicides so I had an inkling I wasn't alone in this weirdness. Light therapy now?

    - sarah

  • April 1, 2011 10:51 a.m.

    Is there a time that you can discontinue the use of the SAD light and just get light exposure outdoors ie gardening , walking etc. I know light exposure varies by the location of the individual. I am curious about locations on the latitude of a city like Iowa City or Omaha.

    - Liz

  • January 9, 2011 8:22 p.m.

    My mother is blind and seems to have SAD - it starts October or Novemer and last through March. Is there any reason why she shouldn't try a light therapy box beause of her blindness? (Blindness was caused by diabetes.)

    - Jane

  • January 2, 2011 1:35 a.m.

    I have struggled with SAD and became really aware of it when I quit drinking and using other substances to try and medicate. After years of being clean from the above, I have been able to identify when the SAD kicks in....and I also am aware of deffinite symptoms "hypomania" in the spring and summer (I much prefer the hypomania) so I would say, my personal experience is YES, u can have both, -

    - Kelly

  • December 31, 2010 11:23 p.m.

    I've been looking all over the net for the past week and I could not find not even ONE article on it. I wonder... how common it is for a person to have the Winter *AND* Summer disorders together? Also, can someone with SAD feel most of the symptoms but do not necessarily feel depressed? Anyone?

    - Serena

  • December 11, 2010 5:47 a.m.

    Two things to keep in mind for seasonal affective disorder suffers, if you have darker skin, it usually means you need a lot more sun, and taking a vitamin might not work, eating your vitamin in food with fat might. This is because most of the vitamins that help with SAD are fat soluble. After almost thirty years of eating a low-fat diet and daily exercise, I went to a full fat diet with very moderate exercise AND "Total" cereal every other morning, and a light box at work 4 hours a day M-F, and if I stick to this, I'm almost 100% cured. It at least gets me through til I can get to Arizona in January for some sun.

    - Sonya

  • December 3, 2010 2:21 p.m.

    Hello. Yes im am man and talking about my health...a rare exception but a real man. Anywys have suffered SAD , i hope this is it for years. I asked myself this years ago but dismissed it for i do not know why.It is soo important to have a doctour to follow u...i tried this year for 1st time the lamp therapy approach , my 4th day. Touch wood. Im extremely depressed and its very difficult to live this way.I hope this is not just another HOPE where there is none...i guess being depressed this this is the way one thinks... What does everyone think outhtere.

    - anthony

  • October 25, 2010 3:10 p.m.

    My relationship is relatively new, but I've known my boyfriend for about 8 years. I've never noticed his depression until now. Its about the time of year that he claims to lose interest in life, and I can really tell he is really losing interest. Everything brings him down, and he gets mad at me for the smallest issues. I don't want this to ruin us. The worst part is he refuses to seek treatment. Help...

    - no name

  • February 4, 2010 3:41 p.m.

    I used bright light before and the headaches and eye pain were just to much for me. Aafter a lot of research I found info about low intensity green light therapy. I was skeptical but since it has been the subject of many positive studies I tried it out, it works for me and I've never looked back.

    - Richard

  • December 15, 2009 7:38 p.m.

    I am sure my husband has been suffering from SAD for years. It is always noticeable but some years are worse than others. Being a man he refuses to talk to a doctor about it, he just says we have to wait it out. It lasts the months of November and December so our holidays are ruined. You would think after 25 years of marriage, I would be able to cope with this better but it turns my world upside down. The rest of the year, our marriage is wonderful. What am I to do. Two months can seem so long when you are just waiting for it to be over.

    - Glenna

  • November 22, 2009 4:54 a.m.

    My question is about seasonal affective disorder (SAD), however as in my case, how offend does this happen to someone in the summer? Or is that a different disorder.

    - Robert

  • November 5, 2009 3:49 a.m.

    I have been living with SAD for 5 years. I use a light box, try and eat right, exercise, be mindful of my moods, talk when I need to and take a good increase in Vit D (up to 4000U) as well as other supplements. I am currently on Welbutrin 450mg and Zolft 100mg. I am wondering if any other medication has worked for someone. I work night, (I know not the best shift) and in the Winter its horrible to get to work at 11pm. So more or less wondering, any word on different medications

    - Shelley

  • October 27, 2009 1:55 p.m.

    I purchased a lightbox from Apollo Health several years ago-- Apollo has been bought out by Phillips so it should be easy to find their products on-line. The technology and style of their lights has improved. I use my lamp for 40-60 minutes in the early morning (upon waking) and 20 minutes in the late afternoon (5pm) for best results. Must be used consistently over a period of time to be effective. Start with a shorter period of time at the beginning of use and ease into longer sessions to avoid hypomania. Do not use within 3-4 hours of bedtime to avoid insomnia.

    - ABK

  • October 4, 2009 11:23 p.m.

    Ellen: how many IU of vitamin D 1000 or 2000 to aid in the symptons of sad

    - Mel

  • October 4, 2009 11:20 p.m.

    does vitamin d help with sad

    - mel

  • August 25, 2009 7:05 p.m.

    how can u tell someone has any form of depression? my mom has been "down" for quite some time if not years to be honest. she is always unhappy, feels left out and alone and when i asked what she feels in an attempt to help her talk her words were "i feel like i had an internal abortion (!!) and any kind of feelings were erased. I cannot feel anything and I am tired to anyway" I fear that telling her to visit a specialist will have a worse impact on her esteem. Besides I strongly want to avoid any involvement with any medical treatment.

    - x.

  • July 31, 2009 8:56 a.m.

    Light Boxes for Seasonal Affective Disorder: There are many complanies that make full spectrum lights- they come in different sizes. The main thing is to make sure the the intensity of the light is 10,000 lux. If the bulb gives off 5000 lux, you need to use it twice as long, so a box that gives off 10,000 lux will need to be used 20-30 minutes each morning. You can purchase light boxes on the internet. Call the company with questions before buying. Good luck!

    - Mayo Clinic. Com Staff

  • July 30, 2009 7:20 p.m.

    I tried to get a recommendation from my Dr. as to where to purchase a legitimate light therapy lamp for treating SADD. My Dr. contacted one or more persons in the psychiatric profession, but was unable to get a recommendation. Where does one purchase one of these light boxes?

    - Carol

  • January 7, 2009 1:37 p.m.

    I don't know is it a late feedback? Life Spring might be a kind of supplement what you mentioned.

    - Being

  • December 10, 2008 10:11 a.m.

    Does anyone know of a RX med or supplement that is supposed to REDUCE Melatonin that I could discuss with my Dr & Psych Therapist?????

    - Linda

  • December 10, 2008 10:00 a.m.

    I'm sufferer of yr-round, hard to treat depression, w/some bi-polar symptoms (more uni-polar than bi-polar ie rarely have multi-day energy bursts w/o sleep but do experience high agitation, outbursts, behavior control, trembling, mind/heart racing etc OR the opposite, sleeping for days in a row & no energy focus/interests etc. Diagnosed SAD 10 yrs & use light box in am AND PM (12 hrs apart)per Psych Therapist & MD - helps! Problem compounded by severe sleep apnea & thyroid disorder(take med). Get SLEEP TEST @ sleep lab if you snore! Treating sleep apnea can lessen SAD & depression & bi-polar! You must check this out w/your Dr. Covered by ins & so is apnea equip usually. Get in SUN whenever available, even if freezing, take a walk, bundle in blankets & coat and sit & read outside, anything outside! The more frequency out in SUN the better you'll feel. Florida vacations make a huge diff for me & if I go 4+ days, effect lasts appx 2+ weeks. If I feel total helpless/suicidal, I take a sunny long weekend (I keep a yr round fund for this) Even when SAD worsens it's not as severe. Everyone's SAD can be different! Mine begins @ Aug & relents in Mar! I even start getting excess energy in late Feb & I know I made it thru another yr! Because of sad/apnea combo, I take RX PROVIGIL as need to make me awake daytimes w/no naps. I was having slow reaction time, minor car accidents & it super helped. PROVIGIL developed for long distance tru

    - Linda B

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