Understanding and managing Seasonal Affective Disorder (SAD)

As the days grow shorter and temperatures drop, many people experience a shift in their mood, energy, and overall sense of well-being. For some, these changes go beyond typical winter blues and turn into a form of depression known as Seasonal Affective Disorder (SAD), commonly referred to as Winter Depression. In this article, we’ll explore what SAD is, its symptoms and causes, and ways to manage it—including tools that can provide comfort and relief.

What is Seasonal Affective Disorder (SAD)?

Seasonal Affective Disorder is a type of depression that follows a seasonal pattern, typically emerging in late autumn or early winter and receding by spring. While anyone can experience a mild dip in mood during the colder months, SAD goes beyond that, with more significant emotional and physical effects. According to the American Psychiatric Association, SAD affects around 5% of the U.S. population, but it's particularly prevalent in northern regions where daylight hours are shorter. In Europe, about 2-8% of the population is affected by SAD, according to the European Journal of Public Health.

SAD is linked to a disruption in the body’s circadian rhythms, which regulate our sleep-wake cycles. When we don’t get enough sunlight, our biological clock can become misaligned, leading to symptoms of depression, lethargy, and irritability. Furthermore, reduced light exposure can lower serotonin levels, a neurotransmitter that affects our mood, and increase melatonin production, causing feelings of sleepiness and fatigue.

Symptoms of seasonal depression

SAD symptoms often mirror those of major depression but are specific to the season. Common symptoms include:

• Persistent feelings of sadness or hopelessness.
• Fatigue or low energy level, even when getting a sufficient amount of sleep.
• Difficulty concentrating or making decisions.
• Changes in sleep patterns, including sleeping too much (hypersomnia) or having trouble sleeping at all (insomnia).
• Increased appetite, often craving carbohydrates, leading to weight gain.
• Social withdrawal, feeling like “hibernating.”

These symptoms typically start mildly in early autumn and intensify as winter deepens, only to disappear once spring brings back longer days.

Causes and risk factors

The exact cause of SAD isn’t fully understood, but it’s clear that lack of sunlight is a major factor. Sunlight plays a critical role in maintaining healthy levels of serotonin and regulating melatonin. When light is scarce, our body’s ability to manage these hormones diminishes, leading to mood imbalances.

Geography plays a significant role in determining who might be affected by SAD. People who live far from the equator, such as in Scandinavia, the northern United States, or Canada, are at higher risk because of the longer, darker winters. Women are also more likely than men to experience SAD, as are those with a family history of depression or other mood disorders, according to an article by the American National Institute of Mental Health.

How to manage Seasonal Affective Disorder

The good news is that several effective treatments exist for managing SAD, and early intervention can greatly improve symptoms. Here are some of the most common approaches:

1. Light therapy

One of the most well-established treatments for SAD is light therapy, which involves sitting in front of a lightbox that mimics natural sunlight sometimes referred to as daylight lamp. Research by Terman et al. (1998) found that light therapy is highly effective in treating winter depression, particularly when administered early in the morning to help reset the body’s circadian rhythm. A lightbox delivering 10,000 lux is recommended for about 30 minutes each day.

2. Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy has also shown great promise. A study by Rohan et al. (2007) suggests that CBT helps patients identify and change negative thought patterns and behaviours associated with SAD. The benefit of CBT is that it provides long-term tools for managing not only (winter) seasonal depression but any depressive episodes that may occur throughout the year.

3. Lifestyle changes

Incorporating small changes into your daily routine can also make a big difference in how you feel during the winter months. Here are a few tips:

• Maximise sunlight: Spend time outdoors when the sun is shining, especially in the morning, and keep your home as well-lit as possible by opening curtains or blinds.
• Exercise: Regular physical activity helps boost serotonin levels and improve mood. According to Dr. James McDeavitt from the Baylor College of Medicine, maintaining or even increasing exercise routines during the winter months can significantly benefit those with SAD. He emphasises that while aerobic exercises like running are beneficial, other options such as yoga, tai chi, or meditation can also positively impact mood and alleviate depression symptoms.
• Maintain a healthy diet: Avoid overeating carbohydrates, and aim for a balanced diet with fruits, vegetables, and protein. Research by Berk et al. (2007) suggests, that the supplementation of vitamin D may be beneficial when suffering from depression as well. This is because vitamin D deficiency has been linked to depression and possibly other mental disorders.

Weighted blankets and duvets may support sleeping problems and alleviate anxiety

If you experience insomnia, sleeping problems, or anxiety the use of weighted blankets or weighted duvets may be beneficial to manage these symptoms. These duvets and blankets are filled with an evenly distributed, heavy filling and use deep pressure therapy (DPT), which is the application of firm, consistent pressure to the body—similar to the sensation of being hugged.

While we would like to be clear, that there currently isn’t any research available specifically on the use of weighted blankets in patients suffering from SAD, research has shown that deep pressure stimulation helps to activate the parasympathetic nervous system, which reduces the production of stress hormones like cortisol and increases levels of serotonin, thereby promoting a feeling of calm when feeling restless or anxious. A study by Ackerley et al. (2015) found that weighted blankets can significantly reduce anxiety, which is often a co-occurring symptom in people with SAD.

Additionally, a 2020 study by Ekholm et al. demonstrated that weighted blankets can improve sleep quality in individuals with insomnia as a co-occurring symptom of psychiatric disorders like depression. According to the study, the use of weighted blankets resulted in a “significantly better sleep-maintenance, a higher daytime activity level, and reduced daytime symptoms of fatigue, depression, and anxiety”.

Since poor sleep is a hallmark symptom of SAD, weighted blankets and duvets can be a useful addition to the bedtime routine for those struggling to maintain regular sleep cycles during the darker months.

Why weighted blankets and weighted duvets may be a helpful tool when suffering from SAD

• Calming Effect: The gentle pressure from a weighted blanket or duvet encourages relaxation, which helps counteract the anxiety and restlessness that many people with SAD experience.
• Improved Sleep: SAD often comes with sleep disturbances, such as oversleeping or insomnia. Weighted blankets can help regulate sleep by reducing tossing and turning, helping you fall asleep faster and stay asleep longer.
• Reduction in Stress Hormones: Studies have shown that using a weighted blanket can reduce levels of cortisol, a hormone linked to stress and anxiety, which is especially helpful for people whose SAD symptoms include feelings of overwhelming stress or panic.

Preventing seasonal depression

If you’re prone to SAD, consider taking steps before winter begins to help mitigate its effects. Here are a few strategies:

• Start light therapy early: Begin using a lightbox in the autumn before symptoms worsen.
• Plan outdoor activities: Make a habit of getting outside, even when it’s cloudy. Sunlight still reaches you through overcast skies.
• Maintain a regular schedule: Keeping a consistent routine throughout your days can help regulate your body’s internal clock.

Additionally, weighted blankets and weighted duvets can also be used proactively to help manage stress and improve sleep during the early stages of SAD.

Conclusion

Seasonal Affective Disorder can feel overwhelming, but understanding the root causes and implementing a combination of treatments can significantly improve quality of life. While light therapy and CBT are among the most commonly used treatments, tools like weighted blankets and duvets may offer an additional layer of support by addressing key symptoms such as anxiety, stress, and disrupted sleep.

As winter approaches, consider trying out some of these methods to take control of your mental health and maintain balance through the darker months, and make sure to seek help if you struggle with managing your symptoms.