Disorder: An Introduction
Part One in a Three-Part Informational
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 first of three
installments on Seasonal Affective Disorder, the experience of SAD, the
symptoms, and the relation of SAD to depression in general will be
described. In the second installment, the etiology, or cause, of SAD and
the probability of developing SAD according to age, gender, and other
factors, will be discussed. In the final and third installment, the
treatment for SAD will be covered. It is hoped that these installments
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.
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
• 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
• Sleep problems
• Lethargic (slow) physical movement or physical agitation
• Diminished interest or pleasure in activities that are usually
• 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 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
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.
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.
Resources and Information
In this brief introduction to
SAD, its relation to depression and the symptoms have been described.
References are provided, below. The next installment of information on
SAD should be posted on this web site by the end of August. Thanks for
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,
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.