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October 30, 2021 11:45 am

Winter is Coming and So Are the Chances of SAD

There's some evidence that the more people ruminate in the fall, the more severe their symptoms are the following winter | Picture Credits Faisal Bashir

By Wasim Kakroo

DO you feel sloppy and lazy as the gloomy days of winter approach? Is it more difficult getting out of bed early in the morning? Is it difficult for you to concentrate at work? Do you feel demotivated and sad for no apparent reason for most part of the day? Do you recline on the couch all day and have difficulties sleeping during night? Do you binge on comfort food and laze around watching TV, or surfing social networking sites. There are chances that you have Seasonal Affective Disorder (SAD).

What is SAD?

Seasonal Affective Disorder or SAD is a recurrent form of clinical depression. It's a type of major depressive disorder that occurs only during particular months of the year (for most of the people during winter months, especially during deep winter).

Can you tell us how SAD differs from depression in general?

Seasonal Affective Disorder differs from depression primarily in that it follows a seasonal pattern, with major depressive episodes reoccurring consistently during particular seasons of the year, especially during winter season, and the person remains almost symptom free for the rest of the months of the year.

What are the various symptoms of SAD?

The various symptoms include:

Feeling totally hopeless

Feeling unable to perform your usual responsibilities

Significant weight loss or weight gain

Thoughts of ending your life

Depressed mood most of the day nearly every day

Loss of interest in things you used to find interesting or enjoyable

Changes in sleep patterns—primarily oversleeping

Low energy and lethargy

Difficulty with concentration and focus

Feeling anxious or irritable, or having difficulty managing stress

A reluctance to engage with others and a desire to be alone

Decreased libido and sexual desire

Craving sunlight

Craving carbohydrate-rich foods

The average SAD episode lasts approximately five months although the symptoms may be more severe in deep winter, so we're talking about five months periodically suffering from these severe symptoms on a yearly basis.

Do the symptoms normally begin when the days become shorter and the weather becomes colder, usually in late October or early November?

Yes. It most certainly begins in late October in Kashmir. In terms of symptom onset, no two people with SAD are the same, but I would say October is when the first early onset symptoms appear.

Then, in November, they build up speed, with a lot more symptoms in December. The months of January and February are usually the most difficult. Those are the months when the majority of people who have a seasonal pattern to their depression will be experiencing a full-blown severe depressive episode.

What causes SAD?

Researchers are unsure of the exact cause of seasonal depression. People who are prone to the disorder may be triggered by a lack of sunlight. According to the theories:

Biological clock shift: A person's biological clock changes as they are exposed to less sunlight during winters. Mood, sleep, and hormones are all controlled by this biological clock. Thus, when the biological clock changes, people may have difficulty regulating their moods.

Chemical imbalance in the brain: Nerve cells communicate with each other through Neurotransmitters through brain chemicals called neurotransmitters. Serotonin is one of these chemicals, and it leads to emotions of happiness. Because sunlight aids in the regulation of serotonin, a lack of sunlight during the winter months can lower down the Serotonin activity and hence lower down the mood and may even cause mood swings.

Vitamin D deficiency: Vitamin D also boosts serotonin levels. Because sunlight is necessary for the production of vitamin D, a lack of sunlight during the winter might result in a vitamin D shortage. This change can have an impact on serotonin levels and mood.

Melatonin boost: Melatonin is a hormone that regulates sleep cycles. Some people may produce too much melatonin due to a lack of sunlight. During the winter, they may feel sleepy and tired.

Are there any gender differences in terms of likelihood of getting SAD?

Almost every epidemiological study on Seasonal Affective Disorder that has ever been undertaken has indicated that SAD was more common amongst women than men. I think that the gender difference in SAD is at least as large as that in non-seasonal depression, which is two to one in favour of women for every male case of clinical depression.

We know that women with non-seasonal depression have a more ruminative response style, which means that when they are sad or start to develop depressive symptoms, they retreat inward and repeatedly reflect or ruminate about why they are feeling this way. What happened to make me feel this way? What are the causes and consequences of this way of feeling?

In the study of seasonal depression, there's some evidence that the more people ruminate in the fall, the more severe their symptoms are the following winter. In the study of seasonal depression, there is some evidence that the more people ruminate in the autumn months, the worse their symptoms are the following winter.

How is SAD diagnosed?

Don't try to diagnose yourself if you think you have SAD symptoms. A complete examination should be sought from a general physician. You could be depressed due to a physical problem. Frequently it has been seen that Seasonal affective disorder is a part of a more serious mental health problem.

You may be referred to a psychiatrist or clinical psychologist by your general physician. These mental health professionals discuss your symptoms with you. They look at your symptoms in order to determine whether you have seasonal depression or another mood condition.

What is the treatment for seasonal affective disorder (SAD)?

Your healthcare professional will discuss your treatment choices with you. It's possible that you'll need a combination of therapies, such as:

Phototherapy: Using a specific lamp, bright light therapy can be used to cure SAD.

Antidepressant medication: Psychiatrists may prescribe antidepressant medication alone or in combination with light treatment/psychotherapy to treat depression.

Spending time outside: Exposure to more sunlight can help alleviate symptoms. Make an effort to get out during the day. Increase the amount of light that comes into your home or office as well.

Vitamin D: Taking a vitamin D pill may help you feel better.

Exercise: Create or maintain a regular workout plan to improve your mood. Exercise will not only make you feel better physically, but it will also trigger the release of feel-good neurotransmitters such as endorphins, which will boost your mood. Exercise can also boost your immune system, which aids in the fight against depression.

Alter your eating habits: What we consume has a significant impact on our emotions. If SAD is already giving you mood swings, you'll want to eat items that can help regulate them. Check to see if you're overeating or not eating enough; both too much and too little food might affect how you feel.

Avoid sugar and refined carbohydrates, which can cause your blood sugar to fluctuate, altering your mood. Consume whole grain carbohydrates such as oats and whole-grain bread instead.Have a more protein rich diet. Each day, consume enough vegetables.Maintain your energy levels by eating smaller, more frequent meals. Consume fruit, legumes, and vegetables as they may help maintain high energy levels.Reduce caffeine consumption as it reduces serotonin production.

What is the role of clinical psychologists in the treatment of SAD?

Clinical psychologists use various types of psychotherapies to treat various mental health issues. Psychotherapies are intended to address SAD-related maladaptive thinking, behaviours, interpersonal patterns, and communication, as well as the various ways the patients use that may lead to relapse and recurrence of SAD every year during winter. Psychoeducation, reflective listening, therapeutic support, challenging of distorted thoughts and behaviors, and empathy are all common elements of these treatment approaches.

Cognitive Behavioral Therapy: 

CBT is a sort of talk therapy that can be used to treat SAD. According to studies, CBT has the longest-lasting effects of any treatment method. Depressive cognitive factors that underlie mood disorders in general, such as dysfunctional attitudes, negative automatic thoughts, and ruminative response style, are the target of cognitive therapies. Structured activities and pleasant event scheduling are the focus of behavioural therapies. Many interventions combine elements of both cognitive and behavioural therapy, as well as basic problem-solving techniques and psychoeducation. Thought journals, activity schedules, and a positive data log are standard CBT methods used to treat people with SAD.

Third wave CBT:

In third wave CBT, traditional CBT methods are coupled with mindfulness and mindfulness meditation in a therapy called as mindfulness-based cognitive therapy (MBCT). MBCT, like CBT, is based on the idea that depression is caused by negative automatic cognitive processes. The purpose of MBCT is to stop these automatic processes while teaching the person to focus less on reacting to stimuli and more on accepting and observing them without judgement. Individuals can then recognise when automatic processes occur and adjust their reactions to demonstrate more contemplation and awareness as a result of their mindfulness practice.

Interpersonal therapy:

Interpersonal therapy is a manualised depression treatment that is based on the notion that improving communication patterns and how people relate to one another can effectively treat depression. Individuals can use interpersonal therapy to identify how they connect with others and to improve undesirable interpersonal behaviours. It may also concentrate on assisting clients in identifying painful emotions and their triggers, as well as learning to express appropriate emotions in a healthy manner. Individuals may evaluate prior relationships that may have been influenced by distorted mood and behaviour in interpersonal therapy, with the goal of learning to be more objective about current relationships.

  • The author is a licensed clinical psychologist (alumni of Govt. Medical College Srinagar). He works at Kashmir Life Line, a free mental health counseling service. Author can be reached at

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