Seasonal Depression: Symptoms, Treatment Options, and When to Seek Help

Lorrie Smith-Esterle

Sep 18

6 min read

For many of us, the transition from the tropical-like temperatures and humidity of summer to the crisp, cool air of fall is a welcome change. Cooler temperatures, changing leaves, cozy sweaters, and the arrival of fall can feel refreshing.

However, for some people, the change in seasons brings more than a temperature shift. It can also bring a noticeable change in mood.

If you notice that your mood consistently worsens during a particular time of year, you may be experiencing seasonal depression, also known as seasonal affective disorder (SAD).

What Is Seasonal Depression?

Seasonal affective disorder is a type of depression characterized by a recurring seasonal pattern. For many people, symptoms begin during the fall or winter and improve during the spring and summer. A less common pattern involves depression occurring during the spring or summer months. [1]

Seasonal depression can affect more than just your mood. Symptoms may include:

Feeling sad, down, or emotionally numb
Losing interest in activities you usually enjoy
Low energy or increased fatigue
Sleeping more than usual
Changes in appetite
Difficulty concentrating
Withdrawing from family and friends
Feelings of hopelessness or worthlessness
Difficulty keeping up with work, school, family, or other responsibilities

Some people notice relatively subtle changes, while others experience symptoms that significantly interfere with their daily lives.

If you notice a recurring seasonal pattern in your depression, it is worth discussing those changes with a mental health professional.

Is It Seasonal Depression or the "Winter Blues"?

Feeling less energetic or motivated as the days become shorter does not automatically mean that you have seasonal affective disorder.

Seasonal depression involves a more significant pattern of depressive symptoms that occurs around the same time of year. It is also important to distinguish SAD from temporary sadness or stress associated with holidays, changes in schedules, family responsibilities, or other seasonal events. [1]

A mental health professional can help evaluate your symptoms and determine whether they may represent seasonal depression or another mental health concern.

Why Can the Change in Seasons Affect Mood?

The exact causes of seasonal affective disorder are not completely understood.

Changes in daylight exposure may affect circadian rhythms, sleep, and biological processes involved in mood regulation. The shorter days of fall and winter may contribute to changes in sleep, energy, and mood for people who experience winter-pattern SAD. [1]

This is one reason it can be helpful to pay attention to patterns in your mood, sleep, energy, appetite, and daily functioning as the seasons change.

How Is Seasonal Depression Treated?

Treatment for seasonal depression is individualized. Depending on your symptoms, medical history, previous treatment, and treatment goals, options may include:

Psychotherapy
Antidepressant medication
Light therapy
Lifestyle and behavioral strategies
Other treatment approaches when clinically appropriate

The National Institute of Mental Health identifies light therapy, psychotherapy, antidepressant medication, and vitamin D as treatment approaches that may be considered for SAD, depending on the type and circumstances. [1]

Treatment should be individualized rather than based solely on a diagnosis or a particular season.

Therapy for Seasonal Depression

Psychotherapy can be an important part of treatment for seasonal depression.

Therapy may help you identify patterns in your mood, develop coping strategies, address unhelpful thoughts and behaviors, and maintain meaningful activities during times when depression makes it more difficult to engage.

Cognitive behavioral therapy has also been adapted specifically for seasonal affective disorder. [1]

Medication for Seasonal Depression

For some individuals, an antidepressant may be appropriate.

Antidepressant treatment can be used for depression, including seasonal patterns of depression. Medication decisions should take into account your symptoms, other medications, medical history, side effects, previous treatment response, and individual treatment goals. [1]

If you are prescribed an antidepressant, it is important to take it as directed and communicate with your prescriber about changes in symptoms or side effects.

What If You Are Already Taking an Antidepressant?

This is an important question because seasonal worsening of depression can occur even when someone is already taking an antidepressant.

You may notice that your depressive symptoms become more noticeable during a particular season despite otherwise doing well on your medication.

In some situations, a psychiatric prescriber may consider adjusting the current medication, changing medications, or adding another medication to the existing treatment plan.

Adding another medication to an existing antidepressant regimen is sometimes referred to as adjunctive or augmentation treatment.

Depending on the individual's symptoms and clinical circumstances, medications such as bupropion (Wellbutrin) or aripiprazole (Abilify) may be considered as part of an individualized treatment plan. Bupropion XL also has evidence supporting its use for prevention of recurrent winter-pattern seasonal depressive episodes in adults with a history of SAD. [1, 2, 3]

These are examples of medications that may be used in certain circumstances; they are not appropriate for everyone and should not be started, stopped, or changed without guidance from a qualified prescriber.

There is no single medication combination that works for everyone.

Your psychiatric provider can consider your symptoms, current medications, medical history, previous treatment response, potential medication interactions, side effects, and treatment goals when determining whether a medication adjustment or augmentation strategy is appropriate.

Do not stop, increase, decrease, or add psychiatric medication on your own. Talk with your prescriber before making medication changes.

What About Light Therapy?

Light therapy is another treatment option that may be considered, particularly for winter-pattern seasonal affective disorder.

Light therapy generally involves sitting near a specialized bright-light device for a prescribed amount of time, often in the morning. NIMH describes a commonly used approach involving a 10,000-lux light box for approximately 30–45 minutes in the morning. [1]

However, light therapy is not necessarily appropriate for everyone. Certain eye conditions and some medications can affect whether light therapy is appropriate or whether additional medical supervision is needed. [1]

Before beginning light therapy, discuss it with your healthcare provider, particularly if you have a history of bipolar disorder, eye conditions, or take medications that may increase sensitivity to light.

Pay Attention to Changes in Your Mood

One of the most helpful things you can do is become familiar with your own patterns.

If you notice that your depression tends to worsen around the same time every year, consider keeping track of:

When your symptoms begin
Changes in sleep
Changes in appetite
Energy level
Motivation
Anxiety
Social withdrawal
Concentration
Changes in your ability to work or complete daily responsibilities

If you are already established with a psychiatric prescriber, let them know if you notice changes in your mood.

Early communication can give you and your provider an opportunity to discuss what is happening and develop an appropriate plan.

Treatment does not have to wait until you are in crisis.

You Don't Have to Navigate Depression Alone

If you are experiencing seasonal changes in your mood, you don't have to simply "push through" and hope things improve.

Reach out to someone you trust, whether that is a friend or family member, therapist, psychiatric provider, or another healthcare professional.

Talking about changes in your mood is an important step toward getting the support you need.

If you are experiencing suicidal thoughts, are concerned about your immediate safety, or are concerned about the safety of someone else, seek help immediately.

Call 911 for an emergency.
Go to the nearest emergency department.
Call or text 988 to reach the Suicide & Crisis Lifeline.
Reach out to a trusted friend or family member and let them know you need support.

You do not have to wait until things feel unbearable before asking for help.

A Change in Season Doesn't Have to Mean a Change in Hope

Fall and winter can look different for everyone.

For some people, the changing seasons bring comfort, renewal, and excitement. For others, they can bring a noticeable shift in mood, energy, sleep, motivation, and overall functioning.

If you recognize a seasonal pattern in your depression, consider talking with a mental health professional. Understanding your pattern is an important first step toward developing an individualized treatment plan.

At Kentucky Psychiatric Care, PLLC, we understand that mental health symptoms can change over time and that treatment sometimes needs to change with them.

Whether you are experiencing new depressive symptoms or noticing a seasonal worsening of symptoms you have experienced before, reaching out for professional support can be an important step toward understanding what you are experiencing and exploring appropriate treatment options.

You don't have to navigate seasonal depression alone.

References

1. National Institute of Mental Health. Seasonal Affective Disorder. National Institute of Mental Health, National Institutes of Health.NIMH: Seasonal Affective Disorder

2. Modell JG, Rosenthal NE, Harriett AE, et al. Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL. Biological Psychiatry. 2005;58(8):658–667. doi:10.1016/j.biopsych.2005.07.021.

3. Gartlehner G, et al. Second-generation antidepressants for preventing seasonal affective disorder in adults. Cochrane Database of Systematic Reviews. Evidence indicates that bupropion XL can reduce recurrence of depressive episodes in adults with a history of SAD, while also carrying potential adverse effects.

4. National Institute of Mental Health. Seasonal Affective Disorder (SAD): More Than the Winter Blues. National Institutes of Health.NIMH: More Than the Winter Blues

5. National Institute for Health and Care Excellence (NICE). Depression in adults: treatment and management (NG222). NICE.

Medical Disclaimer

This article is provided for general educational and informational purposes and is not intended to diagnose or treat any individual. It does not establish a provider-patient relationship or replace an individualized evaluation by a qualified healthcare professional. Treatment recommendations should be based on an individual's symptoms, medical history, current medications, and other clinical considerations. If you are experiencing a mental health emergency or are concerned about your immediate safety, call 911, go to the nearest emergency department, or call or text 988.