Spotlight on Women's Health

Dr. Yael Nillni

6 Questions Answered: Seasonal Affective Disorder

January 31, 2019

Did you know the change in seasons can bring on a type of depression called seasonal affective disorder (SAD)? According to the National Institute of Mental Health, SAD is diagnosed four times more often in women than men. To learn more about SAD and how women can manage it, we talked to Dr. Yael Nillni. She’s a clinical psychologist and assistant professor at the Boston University School of Medicine and the National Center for PTSD, Women’s Health Sciences Division. She talks about when to see a doctor, treatment options, and more.

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How would you describe seasonal affective disorder (SAD)?

SAD is essentially the same as major depression, but it follows a seasonal pattern. It most commonly occurs during the fall and winter and goes away in the spring or summer. However, some people have different seasonal patterns, so SAD can happen during the summer, too. It’s just more common for people to experience it in the fall and winter.

What are the common symptoms of SAD?

Since SAD is essentially depression with a seasonal pattern, the symptoms are the same. During the winter months, many people experience a change in how they feel, such as a change in energy levels or eating habits. But these changes don’t significantly impact their lives the way SAD does. Someone experiencing SAD will usually start to hibernate — I think this is the best way to describe it. They withdraw and stop engaging in their lives by not doing things they typically enjoy and not seeing friends and family. Other classic symptoms of SAD are sleeping more, having low energy, and eating more.

When should women see their doctors?

Ask yourself if your symptoms are getting in the way of your day-to-day life. It’s common to have changes in mood or behavior during the winter, but if your symptoms are affecting your relationships or your ability to get things done, you should see a doctor.

If you’re having thoughts of hurting yourself, get help right away. If you’re in immediate danger, call 911.

How can women manage SAD?

There are effective, evidence-based treatments and therapies, and you can talk to your doctor, nurse, or mental health professional about your options. Some women will do one or a combination of these options.

I’ll start with light therapy, which includes sitting in front of a light box every morning to increase exposure to light. Typically, your doctor, nurse, or a mental health professional prescribes the light box. They tell you when you should sit in front of it and for how long. Then you’ll check in with them to see how it’s working and tweak the approach as necessary. Most people begin using the light box when their symptoms start, so in the fall, and use it daily until symptoms go away, so in the spring or summer.

There’s also cognitive behavioral therapy specific to SAD, which is a type of talk therapy that you can do with a mental health professional. Cognitive behavioral therapy targets thoughts and behaviors that may be getting in the way of feeling better. The cognitive part focuses on examining and challenging negative thoughts, and the behavioral part focuses on scheduling positive and pleasant activities. People often fall into a negative cycle, where they feel down, so they disengage and do less, which in turn makes them feel even more down and depressed. Challenging negative thoughts and scheduling activities you enjoy can help you kick out of this cycle and influence your mood in a positive way.

Your doctor, nurse, or mental health professional may also prescribe medication to help you manage SAD symptoms.

Are there other daily habits you recommend that might help women cope with SAD?

I think if I could give one recommendation it’s to find activities you enjoy. It can be anything! Just choose something you can do throughout the year so you can continue to stay active in your life and not disengage when the seasons change. The key is to stay engaged by doing things you enjoy.

Additionally, know your warning signs. When you see and feel that you’re starting to pull back, that’s the time to act, whether that means using your light box, scheduling activities you like to do, or making an appointment with a mental health professional.

What’s one thing you wish all women knew about SAD?

Help is available! We have effective treatments for SAD that have been well-studied. You don’t have to suffer every winter. A lot of the people I see have been suffering with SAD for years, but they do get better with treatment. SAD affects a lot of people, and there’s nothing wrong with getting help. As mental health professionals, we have a set of skills that we can teach you to help you feel better.

The statements and opinions in this blog post are those of the author and do not necessarily represent the views of the U.S. Department of Health and Human Services' Office on Women's Health.