Managing Seasonal Affective Disorder

Seasonal affective disorder (SAD) is a type of depression. A person who has SAD feels depressed at specific times of the year. The most common times for this condition are late fall and winter.

How to manage lifestyle changes

Managing stress

• Get 6–8 hours of sleep every night. To improve your sleep, make sure you:
  • Keep your bedroom dark and cool.
  • Go to sleep and wake up at about the same time every day.
  • Limit screen time starting a few hours before bedtime.
• Exercise regularly.
• Avoid making major decisions until you feel better.
• Practice techniques to manage your stress, such as:
  • Mindfulness-based meditation.
  • Focused breathing exercises.
  • Relaxation exercises.
  • Journaling.
• Find activities that help you relax, like reading, getting a massage, or spending time with a friend.
• Do mind–body exercises, like yoga or tai chi.

Managing treatment

Treatment for SAD includes talk therapy, light therapy, a combination of both talk and light therapy, and medicines for depression (antidepressants). If you take medicine for SAD, avoid using alcohol and other substances that may prevent your medicine from working properly.

It is also important to:

• Talk with your pharmacist or health care provider about all the medicines that you take, their possible side effects, and what medicines are safe to take together.
• Ask to be referred to a therapist who can help with SAD.
• Use a light box for 30 minutes every morning. This should start in the early fall and continue until spring. It is less common, but possible, for SAD to happen during the summer. If that is the case, light treatment would not be recommended.
• Take part in all treatment decisions (shared decision-making). Give input on the side effects of medicines. Shared decision-making should be part of your total treatment plan.
• Know when you can expect to start feeling better. Antidepressants take a while to start working. Let your health care provider know if you are not feeling better after the expected time.
• Make sure you know all the side effects of treatment. Know which ones are serious enough to call your health care provider about.

Relationships

• Educate your friends and family members about SAD so they can understand how it affects you.
• Ask for support from friends and family members to help you manage SAD. Consider asking family members to participate in family therapy.
• Consider joining a support group. This can help you express yourself and learn how others manage SAD.

General instructions

• Do your best to stay positive by remembering that SAD usually goes away after a few months.
• Work with your health care providers on a treatment plan. Stick to your plan. Make a plan that includes routines such as talk therapy and light therapy.
• Make your home and work environment sunny or bright. Open window blinds. Spend as much time as possible outside. Move furniture closer to windows for exposure to natural light.

How to recognize changes in your condition

• Start to feel your mood get better.
• Have more energy for daily activities.
• Get back to your normal routines for sleeping and eating.
• Think more clearly and be less agitated.
• Feel better about yourself.
• Feel joy and interest return.

• Avoid people and activities.
• Feel guilty and hopeless.
• Not eat well, sleep well, or exercise.

Follow these instructions at home:

• Use a light box and spend as much time in natural daylight as you can.
• Stay busy with activities that get you out of the house. Do activities that you enjoy. Consider making plans for a daily walk with friends or family.
• Eat healthy foods, including plenty of fruits and vegetables. Limit foods that contain a lot of fat or sugar. Do not binge on sweets and other carbs.
• Limit alcohol and caffeine as told by your health care provider.
• Keep all follow-up visits. This is important.

Where to find support

Talking to others

• A therapist.
• Your health care provider.
• Friends and family.
• Online support groups at www.dbsalliance.org

Finances

• Check with your insurance to make sure that treatment for SAD is covered.
• If you have a problem paying for co-pays or counseling, ask to meet with a social worker for help.
• If your medicines are expensive:
  • Use a generic form of the medicine. This may be less expensive than a brand-name medicine.
  • Check to see whether the manufacturer offers assistance programs to patients who cannot afford their medicines.

Where to find more information

• American Psychological Association: apa.org
• American Psychiatric Association: psychiatry.org
• National Institute of Mental Health: nimh.nih.gov

Contact a health care provider if:

• Your symptoms get worse or do not get better.
• You have trouble taking care of yourself.
• You are using drugs or alcohol to manage your symptoms.
• You have side effects from medicines.
• Your symptoms return.

Get help right away if:

• You have thoughts about hurting yourself or others.

• Call your local emergency services (911 in the U.S.).
• Call a suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255 or 988 in the U.S. This is open 24 hours a day in the U.S.
• Text the Crisis Text Line at 741741 (in the U.S.).

Summary

• SAD is a type of depression that typically occurs during the fall and winter months when there is less daylight. It is less common, but possible, for SAD to occur during the summer.
• SAD causes symptoms of depression that can range from mild to severe.
• Lifestyle changes are an important part of managing SAD. Make a plan that includes routines to help you stay active and focused.
• Follow your health care provider's treatment plan, which may include talk therapy, light therapy, or medicine.
• Get help right away if you feel like you might hurt yourself or others.