What is SAD?
Seasonal Affective Disorder (with the appropriate acronym of SAD) is a specific type of depression that is related to the seasons, normally beginning and ending at the same time every year (Mayo Clinic, 2017). Usually the symptoms of SAD will start to appear in autumn as the days start to get longer and the weather cooler. But some people may also have the opposite pattern, where they feel more depressed over the summer months. In all cases the symptoms will progressively get worse as the season deepens, and then start to clear as the weather changes (Health Direct, 2018).
General symptoms of SAD include:
Low energy, feeling sluggish
Sleep difficulties, agitation
Losing interest in your normal activities
Changes in appetite or weight
Feeling hopeless, worthless, or guilty
Having thoughts of death or suicide
SAD in autumn and winter may have some other specific symptoms:
Oversleeping, sleeping through your alarm clock
Cravings for sugar and carbs, comfort foods
More pronounced tiredness and lethargy
SAD in summer also has some specific symptoms:
More pronounced insomnia
Poor appetite, weight loss
Agitation and anxiety
(Mayo Clinic, 2017; Beyond Blue, 2019).
Causes of SAD
Although it is unclear exactly what the specific causes of SAD are, it is thought the role of sunlight plays a big part (Melrose, 2015). People who are experiencing SAD aren’t able to regulate their levels of serotonin as well as others. During summer, serotonin levels are kept higher naturally due to longer hours of sunlight, but in winter are prone to drop as the days get shorter. Serotonin is the neurotransmitter that is thought to be responsible for balancing mood (Jenkins et al., 2016).
People with Seasonal Affective Disorder may also overproduce melatonin, a hormone that is produced as it gets darker at night to help us get to sleep (Melrose, 2015). As we see less sunlight in winter, and are generally inside more in darker environments, more melatonin is then produced, which can lead to you feeling lethargic and unmotivated.
Low Vitamin D levels have also been implicated in Seasonal Affective Disorder (Melrose, 2015). As Vitamin D plays a role in serotonin activity, Vitamin D insufficiency has been shown to lead to an increase in depressive symptoms (Kerr et al., 2015).
Acupuncture and Seasonal Affective Disorder
Acupuncture has been shown to be an effective treatment in improving the quality of life for people with depression (Bosch et al., 2015). In this study it was found to be particularly true for people who were experiencing sleep disorders as part of their depression, which is a common feature of Seasonal Affective Disorder. In further studies, acupuncture was found to be a more cost effective treatment for depression with antidepressant medications than with medication alone (Chan et al., 2015), and acupuncture combined with counselling was found to be both clinically effective and cost effective (MacPherson et al., 2017).
For more information on treatment with acupuncture for depression and what to expect, see the main depression page here.
3 Tips to Help Yourself
Get your Vitamin D levels checked - seeing a GP to get your Vitamin D levels checked is important through winter when our levels naturally drop due to reduced sunlight, particularly if you are experiencing the above symptoms. It is easy to supplement your levels if you find they are too low.
Get enough natural light - Exposure to the sun is the best way to keep your Vitamin D levels up. But during winter in Victoria UV levels are low, so you need more time outdoors without sun protection. Aim to spend at least a few minutes through the middle of the day with some skin exposed.
Get some exercise - Regular exercise (30 minutes, 3-4 times per week) can help reduce the symptoms of depression by increasing energy levels, being a positive distraction for negative thoughts, and increasing your sense of control and self-esteem.
Lachlan McDonald is an acupuncturist and Chinese herbalist in Essendon. He has a special interest in working with patients with mental health concerns, including depression, anxiety, PTSD, general stress, and sleep disorders. To make an appointment, you can book online here, email at email@example.com, or call the clinic on 9337 8572.
Beyond Blue (2019). Feeling SAD (Seasonal Affective Disorder). [Online] Available at: https://www.beyondblue.org.au/personal-best/pillar/in-focus/feeling-sad-seasonal-affective-disorder
Bosch, P., van den Noort, M., Staudte, H. & Lim, S. (2015). Schizophrenia and depression: a systematic review of the effectiveness and the working mechanisms behind acupuncture. Explore, 11(4), 281-291.
Chan, Y., Lo, W., Yang, S., Chen, Y. & Lin, J. (2015). The benefit of combined acupuncture and antidepressant medication for depression: a systematic review meta-analysis. Journal of Affective Disorders, 176, 106-117.
Health Direct (2018). Seasonal Affective Disorder (SAD). [Online] Available at: https://www.healthdirect.gov.au/seasonal-affective-disorder
Jenkins, T., Nguyen, J., Polglaze, K. & Bertrand, P. (2016). Influence of tryptophan and serotonin on mood and cognition with a possible role of the gut-brain axis. Nutrients, 8(1), 56.
Kerr, D., Zava, D., Piper, W., Saturn, S., Frei, B. & Gombart, A. (2015). Associations between Vitamin D levels and depressive symptoms in healthy young adult women. Psychiatry Research, 227(1), 46-51.
MacPherson, H., Vickers, A., Bland, M., Torgersen, D., Corbett, M., Spackman, E., Saramango, P., Woods, B., Weatherly, H., Sculpher, M., Manca, A., Richmond, S., Hopton, A., Eldred, J. & Watt, I. (2017). Acupuncture for chronic pain and depression in primary care: a programme of research. Programme Grants for Applied Research, 5, (3).
Mayo Clinic (2017). Seasonal Affective Disorder (SAD). [Online] Available at: https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651
Melrose, S. (2015). Seasonal affective disorder: an overview of assessment and treatment approaches. Depression Research and Treatment, doi: 10.1155/2015/178564