Is winter making you sad? What to know about seasonal depression symptoms, treatment, more

With daylight saving time in the rearview and cold weather in full swing, you might have a case of the winter blues.

The seasons change, your daily routine is impacted and suddenly you don’t want to get out of bed in the morning or can’t seem to enjoy the things you used to.

If you have been wondering whether there’s a scientific reason for this or a medical diagnosis to be had, there is — and you could be experiencing a type of depression linked to the changing of the seasons.

Although it might be easy to chalk it up to cold weather making you feel like more of a homebody, don’t discredit your feelings.

If you’re one of the many people who has noticed yourself going through a rough patch this time of year, you are not alone, and we have plenty of information about what this means, prevention methods, how you can get help and more to aid you in getting back to feeling like yourself.

Major depressive disorder with a seasonal pattern

Has the change in seasons got you feeling extremely down? Does this happen every year during the transition from warm weather to cold weather? Are you noticing severe changes in your mood or behavior?

You could be suffering from major depressive disorder with a seasonal pattern.

You probably have heard this characterized in other ways, such as “seasonal affective disorder (SAD)” or the “winter blues,” but the current formal diagnosis is major depressive disorder with a seasonal pattern, said Keith Bredemeier, director of the Institute for Community Mental Health Clinic’s training clinic, located on the University of Delaware’s Science, Technology and Advanced Research (STAR) Campus as part of the Department of Psychological & Brain Sciences.

Although the shift in language seems like a minor change, characterizing the condition in this way helps license clinicians accurately group the symptoms into specific diagnostic criteria that can be diagnosed as a major depressive disorder with a seasonal pattern and then be handled with the proper treatment, said Bredemeier.

The National Alliance on Mental Illness defines major depressive disorder with a seasonal pattern — formerly known as seasonal affective disorder — as recurrent episodes of depression in late fall and winter, alternating with periods of normal mood the rest of the year.

“Researchers at the National Institute of Mental Health were the first to suggest that this condition is a response to decreased light, experimenting with the use of bright light to address the symptoms, and scientists have identified that the neurotransmitter serotonin may not be working optimally in many people who experience this disorder,” according to NAMI.

Bredemeier adds that although light exposure is certainly part of the equation, it’s not the only variable contributing to the onset of seasonal depression.

“There’s actually a lot of things that change in the wintertime. It’s not just the length of the days, and especially as it relates to social and cultural phenomenon, the weather is not as good and we don’t have as many things that we can do with people, or a lot of the things that we would normally wanna do for socialization or for enjoyment aren’t as easily accessible,” he said.

This is important to note, Bredemeier said, so people impacted by the condition understand that simply moving somewhere warmer isn’t a fix-all solution for the disorder and, instead, there are a variety of social and behavioral components that have a big impact on whether someone’s depression is seasonal or not.

According to NAMI, researchers have found that the prevalence of major depressive disorder with a seasonal pattern appears to increase among people living in higher/northern latitudes, younger people are at a higher risk and women are more likely than men to experience the condition.

The American Psychiatric Association classifies January and February as the most difficult months for people suffering from seasonal depression. Less commonly, some people experience seasonal depression in the summer.

The association reports that seasonal depression can begin at any age but typically starts when a person is between 18 and 30 years old.

Symptoms of major depressive disorder with a seasonal pattern

Seasonal depression shares many symptoms with other depressive disorders, but there are a few key differences that distinguish seasonal depression from the others.

While not every person experiences each of these, common symptoms of depression, according to the National Institute of Mental Health, include:

• Hopelessness or pessimism.

• Irritability, frustration or restlessness.

• Feelings of guilt, worthlessness or helplessness.

• Persistent sad, anxious or “empty” mood most of the day, nearly every day, for at least two weeks.

• Difficulty concentrating, remembering or making decisions.

• Changes in sleep or appetite, unplanned weight changes.

• Decreased energy, fatigue or feeling slowed down.

• Loss of interest or pleasure in hobbies and activities.

• Physical aches or pains, headaches, cramps or digestive problems that do not have a clear physical cause and do not go away with treatment.

• Thoughts of death or suicide, or suicide attempts.

Of the three general clusters of depressive symptoms, which Bredemeier describes as mood symptoms like feeling sad or lacking enjoyment; cognitive symptoms like difficulty concentrating; and somatic symptoms like impacts on sleep or appetite, the last cluster of symptoms focuses on changes in the way a person feels physically.

These somatic, or vegetative, symptoms, according to data, have the opposite outcome for those with seasonal depression as opposed to depression. Someone with depression may have insomnia or a decreased appetite while someone experiencing depression with a seasonal pattern experiences hypersomnia (oversleeping) or increased appetite, said Bredemeier.

“The bigger picture point is actually more that symptoms are the same, it’s really just the pattern in terms of when they start and potentially get better that’s different with seasonal [depression],” he said, noting that onset is typically in September and December, with a full remission of symptoms that begins in spring into summer.

It is also important to note that seasonal depression is not the same as the “holiday blues,” which is feelings of sadness or anxiety brought on by stresses at certain times of the year or predictable seasonal changes in work, school or other lifestyle changes, according to NIMH.

“We see very similar symptomatology and presentation of mood disorders — particularly depressive disorders — in children, with a handful of differences,” said Franssy Zablah, assistant professor in the University of Delaware’s Department of Psychological & Brain Sciences and associate director of the Institute for Community Mental Health Clinic’s training clinic

In children, heightened irritability may be mistaken as non-compliance or being especially difficult. Low energy and fatigue may come across as boredom, feeling tired or not being interested in their favorite activities. These symptoms also can impact their performance in school if they have more trouble concentrating than usual, she said.

How to prevent or minimize the severity of depressive symptoms

Seasonal depression may feel like a never-ending storm cloud looming over you, but the good news is that there are many ways you can prevent seasonal depression from progressing or being as severe as it once was.

“Some of these strategies are going to be applicable to any sort of periods when we feel that we have kind of like this dip in our mood,” said Zablah. “In general, we would want some of those really nice mental health hygiene activities.”

“Mental health hygiene” refers to routine, at times mundane, actions a person takes to keep up with their physical health or happiness that sometimes fall to the wayside when feeling down or battling depression.

Zablah lists the following as examples of mental health hygiene:

• Being active or exercising, whether it’s going to the gym or walking your dog outside for 20 minutes.

• Listening to your favorite song while cleaning the house (maybe even dancing, too).

• Establishing a sleep routine that allows you to get an adequate amount of quality sleep. (Ahem, no blue light from phone or TV screens right before bed or sleeping with bright lights on.)

• Eating nutritious, balanced meals instead of piling up the junk food and unhealthy comfort meals.

“It’s really fighting against that sort of lethargy that tends to be very, very easy to gravitate to, especially in the winter months when it’s cold out and all we wanna do is snuggle and be warm,” said Zablah.

Establishing these healthy routines for youth is not only beneficial in the present, but also helps set children up to carry on the healthy values instilled in them in adolescence instead of leaning into unhealthy practices when they are feeling down as adults, such as staying in bed all day and loading up on carbs and sweets, she said.

Bredemeier adds that mental health hygiene is essentially self-care practices that are important for people to do whether they are depressed or not, but even more so during bouts of depression, and fighting against the initial feeling of sluggishness is a major part of the treatment licensed professionals work with clients on, especially when it comes to engaging in more activities for enjoyment, a sense of accomplishment or socializing.

If it feels too overwhelming to tackle something as big as going to the gym for an hour or making an elaborate meal, make a checklist of simple tasks to cross off each day or slowly integrate more and more healthy habits into your life until you have a full routine to help you curb your depressive symptoms.

“Giving into that sort of natural desire to shy away from those things — we know it really makes things worse. One of the most tried and true treatments for depression for kids and adults, for now several decades, is called “behavioral activation treatment,” and it’s really based on this premise of breaking the cycle of wanting to withdraw from activities when we’re feeling down or feeling depressed,” said Bredemeier. “And that is just as salient of a treatment, whether it’s more of a seasonal depression or depression at a different time of year.”

Loneliness has consequences, social interaction helps quell depressive symptoms

A major symptom of seasonal depression is social withdrawal, or feeling like hibernating, according to NIMH, and Zablah emphasizes socialization as a way to counteract depressive symptoms, especially when it comes to youth.

It might be much easier to ditch the self-care and instead binge-watch Netflix on repeat, but socializing is a major activity and skill for people that, if not exercised enough, can become difficult to keep up with and have great impacts on a person already struggling with depression.

“Adolescence is a stage of development in which social connection is such a salient aspect of their context that it’s really, really important to try to find ways to build that social connection,” said Zablah.

Things like calling a friend or relative you haven’t talked to recently, hosting a game night or sleepover with friends, engaging in local community events or planning family outings are all ways to counteract that instinct to become reclusive when in the throes of seasonal depression.

“What the data also shows us is that high self-reports of loneliness can be a risk factor for a myriad of concerns. Not just mental health concerns, but also physical health. It can worsen the prognosis of some of these more chronic illnesses like diabetes and cardiovascular concerns,” said Zablah. “These periods of isolation that resulted from the pandemic have really taken a toll on the mental health of our children and adolescents, and that is evidenced with the spikes and rates of depression and anxiety.”

Pandemic impacts also made middle school-aged children more dependent on their parents during a period in which they typically become more independent and foster deeper relationships with peers.

Winter months are a stressor

Seasonal depression is nothing to be ashamed of. An experience shared by many, it is not your fault if the change in the seasons — and the lifestyle changes that come with it — make you feel down for the next few months.

“In the simplest way, the onset of the winter months is a stressor. It’s one that we commonly experience, but at the same time, it’s a stressor in terms of how it affects us biologically, and socially and culturally,” said Bredemeier. “So the reality is that, even though it’s less well established than those other sorts of problems, separate from depression, that have a seasonal pattern, there is some data to suggest that those can get worse, or the symptoms can be more likely to come on, during that time.”

Bredemeier’s explanation of seasonal depression, and the simplicity of how and why symptoms may appear and increase during a depressive episode, is one of the first steps clinicians take in diagnosing patients and helping them understand what they are going through.

Diagnosing seasonal depression

The key to an accurate diagnosis of major depressive disorder with a seasonal pattern, according to NAMI, is recognizing the pattern.

Identifying if the pattern of onset and remission have occurred during at least a two-year period, without the occurrence of any non-seasonal episodes during that same period, means that a diagnosis may not be given the first time someone experiences symptoms and reaches out for help, but that does not mean their feelings are not valid, that they do not have a depressive order or that they may not get a seasonal depression diagnosis in the future, according to NAMI.

It can be easy to talk yourself out of speaking to someone or to convince yourself that your symptoms are not out of the norm, but, according to Bredemeier, most depressive symptoms are things that everyone can relate to and have experienced at some point in their lives. The concern begins when those symptoms are long-lasting and start to impede your daily routine and quality of life.

“The worst that could happen is you get an assessment done and the assessment suggests that you’re doing OK or can continue to manage on your own, but very often when people reach that point of questioning whether it’s a problem or not, it very likely it is, and they have some intuition that it’s starting to cause a problem,” said Bredemeier.

When it comes to addressing concerns about seasonal depression in youth, parents should point out some of the behavioral changes they notice and have a conversation about why their child may be feeling that way and how they can help them.

“Really focusing on some those open-ended questions, because if you give an adolescent or a child a close-ended question, like ‘Is everything OK?’, they might just gravitate toward ‘Yes, everything is fine.’”

Seeking treatment for seasonal depression

If someone already has been diagnosed with major depressive disorder with a seasonal pattern, NIMH suggests planning ahead for the onset of winter (or summer if that is your stressor) by doing things like exercising more toward the end of summer, starting therapy in September, getting a light box to mimic outdoor light during October and scheduling a vacation to a sunny place in January.

Some people with seasonal depression only need treatment during the time of year in which they experience symptoms, and others need treatment that begins before symptoms become severe or year-round, according to NIMH.

However your seasonal depression presents itself, or if you have yet to be diagnosed, always seek help when you are struggling.

“If there are concerns about the severity and the distress that is associated with some of these seasonal mood changes, by far the best thing that you know someone can do is to talk to a licensed provider who is knowledgeable and evidence-based in mood disorders and prevention, especially for those with a seasonal pattern,” said Zablah.

Zablah stresses that while talking to a close friend or loved one, or even enlisting the help of peer support services, are useful options, it’s important to identify the situations when certain support systems are more beneficial than others.

If you’ve been feeling down for a couple of days, talking to a peer who can help you out might do the trick, but if your symptoms are triggering a lot of distress and you haven’t felt this low or depressed in quite a while, that’s when talking to a licensed professional should be your go-to, she said.

When it comes to treatment, seasonal depression is similar to most depressive disorders in that the best treatment includes a combination of cognitive behavioral therapy, exercise and antidepressant medications. Exclusive to seasonal depression, light therapy also can be employed, according to NAMI.

Whether this is the first step in or a small part of your individualized treatment plan that matches the severity of your experience, getting help is always the right thing to do.

Long or short, intense or mild, your mental health journey is a key part of self-care, and taking a chance on yourself is never a waste, especially if it can help you lead a healthier, happier life.

“Going to somebody with expertise in this area, to me, is never a bad way to go whenever it’s feasible,” said Bredemeier. “If there’s not a need for more intensive treatment, then that can be the recommendation from the expert, but better to go in that direction than the other.”

Look inside this mental health haven: Take a fresh look at the people and spaces of Sean's House in Newark

You are not alone. How to get help

The Institute for Community Mental Health Clinic, located on the University of Delaware’s Science, Technology and Advanced Research Campus, is open to the public and offers a range of services for people of all ages, including individual psychotherapy, diagnostic assessments and comprehensive psychological evaluations.

The STAR Tower is open on weekdays from 8 a.m. to 6 p.m., but the clinic, located on the sixth floor, is available by appointment only. Both in-person and telehealth options are offered.

Contact the clinic at (302) 831-2717 or [email protected]. For more information about services and fees, visit www.psych.udel.edu/clinic/about-the-clinic.

Sean’s House just off the University of Delaware campus is open 24 hours a day, seven days a week, and provides a variety of mental health resources free of charge.

The doors are open from 8 a.m. to 8 p.m., but individuals experiencing mental health emergencies outside of those hours can come by for overnight help from the live-in staff and on-call support.

Sean's House can be reached online using the "contact us" page on their website or by sending them a message on Instagram (@seans.house).

More resources: 

• The National Suicide Prevention Lifeline can be reached at 988 or 800-273-8255.

• NAMI Delaware's helpline can be reached at 888-427-2643. Select option 1. For Spanish options, call (302) 415-4356.

• The general NAMI helpline can be reached at 800-950-NAMI (6264) or [email protected].

• The Trevor Project, the world's largest suicide prevention and crisis intervention organization for LGBTQ+ individuals, can be reached by texting "START" to 678-678, by calling 866-488-7368 or chatting online.

• Delaware's 24/7 youth crisis hotline can be reached at 800-969-HELP (4357) or by texting "DE" to 741741.

• Delaware's Mobile Crisis Intervention Services are available in northern and southern parts of the state, and assist with issues related to depression, suicide, interpersonal conflict, substance abuse and grief. The northern hotline can be reached at 302-577-2484 or 800-652-2929. The southern hotline can be reached at 302-424-5550 or 800-345-6785.

Got a tip or a story idea? Contact Krys'tal Griffin at [email protected]. 

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This article originally appeared on Delaware News Journal: What to know about seasonal depression, symptoms, prevention and more