Woman with seasonal depression looking out the window
Although it feels as if summer was just yesterday, we’re now full-swing into autumn, and before we know it, winter will be here. This seemingly abrupt change in seasons can be jarring for many summer devotees, and particularly for those who suffer from Seasonal Affective Disorder (SAD).
Experienced by an estimated 5% of the adult U.S. population, Dr. Norman E. Rosenthal, Ph.D., Clinical Professor of Psychiatry at Georgetown School of Medicine and author of Defeating SAD: A Guide to Health and Happiness Through the Seasons explains that Seasonal Affective Disorder is a condition that many people experience in the autumn and winter as the days become short and dark.
Dr. Michelle DiBlasi, DO, Chief of Inpatient Psychiatry at Tufts Medical Center, describes SAD as a “depressive episode in a cyclical pattern for more than one year based off of the seasonal change.”
Dr. DiBlasi adds that one of the largest risk factors for SAD is having a personal history of being diagnosed with Major Depressive Disorder (MDD) or Bipolar Disorder.
“We also know that women tend to be diagnosed with SAD more often than men,” she adds. “Other risk factors include having a close family member who has suffered from the condition, living further away from the equator where there is a larger change in the amount of daylight in the winter months, and/or having low vitamin D levels in your body.”
Since fall tends to creep up on us, it can actually be surprisingly easy to miss the first pangs of SAD, especially when the weather still feels warm and sunny. But with SAD, or any mental health condition for that matter, starting treatment at the very first sign is key. That’s why it can help to be aware of the number one earliest symptom of SAD that most people overlook.
Related: What Is Seasonal Depression and How Is it Different From the Winter Blues?
The #1 Early Symptom of Seasonal Affective Disorder Most People Miss
The earliest symptom of SAD is one that’s remarkably easy to miss: fatigue, since it can mimic so many other things or just seem like everyday tiredness.
“The number one early symptom of Seasonal Affective Disorder that most people miss is fatigue—especially toward the end of the day,” Dr. Rosenthal says. “The reason that people miss this early symptom is that it sneaks up on you insidiously and has to progress to a certain degree before you notice it. In addition, it is a non-specific symptom that can be attributed to many other causes, such as overwork, viral infections and being under too much stress for any reason.”
Dr. DiBlasi agrees with this line of thinking, saying that in her opinion, the biggest early symptom of SAD that people usually miss is not having enough energy to do things they used to enjoy doing.
“For example, people may start to notice that they are turning down opportunities to spend time with friends or family or just dreading having to socialize or do activities they always used to look forward to,” she says.
Dr. DiBlasi believes that people tend to miss this early symptom because they rationalize it as normal since the weather might not be as nice outside or it could be a lot colder.
“However, I really think they need to reflect on this and try to tease apart whether it might actually be a sign of a depressive episode,” she advises.
Other Common Symptoms
Our experts share the other common symptoms of SAD which may become more apparent after experiencing initial fatigue. They include:
Feeling more tired or sleeping more than normal
Appetite changes (eating too little or too much)
Craving sweets and starches
Having trouble focusing
Isolating more often from others
What To Do About It
If you feel that you’re experiencing any of these symptoms, your first stop should be to your doctor.
“I think it is always important to start by telling your provider, your primary care doctor or psychiatrist, what symptoms you are experiencing so that they can determine if the underlying cause is from SAD,” Dr. DiBlasi says.
Dr. Rosenthal says that when people begin to experience fatigue, it’s important to recognize that this could be an early symptom of SAD, which signals a need to prepare for winter. He recommends that people:
Obtain at least one lightbox that’s adequate in size and meets standard specifications (provides 10,000 lux, has a surface area of at least one-foot square, and is manufactured by a reputable company).
Begin a good exercise program and reinforce the other foundational habits that you associate with health and well-being.
Consolidate your social contacts and put them on notice that you might be entering a difficult time of the year in which you may need extra support from your friends and family.
Dr. DiBlasi also says, “For more severe cases, people may need to speak with their provider about enrolling in regular therapy sessions and exploring taking antidepressant medications.”
Although the doldrums of winter may seem as if they’ll never end, they do for basically everyone who has been diagnosed with Seasonal Affective Disorder. Without treatment, SAD typically lasts until the early springtime (around March or April) in the Northern Hemisphere when the days start to get longer and there is more exposure to natural sunlight, as Dr. DiBlasi says.
Next up, discover 30 ways to treat Seasonal Affective Disorder.
Norman E. Rosenthal, M.D., Clinical Professor of Psychiatry Georgetown School of Medicine and author of Defeating SAD: A Guide to Health and Happiness Through All Seasons.
Dr. Michelle DiBlasi, Chief of Inpatient Psychiatry at Tufts Medical Center.