October 1, 2024

The X-Podcast: Real Conversations About Mental Health

A Conversation About: Major Depressive Disorder with Seasonal Pattern

Episode #33

In this episode the X-Podcast team discusses what Major Depressive Disorder (MDD) with Seasonal Pattern is. They explain the difference between Major Depressive Disorder with Episodes and Major Depressive Disorder with Seasonal Pattern. They explain why it used to be called Seasonal Affective Disorder (SAD) and what it no longer is. Xiomara gets into the details about MDD and the differences with Seasonal Pattern, She also discusses the symptoms, causes and treatment for it. 

Host Xiomara A. Sosa, and co-hosts JRoc have a relatable discussion about this topic and share some of their personal life experiences with it. 

What is Major Depressive Disorder with Seasonal Pattern?

Depression is different from feeling sad or unhappy. It is not a sign of personal weakness or a condition that can be willed or wished away. Get help. If you think you may be depressed, see a healthcare provider as soon as possible. Women are affected more often than men with depression. Without treatment, depression can last weeks, months or years, but most people respond well to medication, therapy or a combination of the two. Most people with clinical depression who seek treatment see improvement, usually within weeks.

Clinical depression also known as Major Depressive Disorder (MDD)  is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

MDD is a mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. Most people with depression feel better with medication, psychotherapy or both.

What is Recurrent vs. Single Episode Depression?

Recurrent major depressive disorder means a person has a history of two or more major depressive episodes. Meanwhile, single-episode depression involves one major depressive episode lasting at least two weeks.

Distinguishing between single-episode depression and recurrent-episode depression is essential for treatment as it influences the duration and intensity of therapy. Recurrent episodes typically require longer-term treatment and more comprehensive relapse prevention strategies.

What causes depression?

Possible causes include a combination of biological, psychological, and social sources of distress. Increasingly, research suggests these factors may cause changes in brain function, including altered activity of certain neural circuits in the brain.

Highly stressful events can trigger episodes of major depression. Stressors capable of triggering major depression may include the death of a loved one and other significant losses, such as a job layoff, or relationship difficulties, such as divorce or separation.

Even normal developmental milestones, such as puberty, marriage, or retirement, may trigger depression when a particular event is personally distressing to a given individual. Stressors that trigger depression may be fresh, or they may be past events that are intensely remembered for some reason or another. For example, thinking deeply about stressful past experiences, such as emotional, physical, or sexual abuse, can be sufficient to trigger an onset of depression.

Individuals with post-traumatic stress disorder (PTSD) who have experienced a traumatic event such as a military battle, rape, severe automobile accident, or natural disaster are more likely to suffer from depression than people who have not experienced such trauma.

A wide range of medical conditions and medications can also cause or worsen MDD. Major depression frequently co-occurs with other mental illnesses such as substance-related disorders, panic disorder, obsessive-compulsive disorder, anorexia nervosa, bulimia nervosa, or borderline personality disorder.

What are the symptoms?

Single episodes and recurrent episodes of major depressive disorder share many symptoms because the episodes themselves are indistinguishable. In addition to depressed mood, other symptoms experienced during MDD include:

• Thoughts of suicide or death
• Issues concentrating or making decisions
• Feeling guilty or worthless
• Severe fatigue or loss of energy
• Sleeping too much or too little
• Loss of interest in previously enjoyed hobbies

The above symptoms must be present for at least two weeks and must cause distress and impaired functioning. If someone has single-episode depression, they will only experience one depressive episode. Conversely, recurrent-episode depression involves more than one depressive episode.

The persistent feeling of sadness or loss of interest that characterizes major depression can lead to a range of behavioral and physical symptoms. These may include changes in sleep, appetite, energy level, concentration, daily behavior, or self-esteem. Depression can also be associated with thoughts of suicide.

Depression may occur only once during your life, some people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

Mood: anxiety, apathy, general discontent, guilt, hopelessness, loss of interest or pleasure in activities, mood swings, or sadness.

Sleep: early awakening, excess sleepiness, insomnia, or restless sleep.

Whole body: excessive hunger, fatigue, loss of appetite, or restlessness.

Behavioral: agitation, excessive crying, irritability, or social isolation.

Cognitive: lack of concentration, slowness in activity, or thoughts of suicide.

Weight: weight gain or weight los.

Also common: poor appetite or repeatedly going over thoughts (rumination).

Feelings of sadness, tearfulness, emptiness or hopelessness.

• Angry outbursts, irritability or frustration, even over small matters
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy, so even small tasks take extra effort
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation or restlessness
• Slowed thinking, speaking or body movements
• Feelings of worthlessness or guilt, fixating on past failures or self-blame
• Trouble thinking, concentrating, making decisions and remembering things
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
• Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

• In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.
• In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Depression symptoms in older adults

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

• Memory difficulties or personality changes
• Physical aches or pain
• Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
• Often wanting to stay at home, rather than going out to socialize or doing new things
• Suicidal thinking or feelings, especially in older men

What is the treatment?

Treatment is usually medication, talk therapy, or a combination of the two. Increasingly, research suggests these treatments may normalize brain changes associated with depression.

How is it diagnosed?

Requires a medical/clinician diagnosis.

To diagnose someone with major depressive disorder (MDD), the person must have had at least one major depressive episode (in which they suffer from a depressed mood or the loss of interest or pleasure in nearly all activities) for at least two weeks.

Depressive symptoms must persist for most of the day, nearly every day, and cause problems in social interactions, work, or someone's ability to function in daily life. 

For some individuals with milder depressive episodes, social and occupational functioning may appear normal, but they are making a serious, concerted effort to appear unimpaired.

When a person has experienced only one episode of depression, it is classified as major depression, single episode. 

When multiple major depressive episodes occur in a row, without  manic or mixed episodes,, the diagnosis changes to major depression, recurrent.

There is no diagnostic laboratory test (e.g., no blood test) that can confirm whether you have major depression. However, some laboratory tests can appear abnormal during an active depressive episode.

For example, sleep electroencephalogram (measurements of electrical activity in the brain during sleep) abnormalities have been found in many individuals who are hospitalized for MDD. Even depressed people who do not have symptoms severe enough to require hospitalization may show EEG abnormalities.

PET scans are used in research studies to detect depression. These brain scans may show changes in brain activity and metabolism associated with the condition.

Even though lab tests aren't used to diagnose depression, don't be surprised if your doctor still sends you to the lab. Medical tests can be helpful in ruling out other conditions that may cause depressive moods, such as thyroid trouble, cancer, or arthritis.

When to see a doctor

If you feel depressed, make an appointment to see your doctor or mental health professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 in the U.S. or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

• Call your doctor or mental health professional.
• Contact a suicide hotline.
• In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
• U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online.
• The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).

• Reach out to a close friend or loved one.
• Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

How Long Does a Major Depressive Episode Last?

Untreated, a major depressive episode may last several months. With antidepressant treatment, the episodes may be shorter. Some people only experience a single depressive episode and, after that, are symptom-free.

Many people who experience one major depressive episode will go on to experience multiple major depressive episodes. The more major depressive episodes an individual experiences, the more likely they are to develop future episodes.

Recurrence in major depressive disorder is common, with over 50% experiencing additional episodes after recovering from the first episode. Around 80% of individuals with a history of two episodes will experience another recurrence.

The course of recurrent major depression varies across individuals. Some people have isolated depressive episodes that are separated by many years during which mood is normal, while other individuals experience clusters of major depressive episodes that occur closely together in time. Still, other people with major depressive disorder experience increasingly frequent episodes as they grow older.

Prevalence and Risk of Recurrence

Factors that may increase the risk of recurrence:

Presence of co-occurring disorders, such as substance use disorders or anxiety disorders

• Inadequate or incomplete treatment of the initial depressive episode
• Environmental stressors like major life events
• Biological factors like neurochemical imbalances and genetic predispositions

Some individuals with recurrent depression may not find relief from standard treatments (antidepressants and psychotherapy). Alternative interventions like low-dose ketamine therapy, transcranial magnetic stimulation (TMS), or neurofeedback therapy may be recommended in these cases."

Symptoms of Major Depressive Disorder

Symptoms of major depressive disorder usually develop over a few days or weeks.

Many people feel anxious or mildly depressed for a while before a full depressive episode becomes apparent. Often, the symptoms eventually disappear, and functioning returns to normal. The DSM-5 provides labels that describe the course of a person's major depression. "Full remission" means no current depressive symptoms; "partial remission" means that the person currently has fewer than five depressive symptoms or has had no symptoms at all for less than two months; and "chronic" means that a person has met all of the diagnostic criteria for major depression for two or more years. 

Treatment for MDD

Treatment consists of antidepressants

The mainstay of treatment is usually medication, talk therapy, or a combination of the two. Increasingly, research suggests these treatments may normalize brain changes associated with depression.

Therapies

• Cognitive behavioral therapy, Behavior therapy, and Psychotherapy
• Medications
• SSRIs, Antidepressant, Anxiolytic, and Antipsychotic
• Medical procedure
• Electroconvulsive therapy
• Medications
• SSRIs, Antidepressant, Anxiolytic, and Antipsychotic
• Medical procedure
• Electroconvulsive therapy

Mental health clinicians prevent, diagnose, and treat mental health disorders.

Clinical psychologists treat mental disorders primarily with talk therapy.

Psychiatrists treat mental disorders primarily with medications.

Primary care provider (PCP) prevents, diagnoses, and treats diseases.

Emergency medicine doctors treat patients in the emergency department.

Cognitive behavioral therapy

A talk therapy focused on modifying negative thoughts, behaviors, and emotional responses associated with psychological distress.

Behavior therapy

A therapy focused on modifying harmful behaviors associated with psychological distress.

Psychotherapy

Treatment of mental or behavioral disorders through talk therapy.

What is Major Depressive Disorder with Seasonal Pattern (Seasonal Affective Disorder/SAD)?

What is Seasonal Affective Disorder (SAD) 

Seasonal depression is considered a type of MDD. Some of the signs and symptoms of seasonal depression are the same as those you might experience with other types of major depressive disorder.

Major Depressive Disorder with a Seasonal Pattern (formerly known as seasonal affective disorder, or SAD) is characterized by recurrent episodes of depression in late fall and winter, alternating with periods of normal mood the rest of the year.

Seasonal affective disorder (SAD) or seasonal depression are older terms for major depressive disorder (MDD) with seasonal patterns. However, since the older terms are more commonly known, they’re used throughout this article.

Seasonal affective disorder (SAD) is a type of depression. It happens during certain seasons of the year, most often fall or winter. It is thought that shorter days and less daylight may set off a chemical change in the brain leading to symptoms of depression. Light therapy and antidepressants can help treat SAD.

We avoid using the abbreviation “SAD,” as it may be confused with social anxiety disorder.

The condition is characterized by feelings of sadness and depression that occur with the changing seasons, most commonly in the fall or winter months when the temperatures begin to drop and the days grow shorter.

The symptoms subside on their own as you transition out of the season that affects you.

Because most people experience these shifts in mood during winter, it’s sometimes referred to as winter depression.

If your symptoms are less severe, the episode can be referred to as the “winter blues.” The official reference for this milder version is winter-type or winter-pattern subsyndromal seasonal affective disorder.

What are the symptoms of SAD?

There are 2 types of SAD:

• Fall-onset. This type is also called winter depression. Symptoms of depression begin in the late fall to early winter months. They ease during the summer months.
• Spring-onset. This type is also called summer depression. Symptoms of depression begin in late spring to early summer. This type is much less common.
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These are the most common symptoms of SAD:

• Increased sleep and daytime drowsiness
• Loss of interest and pleasure in activities formerly enjoyed
• Social withdrawal and increased sensitivity to rejection
• Grouchiness and anxiety
• Feelings of guilt and hopelessness
• Excessive tiredness (fatigue)
• Decreased sex drive
• Decreased ability to focus
• Trouble thinking clearly
• Increased appetite, especially for sweets and carbohydrates
• Weight gain
• Physical problems, such as headaches
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Symptoms tend to come back and then improve at about the same times every year.

The symptoms of SAD may seem like other mental health conditions. Always see a healthcare provider for a diagnosis.

Winter and summer depression also have some specific symptoms, which will be outlined below.

Keep in mind that not everyone experiences all of the symptoms listed.

Symptoms of major depression may include:

• feeling depressed nearly every day for most of the day
• losing interest in activities you enjoyed in the past
• changes in appetite or weight
• sleep problems
• feeling agitated or sluggish
• low energy
• experiencing a sense of hopelessness or worthlessness
• having difficulty concentrating
• experiencing frequent thoughts of death or suicide

Symptoms of winter depression

For winter depression, additional symptoms may include:

• oversleeping (hypersomnia)
• overeating
• craving carbs
• weight gain
• social withdrawal or a desire to “hibernate”
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Symptoms of summer depression

Specific symptoms of summer depression may include:

• trouble sleeping (insomnia)
• a lack of appetite that may lead to weight loss
• agitation and restlessness
• Anxiety

This disorder’s most common presentation is of an atypical depression. With classic depression, people tend to lose weight and sleep less. This condition is the kind of atypical depression often seen in bipolar disorder—people tend to gain weight and sleep more.

Although not everyone experiences all the following symptoms, the classic characteristics of Major Depressive Disorder with a Seasonal Pattern include:

• Hypersomnia (or oversleeping)
• Daytime fatigue
• Overeating
• Weight gain
• Craving carbohydrates

Many people may experience other symptoms as well, including:

• Decreased sexual interest
• Lethargy
• Hopelessness
• Suicidal thoughts
• Lack of interest in usual activities and decreased socialization

What causes SAD?

We don’t know exactly what causes seasonal affective disorder. Though a few factors are thought to play a role.

It’s possible that people who experience seasonal affective disorder have lower levels of serotonin, or the “feel good” hormone, which helps regulate your mood. Because sunlight exposure can impact serotonin levels in the body, winter depression may be brought on by lack of sunlight.

However, summer depression may be triggered by heat, humidity, and too much light exposure, which can lead to an overproduction of melatonin, or the “sleepy” hormone. Too much melatonin in the body can affect your sleep-wake cycle.

When seasonal changes in daylight exposure disrupt the levels of serotonin and melatonin in the body, it can impact your mood.

Less sunlight and shorter days are thought to be linked to a chemical change in the brain. They may be part of the cause of SAD.

Melatonin, a sleep-related hormone, also has been linked to SAD. The body naturally makes more melatonin when it’s dark. So when the days are shorter and darker, more melatonin is made.

 As a first-line treatment for seasonal affective disorder, the lamps can be a bit pricey.

Some insurance plans may cover the cost of the light therapy box, especially if your healthcare professional recommends light therapy. If you have medical insurance, then checking with your insurance provider is a good idea.

Also, inexpensive alternatives are available. You can replace commonly used light bulbs in your home with brighter full spectrum (also known as broad spectrum) light bulbs.

The bulbs cost more than regular light bulbs, but their light is similar to natural sunlight.

Maintain your sleep schedule and routine.

If you can, maintain your schedule and routine, which may help keep depression at bay.

A regular pattern of sleep is most important to maintain.

It may be helpful, for instance, to have your bedroom lights on a timer to turn on a half-hour before you wake. This may help in waking at a regular time every morning when it’s still dark outside in the winter months.

Exercise

Exercising regularly may help boost your mood, which can be especially helpful if you have mild to moderate depression.For adults, aim for 150 minutes of moderate-intensity exercise a week, if you can. It’s important to pick an activity you enjoy, so you’re more likely to stick with it.

If you can, pick an outdoor activity like walking briskly, running, skiing, or sledding, but any type of physical exercise can be helpful.

Eat a balanced diet

Overeating and, particularly, craving carbs are common symptoms of winter depression. High sugar foods and carbs are known to give you a short boost of energy.

There’s nothing wrong with enjoying a tasty treat from time to time, but try to eat a balanced diet rich in lean protein, fruits, and vegetables. These foods contain nutrients and compounds that may positively affect mood.

For example, there’s some research on the potential effects of omega-3s in relieving the severity of depressive symptoms.

Fatty fish is particularly rich in omega-3s. The fatty acids can also be found in plant foods like seeds and nuts, though the type of omega-3s in plant foods aren’t as active in your body.

To help you choose healthier foods, consider putting them in plain sight:

• Place a bowl of fruit in your kitchen where you can easily see it.
• Keep small containers with nuts or seeds by your work desk instead of high carb sweets.

How is SAD diagnosed?

Depression often happens with other conditions, such as heart disease or cancer. It may also happen with other mood disorders, such as substance abuse or anxiety. For these reasons, early diagnosis and treatment is key to recovery.

A diagnosis of SAD may be made after a careful mental health exam and health history. These are done by a psychiatrist or other mental health provider.

Diagnosis

The key to an accurate diagnosis of this condition is recognizing its pattern. Symptoms usually begin in October/November and subside in March/April. Some people begin to experience a “slump” as early as August, while others remain well until January. Regardless of the time of onset, most people don’t feel fully “back to normal” until early May.

For a diagnosis to be made, this pattern of onset and remission must have occurred during at least a two-year period, without the occurrence of any non-seasonal episodes during that same period.

This means you will not receive this diagnosis the first time you experience symptoms. If you believe you may have a seasonal depressive pattern, it’s important to pay attention to the pattern. Track your symptoms, noting when they begin and when they subside. This self-awareness can help. Mental health professionals will ask you about your observations and also your family history since mood disorders tend to run in families.

How is SAD treated?

The treatments for winter depression and summer depression often differ. They may include any of these:

• Exposure to sunlight. Spending time outside or near a window can help ease symptoms.
• Light therapy. If increasing sunlight is not possible, exposure to a special light for a certain amount of time each day may help. Certain light sources are best for SAD. Check with your healthcare provider for a recommendation.
• Psychotherapy. Cognitive-behavioral or interpersonal therapy helps change the distorted views you may have of yourself and the environment around you. It can help you improve interpersonal relationship skills. And it can help you identify things that cause you stress and learn how to manage them.
• Antidepressants. These prescription medicines can help correct the chemical imbalance that may lead to SAD.

If you’re experiencing symptoms of seasonal depression, reach out to a doctor or mental health professional to discuss your treatment options, which may involve a combination of therapy, medications, and coping strategies.

Strategies that may help with winter depression

• Get as much natural light as possible.
• If you experience winter depression, increasing your daily exposure to as much natural light as possible can be helpful.
• You might find getting as much sunlight during the winter months as you can helpful.
• If you can, take a walk throughout the day or sit next to a south-facing window at your office, in a classroom, or at home. This will increase your sunlight exposure.
• Exercising next to a window or outdoors when possible is another activity that may help.
• Consider light therapy

Light therapy can be an effective treatment for seasonal affective disorder.

You can purchase specialized light therapy lighting boxes — sometimes called “SAD lamps” — for your home or office. It’s often recommended to sit in front of these lightboxes for about 30–60 minutes per day.

Light therapy is thought to improve seasonal depression. The increased exposure to light may:

• cause your brain to reduce the production of the hormone melatonin, which makes you sleepy
• increase the production of the hormone serotonin, which affects your mood

Treatment

As with most depressive disorders, the best treatment includes a combination of antidepressant medications, cognitive-behavioral therapy, and exercise. Unlike other depressive disorders, this condition can also be treated with light therapy. Light therapy consists of regular, daily exposure to a “light box,” which artificially simulates high-intensity sunlight. Be aware that ordinary indoor light is not sufficient to treat this condition.

Some primary care doctors have experience treating this disorder. Remember that this condition is a subset of major depression. If your primary care doctor prescribes you an antidepressant, orders you a lightbox and sends you to a social worker—and you have trouble the following year—consider seeking consultation from a psychiatrist. Treatment planning needs to match the severity of the condition for each individual.

There are also things you can do for yourself to help ease symptoms:

• Get help. If you think you may be depressed, see a healthcare provider as soon as possible.
• Set realistic goals in light of the depression. Don’t take on too much. Break large tasks into small ones, set priorities, and do what you can as you can.
• Try to be with other people and confide in someone. It is often better than being alone and secretive.
• Do things that make you feel better. Going to a movie, gardening, or taking part in religious, social, or other activities may help. Doing something nice for someone else can also help you feel better.
• Get regular exercise.
• Expect your mood to get better slowly, not right away. Feeling better takes time.
• Eat healthy, well-balanced meals.
• Stay away from alcohol and illegal drugs. These can make depression worse.
• Delay big decisions until the depression has lifted. Don't make a big change right away, such as getting a new job or getting married or divorced. Talk it over first with others who know you well. They will likely have a more objective view of your situation.
• People don't often snap out of depression. But they can feel a little better day by day.
• Try to be patient and focus on the positives. This may help replace the negative thinking that is part of depression. The negative thoughts will go away as your depression responds to treatment.
• Let your family and friends help you.
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Key points about SAD

• SAD is a type of depression that happens during a certain season of the year, most often fall and winter.
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• There is no clear cause of SAD. But less sunlight and shorter days may be part of the cause. Melatonin, a sleep-related hormone, also may be linked to SAD.
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• Symptoms can include increased sleep and daytime drowsiness, social withdrawal, grouchiness, and decreased sex drive.
• 
  
• SAD may be diagnosed after a mental health exam and health history. These are done by a psychiatrist or other mental health professional.
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• Depression is most often treated with light therapy, psychotherapy, and in some cases antidepressants.
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Growing research has found that in some countries, notably in North America, there’s a clear connection between latitude, or how far north or south you live, and the occurrence of seasonal depression.

In other parts of the world, like parts of Europe, this connection is less clear.

Overall, it’s estimated that between 1% and 10%  of people experience seasonal depression. This can vary by country.

Some research has found that 20% of people in the United Kingdom experience winter blues, while 2% experience winter depression.

In Canada, the numbers are 15% for winter blues and 2%–6% for winter depression. Plus, in the United States, about 1% of people living in Florida experience seasonal depression, compared with 9% of Alaska’s population.

Women are 4 times more likely to experience seasonal affective disorder than men, and the condition often begins when you’re between ages 18 and 30.

Does seasonal affective disorder occur only in the winter?

Though symptoms in winter are much more common, some people experience changes in mood at the onset of summer.

This is known as summer-pattern or summer-type seasonal affective disorder, summer depression, or in its milder form, “summer blues.”

Though statistics on the prevalence of summer depression are not as easily found as those for winter depression, it’s estimated that about 10% of people with seasonal depression experience it in the spring or summer.

Plus, it can be observed that summer depression may be more common in some regions with warmer climates and possibly less access to air conditioning.

For example, an early study in the Netherlands found that only 0.1% of participants experienced the symptoms of summer depression, compared with 3% for winter depression.

In comparison, a 2000 study of Chinese college students noted that summer depression was more common than winter depression, with 7.5%, compared with 5.6%.

Similarly, in an early study conducted in Thailand, the prevalence of summer depression and summer blues were 6.19% and 8.25%, respectively, compared with 1.03% for winter depression. Only 97 people were included in the study.

Who is at risk for SAD?

SAD often starts during adulthood. The risk of SAD increases with age. It’s rare in people younger than age 20. Women are affected more often than men.

Strategies that may help with summer depression

Spend time in darkened rooms.

Unlike winter depression, which seems to be triggered by a lack of sunlight, summer depression may be caused by too much sun exposure, which may affect your sleep-wake cycle.

If you experience symptoms of summer depression, consider limiting your time outside. If you can, spend more time inside, preferably in darkened rooms.

Still, it may be important to find a balance between seeking light exposure and avoiding it. Getting too little natural light may affect your mood.

Try to cool down

If heat seems to trigger your onset of summer depression, it may be important to find ways to stay cool.

If you have one, using an air conditioning unit can be beneficial.

Another option, if possible, is to consider going to locations with air conditioning running, such as supermarkets, malls, movie theaters, or libraries.

You can also cool your home at night by opening windows if you don’t have air conditioning.

Exercise

Regular exercise can help treat mild to moderate depression. It may also be an effective strategy in managing your summer depression.

However, since too much sun exposure and heat could trigger your symptoms, you may want to opt for indoor activities, such as working out at a gym with air conditioning, swimming at an indoor pool, or trying a yoga class (just maybe not hot yoga).

What if these strategies don’t work?

If you start with coping strategies and techniques and they don’t seem to relieve your symptoms alone, your doctor may recommend psychotherapy or medications.

Often, a combination of therapy, medication, and self-care strategies will be the most effective for treating seasonal affective disorder, similar to treating other types of depression.

No matter what, don’t be afraid of speaking with your healthcare professional about your symptoms. Together, you can work to find the right treatment options for you.

Coping with suicidal thoughts

If you’re in crisis or experiencing suicidal thoughts, help is always available.

You can reach the National Suicide Prevention Lifeline 24/7 by dialing 988.