As daylight fades earlier and the weather becomes colder, millions of Americans fall into a common variant of seasonal depression formally known as seasonal affective disorder or SAD. 

"SAD is a type of depression that follows a regular seasonal pattern, with symptoms lasting about four to five months out of the year," states the National Institute of Mental Health.

Prevalence, according to the American Psychiatric Association, may vary upon geographical latitude, age and sex.

In most people with winter-pattern SAD, symptoms start to subside once spring approaches. If the seasonal depression affects you or a loved one, here are some ways to try to cope.

Causes and Symptoms of SAD

Even though winter-pattern SAD is studied so much more extensively, the exact cause of seasonal affective disorder still remains unknown. According to some studies, individuals who suffer from SAD have lower levels of serotonin – neurotransmitters that help regulate mood – and the lack of sunlight affects levels of molecules that help maintain normal serotonin levels, according to NIMH.

“Shorter daylight hours may prevent these molecules from working effectively, reducing serotonin levels in the winter," NIMH said.

Less sunlight can also trigger an onset of a vitamin D deficiency that your body needs to absorb calcium. Calcium can be ingested through various types of food but also comes from exposure to the sun on your skin.

"With less daylight in the winter, people with SAD may have lower levels of vitamin D, further reducing serotonin activity," NIMH said.

Symptoms of winter-pattern SAD may include sleeping too much, eating too much (usually with accompanying weight gain) and withdrawing from social life. It may even feel like one is "hibernating." In the most extreme forms, there is a risk of thoughts of death and suicide.

These symptoms are usually felt for at least two consecutive weeks and may be associated with other depression symptoms such as low energy, feelings of sadness, changes in sleep and appetite. SAD is different from the "holiday blues," which is holiday stress-related, not daylight hours and seasonal changes related.

Treatment Options for SAD

Intermountain Health advises that anyone experiencing symptoms of SAD to consult a physician, nurse or counselor. The general strategies to cope with this disorder include light therapy, vitamin D supplements, medications and psychotherapy.

Light Therapy

Light therapy is the more common treatment for SAD and was developed in the 1980s. Individuals will sit in front of a bright light – usually 10,000 lux – for about 30-45 minutes per day. Intermountain Health encourages people to consult a health professional on this treatment instead of buying your own light and trying the treatment at home.

Vitamin D

Vitamin D supplements may help improve some of the symptoms associated with SAD. Results from studies have been inconsistent: Some found that it has proved to work as well as light therapy does, while others found little improvement. Because vitamin D might interact with other medications, patients must not take it without first speaking with their health professional.

Medication

"The same medicines used to treat depression can help people with SAD," Intermountain Health said.

However, it can take up to four to eight weeks before someone will see results, and it may take several tries to find the right medication and/or dosage. It's essential to consult a health professional before taking or stopping any medication.

TMS (transcranial magnetic stimulation)

If you’ve tried medication and it doesn’t do the job, another option is Transcranial Magnetic Stimulation.

It’s a non-invasive, FDA-approved treatment alternative to antidepressants. The device uses magnetic pulses to stimulate brain cells in a particular area of the brain. The rapidly pulsing magnetic fields that are generated go directly through the hair, scalp and skull and create small electric currents in the area of the brain directly under the treatment coil. The electric currents created in the brain make nerve cells in that region become active and affect other nerve cells deep in the brain that are involved in mood.

Standard TMS treatment consists of 36 treatments, one 30-minute treatment daily. Neurostar TMS reported 83% of patients responded to treatment and 62% achieved remission.

There are a number of clinics offering TMS around both Salt Lake and Davis counties. To learn more about it, and find out if TMS is a course of action for you, visit the NeuroStar website where you can find a provider near you. 

Counseling

Another option from both Intermountain Health and NIMH is counseling or "talk therapy."

NIMH said there is a type of cognitive behavioral therapy adapted for patients with seasonal affective disorder. It is called CBT-SAD, a type of psychotherapy that can help teach people new ways of thinking and may even help alter habits contributing to their depression.

These can all be helped by exercise and good sleep habits. Intermountain Health suggests 30 minutes of activity most days, even on days when motivation may not be high. Additionally, going to bed and getting up at the same time each day and reducing screen time before bedtime may further improve symptoms of SAD.