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Seasonal Affective Disorder (SAD)
Seasonal affective disorder (SAD)
Explains seasonal affective disorder, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.
What is seasonal affective disorder (SAD)?
Seasonal affective disorder (SAD) is a type of depression that you experience during particular seasons or times of year. Depression is a low mood that lasts for a long time, and affects your everyday life.
If you have SAD, you’ll experience depression during some seasons in particular, or because of certain types of weather or temperature. You can experience it in winter or summer.
“It’s like having your own portable black cloud.”
It’s common to be affected by changing seasons and weather, or to have times of year when you feel more or less comfortable. For example, you might find that your mood or energy levels drop when it gets colder or warmer, or notice changes in your sleeping or eating patterns.
But if your feelings are interfering with your everyday life, it could be a sign that you have depression. And if they keep coming back at the same time of year, doctors might call this seasonal affective disorder (SAD) or ‘seasonal depression’.
“In the weeks before the clocks go back, I start to feel sluggish and down. It’s harder to keep to my morning routine of going out for a walk before breakfast because it’s wet, cold and dark.”
What are the symptoms of SAD?
If you have SAD, you might experience some of the signs and symptoms below. But it’s different for different people, and can vary season to season, so you might also have other kinds of feelings which aren’t listed here:
- Lack of energy
- Difficulty concentrating
- Not wanting to see people
- Feeling sad, low, tearful, guilty or hopeless
- Feeling anxious, angry and agitated
- Being more prone to physical health problems, such as colds, infections or other illnesses
- Sleeping too much, or difficulty waking up (common with SAD in winter)
- Sleeping too little, or waking up a lot (common with SAD in summer)
- Changes in your appetite, for example feeling hungrier or not wanting to eat
- Losing interest in sex or physical contact
- Suicidal feelings
- Other symptoms of depression
If you also have other mental health problems, you might find that things get worse at times when you’re affected by SAD.
If you feel unable to keep yourself safe, it’s a mental health emergency.
Get emergency advice
“I just can’t stay awake and the thought of having to go out, stay awake, make conversation. I just can’t do it.”
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“I close the curtains in the evening and wish it was dark so I could go to bed early but it’s broad daylight. I need to sleep and withdraw again from the world.”
Are there common misconceptions about SAD?
Lots of people have heard of SAD, but this doesn’t mean that they understand what it’s like or how you’re affected. It doesn’t mean you ‘just feel a bit low in winter’. There are many factors that can cause it or make it worse, and it can affect your life just as much as other types of depression.
It can be frustrating and upsetting if people don’t understand this, but it’s important to remember that you are not alone.
See our page on stigma and misconceptions for lots of ideas on how to deal with stigma.
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What causes SAD?
The exact causes of SAD aren’t clear – a range of different factors are likely to contribute and these can vary a lot between different people.
Research suggests that the causes are similar to causes of depression, but there are also factors which can lead specifically to SAD.
Possible causes of SAD include:
- Effects of light
- Disrupted body clock
- Problems with melatonin and serotonin levels
- Weather and temperatures
Effects of light
When light hits the back of your eye, messages go to the part of your brain that controls sleep, appetite, sex drive, temperature, mood and activity. If there isn’t enough light, these functions can slow down and gradually stop.
Some people seem to need a lot more light than others. This may mean they’re more likely to get SAD during the winter months.
“It’s like someone has switched off the light suddenly. I’m plunged into darkness, which paralyses me and keeps me pinned down to my bed.”
Disrupted body clock
Your brain sets your body clock by the hours of daylight. One theory is that if you experience SAD in the winter, this part of your brain isn’t working in the same way.
This could mean your body clock is out of sync with daylight, leading to tiredness and depression. Some researchers think this is because your sleep pattern starts at a different time.
Is SAD more common in certain countries?
SAD is thought to be more common in countries where there are greater changes in the weather and in daylight hours during different seasons. This includes England and Wales.
“The evening is endless. I would watch the clock and feel trapped in the dark.”
Problems with melatonin and serotonin levels
When it’s dark, your brain produces a hormone called melatonin which helps your body get ready for sleep. The levels of serotonin, a brain chemical that affects your mood, are also affected by how much sunlight you get.
Some people with winter SAD seem to produce higher levels of melatonin and lower level of serotonin during winter. Research suggests these can contribute to winter SAD, but the exact relationship between them isn’t clear.
“When winter comes and I feel the change in the seasons, I feel more drained. I find it very hard to motivate myself into getting dressed or out of bed.”
Weather and temperatures
We all have different experiences of particular seasons and types of weather. You might feel particularly uncomfortable in hotter or colder temperatures, which could contribute to you developing depression (or any existing depression worsening) at those times.
While more people are aware of SAD happening in winter, some people have more difficulty in warmer weather. Some studies have suggested that summer SAD is linked to higher temperatures and humidity. But more research is needed to understand why.
“Sunshine and heat make me feel defensive, misanthropic, angry, anxious, resentful and impatient. I don’t want to see anyone, go anywhere or do anything. Even bright, low winter light depresses me. I feel under siege.”
Do stressful times of year cause SAD?
SAD is diagnosed if your depression has a seasonal pattern. Some of us might have other times of the year, we find especially difficult, such as Christmas or bereavement anniversaries when we feel depressed. Some other mental health problems can also have a seasonal pattern, like bipolar disorder.
These feelings aren’t necessarily a form of SAD but they can still mean that you need extra support at certain times of year.
Our self-care tips for SAD have some suggestions for you to think about, and our pages on coping with loneliness and stress may also be helpful.
How can I help myself?
Living with SAD can be difficult, but there are lots of things you can do to help yourself cope. This page has some suggestions for you to consider.
Different things work for different people at different times, so if something doesn’t feel possible just now try not to put pressure on yourself. You can always try something else or come back to it another time. For example:
- Talk to someone
- Keep a diary
- Plan for difficult times
- Try peer support
- Learn ways to relax
- Look after your physical health
Winter SAD-practical-day to day tips
If SAD affects you during winter, there are particular things you could try that might help. You could:
- Make the most of natural light. It might help to spend time in natural light, for example going for walks, spending time in parks or gardens, or simply sitting near a window. This seems to be helpful if you experience SAD in winter.
- Plan ahead for winter. For example, try to make meals in advance and freeze them if you know you are likely to lack the energy to do this during the most difficult period.
“I try to get some natural light during the day just by being outside, maybe tidying up the garden or taking my dog for a walk. Exercise in natural light is really helpful.”
Summer SAD-practical-day to day tips
If SAD affects you during hot weather, there are particular things you could try that might help. You could:
- Drink plenty of water so that you stay hydrated.
- Find ways to keep cool, such as finding shade or wearing loose clothing.
- Visit indoor places. Staying inside all the time could make you feel isolated. It could help to try doing activities indoors, like visiting your local library or going to the cinema.
- Plan ahead for summer. For example, try to avoid going outside at the hottest times of day where possible.
Talk to someone
It can be hard to reach out when you’re not feeling well, but it might help to share how you’re feeling. If you don’t feel you can talk to the people around you or you need additional support, you could contact a helpline such as:
- Samaritans – open 24 hours a day, 365 days a year to listen to anything that’s upsetting you. You can call 116 123 (free from any phone), email jo@samaritans.org or visit some branches in person. You can also call the Welsh Language Line on 0300 123 3011 (7pm–11pm every day).
- SANEline – support for people experiencing a mental health problem or supporting someone else. You can call them on 0300 304 7000 (4.30pm–10.30pm every day).
- Campaign Against Living Miserably (CALM) – support for anyone who wants to talk. You can call them on 0800 58 58 58 (5pm–midnight every day) or use their webchat service.
For more options, see our page on helplines and listening services. Mind’s Infoline can also help you find services that can support you.
“SAD is like a cold blanket that keeps depression and anxiety wrapped close to me. When I feel I can, I go outside and face the sun, close my eyes and focus on the light and warmth.”
Keep a diary
You might find it helps to keep a note of your symptoms, including when they start and if particular things seem to trigger them, including changes in the weather. This could help you notice any patterns.
You could also make a note of things that feel helpful for you or which seem to make things worse. This can be helpful because SAD affects you at some times and not others, so you might not easily remember these details.
“I keep a daily diary and it’s helpful to look back over the years and see how each year I’ve felt the downward spiral starting.”
Plan for difficult times
If you’ve noticed your symptoms follow a pattern, you may be able to work out when they’re most likely to start in the future. This may help you put things in place for those times.
For example, you could:
- Re-arrange stressful activities or events for another time.
- Plan relaxing activities that might help improve your mood.
- Plan ahead, such as stocking up on things you need.
- Make more spare time to rest or do things you enjoy.
- Create a self-care box.
“December is dark but the festive lights and cheerfulness are an antidote. I now put up my Christmas decorations really early (1st Dec) as a way of coping with my SAD symptoms and stretching out the ‘fairy-lights antidote’ for a whole month.”
Try peer support
Peer support brings together people who have had similar experiences. Some people find this very helpful.
To find peer support, you could:
- Contact Mind’s Infoline or your local Mind to see what support there is in your area.
- Ask your GP for details of support groups, and if you live in England you can also contact your local psychological therapies service.
- Look for details of groups through organisations like Depression UK and Rethink Mental Illness.
- See if your local library or community centre has details of groups in your area.
- Explore our peer support directory.
- Try an online peer support community like Mind’s Side by Side or SANE’s support forum.
If you’re seeking peer support on the internet, it’s important to look after your online wellbeing. For more information see our pages on online mental health and peer support.
“I have a dawn simulator alarm clock which lights up gradually to fill my space in the bedroom with a glow.”
Learn ways to relax
- Manage stress. It can help to think of ways to manage pressure and build your emotional resilience. See our pages on how to manage stress for more information.
- Try some relaxation techniques. Learning to relax can help you look after your wellbeing when you are feeling stressed, anxious or busy. See our pages on relaxation for tips you could try, or see our information on mindfulness.
- Spend time in nature. Being outside in green space can help you feel more in touch with your surroundings. See our pages on nature and mental health for more information.
“I get up early, wrap up warm, put on my pedometer and walk in the dark to enjoy the solitude. By the time people are up and about, I’m back home having walked a good few miles and feel so much better for it.”
Look after your physical health
Looking after your physical health can make a difference to how you feel emotionally. For example, it can help to:
- Think about your diet. Eating regularly and keeping your blood sugar stable can be difficult when you have SAD. But trying your best to manage this where possible could make a difference to your mood and energy levels.
- Try to do some physical activity. If you find exercise a challenge remember that even gentle activities like yoga, swimming or walking can be a big boost to your mood. See our pages on physical activity for more information.
- Get help with sleep problems. For lots of people who experience SAD, sleeping too little or too much can be a problem. See our pages on coping with sleep problems for tips that might help.
- Try to look after your hygiene. When you’re experiencing SAD, it’s easy for hygiene to not feel like a priority. But small things, like taking a shower and getting fully dressed whether or not you’re going out of the house, can make a big difference to how you feel.
- Try to avoid drugs and alcohol. While you might want to use drugs or alcohol to cope with any difficult feelings, in the long run they can make you feel worse. See our pages on the mental health effects of recreational drugs and alcohol for more information.
“In summer my eyes, skin, throat and muscles ache. I find it difficult to concentrate. I can’t take in information, and my short-term memory is unreliable. Evenings come as a relief. I feel my muscles relaxing as the sun goes down.”
For more tips on supporting yourself see our pages on self-care for depression and self-care for anxiety.
What treatments are there for SAD?
Whether or not your depression seems to be seasonal, it’s ok to ask for help at any time. You don’t need to wait to see if there’s a pattern.
This page covers:
- How can I access treatment?
- Talking therapies
- Medication
- Light therapy
- Other treatments
- What if I don’t feel better?
How can I access treatment?
The first step is usually to visit your GP. If you’re given a diagnosis of SAD, this will be based on your symptoms repeatedly following a seasonal pattern, usually for two or more years.
Or if the seasonal pattern isn’t clear yet you can still get help from your GP for symptoms of depression or anxiety.
Our guide to seeking help for a mental health problem has information about talking to your doctor about your mental health, including what might happen at the appointment and making your voice heard.
“I was well into adulthood before I began to recognise a pattern. Initially I noticed that I often took more sick leave from my job in the winter months.”
The National Institute for Health and Care Excellence (NICE) guidelines say you should be offered the same types of treatments for SAD as for other types of depression, including talking therapies and medication. This is because there isn’t currently enough evidence to show whether or not particular treatments help with SAD.
You can read the full guidelines on the NICE website, including recommendations on treating SAD. This information uses the term ‘seasonal depression’ to describe SAD.
Talking therapies
There are many different talking therapies that can be effective in treating depression. See our pages on treatment for depression and talking therapies and counselling for more information and how to access them, including through the NHS, charities or privately.
“My energy levels fluctuated between autumn/winter and spring/summer. I absolutely dreaded the onset of darker days and felt that I was literally shutting down.”
Medication
You might be offered an antidepressant, either on its own or in combination with talking therapy. This will most commonly be a selective serotonin reuptake inhibitor (SSRI). Your GP might recommend you start taking them a few weeks before the season when your symptoms normally begin.
Our pages on treatment for depression, treatment for anxiety and antidepressants have more information.
“Antidepressants have helped to put me in a place where I was more able to cope with counselling. This required a lot of hard work and I had to accept a completely different way of thinking.”
Medication really helps some people but isn’t right for others. Before deciding to take any drug, it’s important to make sure you have all the facts you need to make an informed choice.
See our pages on things to consider before taking medication and your right to refuse medication for more information.
Our pages on coming off medication give guidance on how to come off medication safely.
Light therapy
Some people with winter SAD find it helpful to use a light box – a device that gives off strong white or blue light. Or a lamp or alarm clock that simulates dawn. This is sometimes called light therapy.
The NHS doesn’t usually provide light therapy because there isn’t yet much evidence to show it works, although some people find it helpful. So more research needs to be done to establish why it works for some people and not others.
You can buy light therapy equipment yourself but unfortunately it tends to be expensive. For more information on how light therapy works and tips on how to choose a light box see the NHS guidance on trying light therapy.
Light therapy might not be suitable for you if you’re using other treatments that can make your skin sensitive to light. For example:
- St John’s wort
- Some antipsychotics
- Some antibiotics
If you decide to try using a light box or lamp, you may wish to discuss this with your doctor who can advise on whether it’s suitable for you to try. If you have existing eye problems or use a light box regularly, it’s also a good idea to talk to an optician and to have regular eye check-ups.
“Using a light box wasn’t perfect but the change was tangible. A real shift. I began to cope better with the dark days and didn’t have the all-encompassing desire to get back into bed and stay there.”
Other treatments
You might also decide to try other treatments alongside, or instead of, talking therapies or medication. These might include:
- Complementary and alternative therapies
- Ecotherapy (nature-based treatments)
- Arts and creative therapies
Your doctor may be able to refer you to some of these. You can also contact your local Mind to find out what they have available.
What if I don’t feel better?
Your doctor should offer you regular appointments to check how you’re doing, and see how well any treatment is working for you. Different things work for different people at different times, and if a particular medication or talking therapy doesn’t work for you, your doctor should be able to suggest an alternative.
If you’ve tried a range of treatments and none of them have helped, speak to your doctor about this and they may be able to refer you for additional support.
For more suggestions, see our pages on seeking help for a mental health problem.
“I approached my GP and reported my symptoms but, as my antidepressant was increased, this just added another degree of sedation.”
How can other people help?
This page is for family or friends who want to support someone with SAD.
If you are supporting a friend or relative who is experiencing SAD it can be hard to know what you can do to help. This page has some suggestions of things you could try while also looking after your own wellbeing.
- Let them know you are there
- Support them to seek help
- Don’t be critical
- Be sensitive when talking about the weather
- Ask them what helps
- Help them to plan ahead
- Stay in touch
- Look after yourself
“Their self-esteem is very low in the winter months, particularly November and December, as the days get shorter.”
Support them to seek help
Supporting your friend or loved one to seek help can be really important. It can help to remind them that SAD is a recognised condition like many others, and that they deserve help and support.
You can read our information on treatment and self-care for SAD, and encourage them to seek help from their GP. See our pages on how to support someone else to seek help for more information.
“I can see my family members with winter SAD shutting down through autumn, until in winter they are prone to afternoon naps, shutting themselves away alone in a room, and have a lack of interest in anything.”
Don’t be critical
If you’ve not experienced SAD yourself, it can be hard to understand why your friend or family member can’t just ‘snap out of it’. Try not to blame them. They are probably being very critical and harsh towards themselves already.
It’s also important to not put pressure on them to feel or behave a certain way, for example expecting someone to be active and particularly happy in the summer.
Be sensitive when talking about the weather
It’s common to describe certain types of weather as being good or bad, for example talking about ‘nice weather’ or describing rainy days as ‘dreary’ or ‘miserable’.
This could make someone with SAD feel criticised or alone, so it might really help if you consider how you talk about different types of weather.
Ask them what helps
SAD can affect people in different ways, so it’s important to ask your friend or loved one what support they would find most helpful, and what has or hasn’t helped them in the past. They may just want your emotional support or there may be specific practical things you could do that could help them cope.
What people need can also change over time, so it is a good idea to check in with them regularly to see if anything has changed.
Help them to plan ahead
If you have some idea when their symptoms are likely to start, you may want to plan things in advance that might help. For example, you could:
- Schedule time to offer practical support
- Plan activities to help them relax
- Make sure there will be people around to offer support
It may also help to avoid planning any activities during the period that they find particularly difficult, and to talk together about what demands they can cope with. For example, you might decide to avoid having guests during difficult times.
“I try to encourage my winter-suffering family members to think ahead and get helpful things organised for during their difficult time before winter starts, while they still have the energy and ability to do so.”
Stay in touch
SAD can cause people to feel very isolated. For example, if they don’t feel up to joining in with social activities or they struggle to find things they can do during difficult times.
It could help to suggest things they might find easier to do such as, in the case of someone who feels worse in hot weather, doing indoor activities like watching a film together.
Look after yourself
There are times when supporting someone can be challenging. So it’s common to feel overwhelmed at times. It’s important to look after your own mental health too. It may help if you:
- Set boundaries and don’t take too much on. It’s important to decide what your limits are and how much you are able to help them. Your needs matter too and you’ll want to avoid becoming unwell yourself. See our pages on how to manage stress for more information.
- Share your caring role with others, if you can. It’s often easier to support someone if you’re not doing it alone.
- Talk to others about how you’re feeling. You may want to be careful about how much information you share about the person you’re supporting, but talking about your own feelings with someone you trust can help you feel supported too.
- Find support for yourself. The organisations in useful contacts are there to support you too. It could also help to explore peer support and talking treatments.
For more suggestions, see our pages on how to cope when supporting someone else, managing stress and looking after your wellbeing.
Useful contact
Mind’s services
- Mind’s helplines provide information and support by phone and email.
- Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.
- Side by Side is our supportive online community for anyone experiencing a mental health problem.
Other organisations
Anxiety UK
03444 775 774 (helpline)
07537 416 905 (text)
anxietyuk.org.uk
Advice and support for people living with anxiety.
British Association for Counselling and Psychotherapy (BACP)
bacp.co.uk
Professional body for talking therapy and counselling. Provides information and a list of accredited therapists.
Campaign Against Living Miserably (CALM)
0800 58 58 58
thecalmzone.net
Provides listening services, information and support for anyone who needs to talk, including a web chat.
Depression UK
depressionuk.org
Depression self-help organisation made up of individuals and local groups.
National Institute for Health and Care Excellence (NICE)
nice.org.uk
Produces guidelines on best practice in healthcare.
NHS UK
nhs.uk
Information about health problems and treatments, including details of local NHS services in England.
Rethink Mental Illness
0808 801 0525
rethink.org
Provides support and information for anyone affected by mental health problems, including local support groups.
Samaritans
116 123 (freephone)
jo@samaritans.org
Freepost SAMARITANS LETTERS
samaritans.org
Samaritans are open 24/7 for anyone who needs to talk. You can visit some Samaritans branches in person. Samaritans also have a Welsh Language Line on 0808 164 0123 (7pm–11pm every day).
Sane
sane.org.uk
Offers emotional support and information for anyone affected by mental health problems.