CPC Mental Health Ministry Spotlight:

 

Major Depressive Disorder with a Seasonal Pattern

 

Major Depressive Disorder with a Seasonal Pattern—formerly referred to as Seasonal Affective Disorder (SAD)—involves recurrent depressive episodes that occur predictably during late fall and winter, with a return to typical mood and functioning in the spring and summer months.

 

Researchers at the National Institute of Mental Health (NIMH) were the first to link this condition to decreased exposure to natural light and to explore bright-light therapy as a treatment. Scientific evidence also suggests that serotonin functioning may be altered in individuals who experience this disorder.

 

Prevalence

Rates of Major Depressive Disorder with a Seasonal Pattern vary based on several factors:

• Geography: Higher prevalence among individuals living in northern latitudes.

• Age: More common in younger people.

• Sex: Women are affected more frequently than men. 

 

Diagnosis

Accurate diagnosis depends on identifying a consistent seasonal pattern. Symptoms typically begin between October and November and improve between March and April. Some people may feel a decline as early as late summer, while others maintain wellness until mid-winter.

 

Most individuals report not feeling fully “back to normal” until early May. A diagnosis requires that this seasonal pattern occurs for at least two consecutive years, without any depressive episodes arising outside the seasonal timeframe.

 

Because of this two-year requirement, clinicians cannot diagnose this condition based on the first occurrence of symptoms. Tracking your symptoms, including when they begin and when they resolve—can be extremely helpful. Mental health professionals will use this information alongside family history, as mood disorders commonly run in families.

 

Symptoms

This condition most often presents as an atypical depression. Unlike classic depression, which often involves decreased appetite and insomnia, individuals with this disorder typically experience:

• Hypersomnia (sleeping more than usual)

• Daytime fatigue

• Increased appetite

• Weight gain

• Carbohydrate cravings

 

Additional symptoms may include:

• Reduced sexual interest

• Low energy or lethargy

• Hopelessness

• Suicidal thoughts

• Diminished interest in activities and social withdrawal 

 

Treatment

Treating this condition usually involves a combination of:

• Antidepressant medication

• Cognitive Behavioral Therapy (CBT)

• Regular exercise

 

A unique and effective intervention for this disorder is light therapy, which involves daily exposure to a specialized light box that mimics high-intensity sunlight. Standard indoor lighting, such as typical office or household bulbs, is not strong enough to be therapeutic.

Some primary care providers are comfortable initiating treatment for this condition. However, because it is a subtype of major depression, individuals who continue to struggle year after year may benefit from consultation with a psychiatrist. Treatment plans should always be tailored to the severity and impact of symptoms.

 

Planning Ahead

Because symptoms follow a predictable seasonal pattern, proactive planning can make a significant difference. Consider strategies such as:

• Increasing physical activity as summer ends

• Beginning therapy in September

• Starting light therapy in October

• Planning a mid-winter trip to a sunnier location

 

Some individuals only require treatment during symptomatic months, while others may choose to maintain year-round supports.

 

You are also encouraged to check out the array of mental health supports on the CPC Mental Health Ministry’s webpage.