Something I flat out love about talking with fellow psychology students is that you get talking about different mental health conditions. As well as because a lot of university students, especially in psychology seem to have different mental health conditions and difficulties, or at least the ones I talk and become friends with, I often get thinking about new conditions that I haven't focused on before. For example, I was talking with a new friend the other week about how they next sad and depressed at this time of year. So I started wondering if they had Seasonal Affective Disorder, and when I asked them a few nights ago about it, they weren't sure but it was possible. Of course, I'm not going to say anything more about SAD to my friend because it isn't my business, but I wanted to learn more for my own knowledge and entertainment. Therefore, in this clinical psychology podcast episode, you'll learn what is Seasonal Affective Disorder, what is the DSM-5 diagnostic criteria of Seasonal Affective and what are some treatment options for Seasonal Affective Disorder. If you enjoy learning about mood disorders, mental health and more then this will be a great episode for you.
Today's psychology podcast episode has been sponsored by Today’s psychology podcast episode has been sponsored by CBT For Depression: A Clinical Psychology Introduction To Cognitive Behavioural Therapy For Depression. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
Note: as always nothing on this podcast is ever any sort of official advice.
What Is Seasonal Affective Disorder?
Seasonal Affective Disorder (SAD) is a depressive episode that happens in the autumn and/or winter months and it resolves itself in the summer months when there is more light and the seasons become “happier” and less “depressing”. Although, in the third quarter of 2024, I did cover on the Psychology News Section of the podcast (or maybe I saw an article on it. I forget) that it is possible to get Seasonal Affective Disorder in the summer months and it resolves itself in the winter months. That’s a fascinating idea and I look forward to seeing more research on that aspect of the condition in the coming years.
In addition, in the United States of America roughly 5% of the adult population experiences Seasonal Affective Disorder. As well as Sad is believed to be caused by the disruption to a person’s circadian rhythm that is caused by the decreased sunlight exposure that everyone experiences as the days get shorter and the nights get longer.
Now I am saying this for information purposes but I do believe in this reason because serotonin and a biological basis for depression has been debunked over the years. Especially by Read and Moncrieff (2022). However, it is apparently believed that this decreased sunlight exposure leads to a decrease in the neurotransmitter serotonin that is important for regulating and stabilising our mood.
Moreover, according to Melrose (2015), women are 4 times more likely to experience Seasonal Affective Disorder than men, as well as it tends to first manifest itself in early adulthood, so somewhere between 18 and 30 years old. And at first I thought this finding was strange but in reality it isn’t. Since it turns out that the further you live away from the equator (that have the longest amounts of sunlight), the more prevalent Seasonal Affective Disorder is. For example, according to an article by Horowitz (2008), only 1% of Floridians have Seasonal Affective Disorder but 9% of Alaskans do.
In addition, besides from depressed mood, some symptoms of Seasonal Affective Disorder can include, difficulty in concentrating or thinking, loss of interest in activities, sleeping for long hours (also known as hypersomnia), changes in appetite and lack of energy or feelings of malaise or fatigue.
What is The DSM-5 Diagnostic Criteria For Seasonal Affective Disorder?
From time to time I really like to look at the DSM-5 diagnostic criteria for different mental health conditions because it's interesting, insightful and good to be aware of. Not because the DSM is good or even a fine system and it certainly has flaws. Yet it is interesting to think about.
Therefore, when it comes to Seasonal Affective Disorder, the DSM-5 focuses on the lifetime pattern of mood episodes. These mood episodes can be depressive, hypomanic or manic, so feeling extremely good instead of having a depressed mood. As well as when a client has Seasonal manic episodes as part of their Seasonal Affective Disorder, their depression may not regularly occur during a specific time of year. In other words, there might not be anything Seasonal about it.
Also, the DSM makes use of different Criterions that have to be met in order for a diagnosis to be given. For example, Criterion A requires a client to have a regular temporal relationship between the onset of a major depressive, hypomanic or manic episode and a particular time of year, like the autumn or winter, in bipolar disorder type 1 and 2 cases. As well as these don't include cases where there are clear effects of seasonally related psychosocial stressors. For instance, if you aren't employed every winter for some reason.
When it comes to Criterion B, Seasonal Affective Disorder requires a full remission or a change from major depression to hypomania or mania or vice versa at a characteristic time of year. For example, the depression disappears in the summer months.
Penultimately, Criterion C requires a client in the past 2 years to show that their manic, hypomanic, or major depressive episodes have a temporal seasonal relationship, as well as no non-seasonal episodes of that polarity have occurred during that 2-year period. In other words, a client needs to show that in the past 2 years, they have experienced a depressive, hypomanic or manic episode that starts in the winter months and goes in the summer months.
Finally, Criterion D requires that the number of depressive, hypomanic or manic episodes that happen seasonally outnumber any nonseasonal manic, hypomanic, or depressive episodes that might have happened over their lifetime.
That’s it for the Criterions then in terms of signs and symptoms, the DSM-5 requires the major depressive episodes that happen in a seasonal pattern to be often characterised by prominent energy, hypersomnia, weight gain, overeating as well as a craving for carbohydrates. Also, this specifier can be applied to the pattern of major depressive episodes in bipolar I disorder, bipolar II disorder, or major depressive disorder, recurrent.
Moreover, the onset and remission of the major depressive episodes that happen as part of Seasonal Affective Disorder happen at characteristic times of the year. This feature we spoke about earlier.
What Are Some Treatment Options For SAD Clients?
As a result of Seasonal Affective Disorder being related to a lack of sunlight, the condition is typically treated by getting clients to be exposed to more sunlight. Therefore, some clients push themselves to spend time outdoors or move closer to a window facing the sun. Whereas for other clients, SAD is treated using Bright Light Therapy because this gives the client more exposure to “sunlight”. In this situation, clients are exposed to a full-spectrum fluorescent light box that emits brightness similar to real sunlight.
Thankfully, Bright Light Therapy is now recognised as a first-line treatment for Seasonal Affective Disorder and clients might start to feel an improvement in their symptoms after using the lightbox for only 20 or 60 minutes a day. As well as research shows that lightboxes are most effective when they’re used early in the morning.
Another treatment for Seasonal Affective Disorder can be using Selective Serotonin Reuptake Inhibitors because this is shown to improve depressive symptoms. Yet again, the issues with this treatment still remain. Especially, because when you combine the published and unpublished data, anti-depressants, SSRIs and more biological treatments for depression are next to useless.
Finally, another treatment option for Seasonal Affective Disorder (and this is something else that my friend mentioned too) is that SAD could be caused by a Vitamin D deficiency. Since as humans our vitamin D levels naturally falcate throughout the year depending on the amount of sunlight available to us. Therefore, we normally have to make up for this deficiency through our dietary intake as we cannot produce vitamin D as effectively in the winter as there is less sunlight available to us.
As a result, when it comes to treating Seasonal Affective Disorder, good eating habits and/ or Vitamin D supplements are important so clients can make sure to maintain their Vitamin D levels. And ultimately fight against seasonal depression.
Clinical Psychology Conclusion
Often we focus so much on depression that we tend to forget that other mood disorders exist. That's why I really enjoyed this podcast episode because we got to see that Seasonal Affective Disorder is characterised by depressive, manic or hypomanic episodes starting in the winter months and ending or changing in the summer months for at least the past 2 years.
Also, we got to see that Bright Light Therapy is an effective treatment for SAD. Which to me is oddly hopeful because it just goes to show that interventions for certain conditions don't need to be scary, expensive and time-consuming. SAD can be treated with an affordable Light Therapy lamp and as long as the client does this early in the morning for at least 15 minutes a day then hopefully they should start to see an improvement.
And considering most of the interventions we learn about on the podcast take on psychotherapy that takes 3 months at least according to NICE guidelines. Light therapy is a pretty fascinating treatment option and that's why different mental health conditions are great to learn about, because you never know what's going to excite you. For me it was light therapy, for you it might have been completely different.
That's one of the many joys of learning about the fascinating world of mental health.
Don't you agree?
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
CBT For Depression: A Clinical Psychology Introduction To Cognitive Behavioural Therapy For Depression. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
Have a great day.
Clinical Psychology References And Further Reading
Bertrand, L., d'Ortho, M. P., Reynaud, E., Lejoyeux, M., Bourgin, P., & Geoffroy, P. A. (2021). Polysomnography in seasonal affective disorder: a systematic review and meta-analysis. Journal of Affective Disorders, 292, 405-415.
Cotterell, D. (2010). Pathogenesis and management of seasonal affective disorder. Progress in Neurology and Psychiatry, 14(5), 18-25.
Do, A., Li, V. W., Huang, S., Michalak, E. E., Tam, E. M., Chakrabarty, T., ... & Lam, R. W. (2022). Blue-light therapy for seasonal and non-seasonal depression: a systematic review and meta-analysis of randomized controlled trials. The Canadian Journal of Psychiatry, 67(10), 745-754.
Galima, S. V., Vogel, S. R., & Kowalski, A. W. (2020). Seasonal affective disorder: common questions and answers. American family physician, 102(11), 668-672.
Horowitz, S. (2008). Shedding light on seasonal affective disorder. Alternative and Complementary Therapies, 14(6), 282-287.
Melrose S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression research and treatment, 2015, 178564. https://doi.org/10.1155/2015/178564
National Institute of Mental Health. Seasonal Affective Disorder. https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder
Roecklein, K. A., & Wong, P. M. (2020). Seasonal affective disorder. Encyclopedia of Behavioral Medicine, 1964-1966.
Thalén, B. E., Kjellman, B., & Wetterberg, L. (2020). Phototherapy and melatonin in relation to seasonal affective disorder and depression. In Melatonin (pp. 495-511). CRC Press.
UGA Today. (2015, January 20.) Vitamin D deficiency, depression linked in study. https://news.uga.edu/vitamin-d-deficiency-depression-linked-in-study/
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