Seasonal Affective Disorder
What is Seasonal Affective Disorder?
Seasonal Affective Disorder (SAD) is a form of depression in which symptoms return during a specific season, most commonly in autumn and winter. It is the same diagnosis, a depressive disorder, but with a clear seasonal pattern. Seasonal depression is therefore not a separate diagnosis, but a specifier within depression indicating that the symptoms follow a recurring pattern. With seasonal depression, you may experience depressive symptoms such as low mood, fatigue, and a lack of energy, which occur each year during the same period and often improve again in spring or summer.
Symptoms can vary in severity, but are often accompanied by an increased need for sleep, reduced motivation, and difficulty maintaining a daily routine. Because it returns each year, it can be frustrating to notice the same symptoms repeating. That is why it is important to take this pattern seriously and to explore appropriate treatment and support in time, so you can better prepare for the period in which symptoms return.
Recurring pattern
Many people recognize that their symptoms begin around the same time each year. This predictable pattern can help you take action earlier and reduce the impact of symptoms.
Influence of daylight
Reduced daylight has a direct effect on your brain and hormones. This can lead to fatigue, low mood, and a disrupted sleep pattern during the darker months.
Biological rhythm
Your mood can gradually change, with increasing low mood, reduced motivation, and less enjoyment in daily activities. Maintaining routines can start to feel more difficult.
When is it considered a seasonal pattern?
In seasonal depression, there is a recurring pattern of depressive symptoms in a specific season, usually in autumn and winter. It is not a one-time period of low mood, but symptoms that return each year.
A seasonal pattern is identified when symptoms:
- Occur during the same period for multiple consecutive years
- Are related to seasonal changes
- Clearly improve or disappear during other periods (such as spring or summer)
Important
Although seasonal depression most commonly occurs in autumn and winter, symptoms can also develop in other seasons, such as summer. In that case, it is still considered a seasonal pattern, but the symptoms often present differently.
Winter depression
Winter depression is the most common form and typically develops in autumn or winter. Many people experience a decline in energy and mood during this period.
You may feel low, have less motivation, and need more sleep. It may also be harder to get started in the morning, and daily activities can require more effort. Some people also notice an increased appetite, especially for carbohydrates.
Symptoms often improve again when spring begins.
- Less energy
- Increased need for sleep
- Increased appetite
- Low and slowed-down feeling
Summer depression
Summer depression is less common, but can present differently. Instead of fatigue and slowed-down feelings, people more often experience restlessness and tension.
You may experience irritability, sleep problems, or a feeling of agitation. Appetite may decrease, and it can be harder to relax. Longer days, heat, and changes in routine can play a role.
Symptoms often improve again when the season changes.
- Increased restlessness
- Poor sleep
- Reduced appetite
- Irritability and a restless feeling
Why does your mood change with the seasons?
The effect of light on hormones
In autumn and winter, you are exposed to less daylight. This affects your biological clock, which regulates your sleep-wake cycle. As a result, you may feel more tired and find it harder to get going. The hormone melatonin also plays a role. This hormone is produced in darkness and helps regulate sleep. In winter, your body may produce more melatonin, making you feel more sleepy and less energetic.
Daylight also influences serotonin, a neurotransmitter involved in mood and motivation. Reduced light exposure can disrupt this balance, contributing to low mood and reduced enjoyment in daily activities.
Differences between seasons
In other seasons, your brain also responds to changes in light and environment. In spring, increased daylight often leads to higher serotonin levels, helping you feel more energetic and stable. During summer, longer days and higher temperatures can affect your sleep-wake cycle and melatonin production. This may lead to difficulty sleeping or relaxing. Increased stimulation can also affect stress systems in the brain, leading to restlessness or irritability.
Your brain and hormones are constantly adapting to these changes. For most people, these fluctuations remain within normal limits. However, in individuals who are more vulnerable to depressive symptoms, these changes can have a stronger impact, leading to worsening symptoms and a recurring seasonal pattern.
The impact of Seasonal Affective Disorder
In seasonal depression, depressive symptoms return in a fixed pattern, usually during the same period each year. This recurring impact on daily functioning makes it important to take timely steps and prepare for periods when symptoms may return or worsen.
Temporary worsening
During certain times of the year, existing symptoms may temporarily worsen. Even if things were improving before, you may notice your mood declining again and your energy decreasing. This is often linked to changes in light and rhythm.
Anticipatory stress
If you know that symptoms return each year, you may start to feel tension even before the season begins. You may dread the months ahead, which can affect your mood. This can also increase feelings of hopelessness, as the season does not change quickly.
Sensitivity to change
Even when depressive symptoms have improved or resolved, you may remain sensitive to seasonal changes. Your brain and body may respond more strongly to these shifts, making it important to stay aware of this sensitivity.
When do we treat seasonal depression with rTMS?
At rTMS International, we primarily use rTMS for depression with a seasonal pattern when there is also treatment-resistant depression, meaning previous treatments have not been sufficiently effective.
Based on scientific evidence and clinical experience, we see that rTMS is most meaningful and effective in these cases. There is often a broader imbalance in brain activity, and rTMS can help restore this balance, contributing to improvements in mood and energy. Because seasonal depression follows a recurring pattern, we look not only at current symptoms, but also at how they develop over time. This allows us to carefully assess whether and when rTMS is an appropriate treatment option.
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