Winter Blues Got You SAD? Symptoms and Solutions for Seasonal Depression

by Debra Milinsky, MSW, LCSW

 ::  When those hot, sultry, end of summer, dog day blahs morph into winter mood indigo blues, is it SAD — Seasonal Affective Disorder?

 “You ain’t been blue, no, no, no;  You ain’t been blue ’til you’ve had that mood indigo. That feelin’ goes stealin’ down, down to my shoes. While I sit and sigh, “So long, blues.”                                         Mood Indigo  Lyrics: Mitchell Parish ~ Music: Duke Ellington & Barney Bigard

Are you feeling a bit more tired and sluggish lately? Maybe you feel less energetic, even a bit depressed, hopeless, dark, as daylight hours decrease in October, November and December. You find you can’t get a restful night of sleep, can’t focus, concentrate or finish tasks.

As year-end pressures build to get everything done at home and at work, you find yourself in a hurry-up-and-collapse rip-tide. All you want to do is withdraw, sleep and surrender to that urge to hibernate until spring.

Is it just the winter blues or a seasonal clinical depression?

If you notice any of these behavior patterns and mood changes that begin as summer fades to winter, patterns that last at least four weeks and for at least two years in a row, you might be among the 14% of people living in northern climates who report “winter blues”, or among the estimated 6% of the US population who experience a more intense, protracted “Seasonal Affective Disorder” or “SAD” (Rosenthal, 2006.) Consider that when these two groups are combined, approximately 20% or one in every five Americans suffer from symptoms of depression during winter months!

Less common but just as disruptive are seasonal mood symptoms that appear in the spring when increasing sunlight brings debilitating anxiety, a feeling of over-exposure, the wish to isolate and crawl right back to bed.

Adapting to environmental changes is essential for survival

Sensitivity to seasonal changes and biological cycles are fundamental facts of nature that affect all organisms large and small. Animals seem to respond more predictably to environmental influences with distinct seasonal rituals for food gathering and storage, mating, migration and hibernation.

When humankind began to move away from the temperate equatorial cradle of civilization where hours of sunlight and temperature are more balanced and mild, these earliest travelers had to adjust and adapt in order to survive. Even though adaptation to the immediate external environment is necessary for survival, every living creature has an internal rhythm coded in the deep structure of evolutionary memory that still marches to an ancient drumbeat.

Have we forgotten the beat of our circadian rhythm?

Later, technology and the industrial revolution would irreversibly disrupt the ways in which our ancestors’ lives were regulated by sunrise and sunset. The demands of modern life and our new-found ability to ‘see in the dark’, radically changed the way we live and work. Our circadian rhythms and bio-psycho-social health needs for sensory attunement with nature, for predictable sleep cycles and mealtimes, for a good balance of work, exercise and play, and for the support and structure of socializing and family life, have become less and less influenced and regulated by the natural world.

Technological advances, and in many cases economic necessity, have made the 24-7 work schedule a fixture of modern life. We work swing and night shifts, we work day jobs in office cubicles without natural light, leaving home in the early morning darkness and returning after the sun has set. We survive on less and less sleep while frantically “multi-tasking.”

Electronic devices allow us to connect in nano-seconds and paradoxically lose ourselves and huge chunks of time sitting virtually immobilized for hours in front of mesmerizing television and computer screens. Thus, our abilities to regulate and maintain a healthy balance of work, family and personal life have become increasingly challenged and stressful.

What does sunlight have to do with it?  Mood assessment tool measures seasonal changes in the following six areas: length of sleep, social activity, mood, weight, appetite and energy level

The surprising effects of environmental changes on mood, and particularly the loss of natural sunlight, was immediately brought home to researcher, Dr. Norman Rosenthal, when he moved from his native South Africa to New York City in 1979. Previously aware that his own moods fluctuated with the seasons, Dr. Rosenthal discovered that his mood symptoms intensified when he experienced his first northern hemisphere winter. Together with colleagues at the National Institute of Mental Health in Bethesda, Maryland, he began a several decades-long study of how brain chemistry varied with mood, developing the Seasonal Pattern Assessment Questionnaire (SPAQ), a subjective measure used to diagnose adults with this form of mood disorder.

The resulting “seasonality score” differentiates winter blues from SAD, and has been used in many subsequent studies all over the world. Research indicates that people living in the northern hemisphere are much more likely to suffer in varying degrees from winter blues and more severe SAD symptoms.

Women are more likely to have SAD than men

Studies also show that women are more likely to have SAD than men, which may be linked to hormonal changes between menarche and menopause and other psychosocial factors that show women are twice as likely to be diagnosed with depression than are men.

One million US children and adolescents suffer from seasonal depression

It is estimated that about 3% of US children ages 9-17, or approximately one million children and adolescents, suffer from seasonal depression making this more subtle symptom picture as common as ADD/ADHD (Rosenthal, 2006; Carskadon and Acebo, 1993.) If you notice that your child or teen shows a pattern of beginning each fall semester with great promise until attitude and performance take a nose dive by Halloween, consider that mood and behavior consequences of seasonal changes may be the culprit! Your child is not bad… he or she may have SAD!

What you can do if you think that you or a family member may have seasonal depression?

There are a number of options ranging from “do-it-yourself” life-style changes to seeking professional consultation. Anticipating the impact of seasonal changes and stepping up self-care – greater attention to sleep, healthy diet, movement and exercise – is always a good place to start. Light therapy, which seeks to augment decreasing hours of natural light during winter months with prescribed light box exposures, and cognitive-behavior therapy (CBT) interventions that identify and examine core beliefs and behaviors in order to develop more effective skills to regulate and manage mood, offer significant relief for many SAD sufferers. Anti-depressant medications that regulate serotonin and dopamine levels may also offer relief from SAD symptoms. A combination of light therapy and routine exercise to prevent seasonal symptoms and improve mood is also an effective combination for many study participants (Leppamaki, 2006.)

When it comes to diet, exercise, medication and therapy — one size does not fit all

Many of life’s problems are managed and resolved within a supportive and resourceful community of family and friends, personal resilience, and with the “tincture of time.” When distress is seasonal, lasts for a number of weeks and months, and when symptoms emerge that disrupt work, school and family life, professional consultation can offer new perspectives, resources and skills that quicken recovery and bring relief from SAD’s uninvited symptoms and suffering.


Carskadon, Mary A., PhD, and Acebo, Christine, PhD, Parental Reports of Seasonal Mood and Behavioral Changes in Children. Journal of the American Academy of Child & Adolescent Psychiatry, 32:2, March, 1993.

Leppamaki, Sami, The Effect of Exercise and Light on Mood, Academic Dissertation. Helsinki, FINLAND: National Public Health Institute, Department of Mental Health and Alcohol Research, University of Helsinki, Department of Psychiatry, 2006.

Rosenthal, Norman E., MD, Winter Blues: Everything You Need To Know to Beat Seasonal Affective Disorder. New York: Guilford Press, 2006.

Smith, Laura L., PhD, and Elliott, Charles H., PhD,  Seasonal Affective Disorder for Dummies. Indianapolis, Indiana: Wiley Publishing, Inc., 2007.

© Copyright 2013 Debra Milinsky, MSW, LCSW

::  We invite your reply and comments in the space provided below  ::


Debra Milinsky, MSW, LCSW, is a licensed psychotherapist, practicing in Berkeley and Vallejo. She helps women and men, couples and families, mothers and daughters from diverse cultural and ethnic backgrounds, sexual and gender identities develop healthy, harmonious and satisfying relationships. She has been a guest on KISS-FM radio, Childhood Matters, discussing family violence and domestic abuse prevention and intervention, and is a Past-President of the Association of Family Therapists of Northern California.

Contact Debra Milinsky @ 510.525.7575.

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