Autumn depression in adults

Many people report “autumn-winter blues” or autumn depression, which in fact, from a medical point of view, is correctly called seasonal affective disorder (SAD). It affects 1–3% of adults and can markedly reduce quality of life. This disorder shares features with major depressive disorder (MDD). The main difference, according to psychiatrists, is that the symptoms of this disorder follow a specific seasonal schedule, with problems usually occurring during the fall/winter months, with complete remission in the spring and summer.

Researchers have found that many of the specific symptoms of autumn depression, or SAD, are similar to those of depression—loss of energy, interest, changes in appetite, problems with sleep and concentration, etc. However, this type of depression is more likely to cause fatigue, increase sleep, increase appetite , especially for high-carbohydrate foods and weight gain, than for non-seasonal depression.

What is depression?

Many people go through short periods of time when they are sad or not like themselves. Sometimes these mood swings start and end with the change of seasons. People may start to feel “down” when the days get shorter in autumn and winter (which is why it’s often called the “autumn or winter blues”), and start to feel better in the spring when daylight hours get longer.

In some cases, these mood changes are more severe and can affect how a person feels, thinks, and manages daily activities. If you notice significant changes in your mood and behavior as the seasons change, you may be suffering from seasonal affective disorder (SAD), a type of depression.

Causes of autumn depression in adults

In most cases, the symptoms of autumn depression begin in late autumn or early winter and resolve in spring and summer. Some people may experience depressive episodes during the spring and summer months—this is called summer SAD, or summer depression, and is less common.

The scientists explain that there are many theories behind the causes of autumn depression in adults, but the most widely accepted is that the amount of sunlight people are exposed to in the fall and winter decreases. If you look at the prevalence of major depression at different latitudes, studies show that it is quite common in northern latitudes, and much less common in southern latitudes.

Sunlight affects an area of ​​the brain called the suprachiasmatic nucleus, which is located in the hypothalamus and is responsible for functions such as sleep, heart rate and blood pressure, appetite, weight regulation, and sexual function.

• One theory is that with less exposure to sunlight, the internal biological clock that regulates mood, sleep hormones, shifts in humans. Exposure to light can reset the biological clock.
• Another theory is that brain chemicals (neurotransmitters such as serotonin) that relay information between nerves may change in people with SAD. It is believed that exposure to light can correct this imbalance.

Melatonin, a key chemical known to affect sleep patterns, may also play a role in triggering seasonal affective disorder. Some researchers have suggested that lack of sunlight stimulates the production of melatonin in some patients. This may be one of the factors that cause lethargy and drowsiness.

Young people are more likely to develop SAD, and the risk decreases with age. A family history of mood disorders or other forms of depression increases the risk of developing problems.

Symptoms of autumn depression in adults

In general, the list of signs and symptoms of SAD is about the same as the symptoms of major depression. However, in autumn depression, these signs and symptoms come and go at about the same time each year. The main symptom is a sad, hopeless mood that:

• present most days and lasting most of the day;
• lasts more than 2 weeks;
• impairs a person’s performance at work, at school, or in social relationships.

Other symptoms of depression include:

• changes in appetite and weight fluctuations (both plus and minus);
• sleep problems (from insomnia to constant drowsiness);
• loss of interest, desire, and desire for work, hobbies, people, or sex;
• withdrawal from family members and friends;
• feelings of worthlessness, hopelessness, excessive guilt, pessimism, or low self-esteem;
• excitement or a feeling of slowing down, lethargy;
• irritability;
• fatigue;
• trouble concentrating, remembering, and making decisions;
• tears come out quickly or you want to cry, but the person is not able to;
• suicidal thoughts (which should always be taken seriously);
• losing touch with reality, hearing voices (hallucinations), or having strange ideas (delusions).

Treatment of autumn depression in adults

It is very important not to self-diagnose. If you have symptoms of depression, see your doctor for a thorough evaluation. Sometimes physical problems can cause depression. But in other cases, SAD symptoms are part of a more complex psychiatric problem. A mental health professional can usually evaluate your symptom pattern and determine if you have autumn depression or another type of mood disorder.

Diagnostics

To receive a diagnosis of SAD, a person must meet the following criteria:

• must have symptoms of major depression or more specific symptoms listed above;
• depressive episodes must occur in certain seasons (i.e., only during the winter or summer months) for at least 2 consecutive years, but not all people with SAD experience symptoms every year;
• these episodes should be more frequent than other depressive episodes the person may have had at other times of the year during their lifetime.

Modern treatments

If you think you may be experiencing SAD symptoms, talk to your GP or psychiatrist.

Therapies that can help many people with SAD fall into four main categories, which can be used alone or in combination:

• light therapy;
• psychotherapy;
• antidepressants;
• vitamin D

World. There is strong evidence that light boxes that are up to 20 times brighter than conventional indoor lighting are very effective. Light boxes are commercially available and easy to buy, however a person should not start light therapy without talking to their doctor or psychiatrist as it may worsen certain eye conditions.

While the artificial sunlight produced by light boxes is effective, nothing works better than natural street light. In general, improved mood usually correlates with longer daylight hours, so most people feel significantly better when spring is in full bloom. Cold weather and many overcast days make it difficult for people to get enough outdoor light during the autumn and winter months.

Psychotherapy. She – “talking therapy” – is also used in the treatment of autumn depression. Cognitive behavioral therapy (CBT) is a type of talking therapy designed to help people learn how to deal with difficult situations. It is also adapted for people with SAD. It is usually done as 2 group sessions per week for 6 weeks and aims to eliminate negative thoughts associated with the winter season (such as the darkness of winter) with more positive thoughts. She also uses a process called behavioral activation, which helps people identify and plan enjoyable indoor or outdoor activities to combat the loss of interest they usually experience during the winter.

Pharmacology. Medications are also effective in treating SAD. But only a specialist should select them. Because SAD, like other types of depression, is associated with abnormalities in serotonin activity, antidepressants called selective serotonin reuptake inhibitors (SSRIs) are used when symptoms appear. These agents can significantly improve the mood of patients. Commonly used SSRIs include fluoxetine, citalopram, sertraline, paroxetine, and escitalopram. All medicines can have side effects. Talk to your doctor about the possible risk of using these medications for your condition.

Healthy lifestyle. Whether medications alone or other treatments or combinations are used, anyone with SAD can benefit from healthy lifestyle changes. A regular sleep and exercise regimen, a healthy diet, and a constant desire to socialize with others can reduce symptoms.

Because many people with SAD are often deficient in vitamin D, vitamin D supplements may help improve their symptoms. However, studies testing whether vitamin D is effective in treating SAD have had mixed results: some results indicate it is as effective as light therapy, while others show no effect.

Prevention of autumn depression in adults at home

Since the timing of winter SAD is predictable, people with a history of depression may benefit from starting the treatment mentioned above before the start of the season to prevent or reduce depression.

To date, very little research has focused on this issue, and existing research has not found conclusive evidence that early initiation of light therapy or psychotherapy can prevent the onset of depression. Only prophylactic antidepressant treatment prevented SAD in study participants, but it also had a higher risk of side effects. Therefore, people should discuss with their doctor beforehand whether they want to start treatment early to prevent depressive episodes.

Popular questions and answers

Answered questions about autumn depression in adults neurologist, teacher of neurology Elena Gayvoronskaya.