Seasonal Affective Disorder Causes, Symptoms, Treatment, Ayurveda Concept

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Seasonal Affective Disorder (SAD) is a type of mood disorder and a kind of depression to be precise. This kind of depression occurs in relation to the changes in the seasons. This condition saps one’s energy and brings about mood variations. The person would usually be in a low mood. SAD is treated with a combination of psychotherapy, medications and phototherapy.

This condition is considered by many people as ‘casual disturbance of health due to season’ or ‘winter blues’ or ‘seasonal funk’. It should not be neglected in actual sense. One should constantly keep oneself motivated throughout the year in terms of their mood and motivation.
Read – Ritucharya – Ayurvedic Seasonal Regimen – 3rd Chapter – Ashtang Hriday

Symptoms of SAD

The symptoms of this condition usually occur during late fall or early winter. The symptoms go away during the spring and in summer. There is also an opposite pattern. This condition begins less commonly in spring or summer. In both the patterns of presentation of SAD the symptoms start in milder form and become more severe as the season progresses.

Signs and symptoms –
Depression – the patient will be depressed for most of the day, almost everyday
Loss of interest – one would lose interest in the same activities which he or she used to enjoy previously
Low energy
Sleep issues like excessive sleep / insomnia / disturbed sleep patterns
Feeling low or high
Feeling of guilt, hopelessness, worthlessness
Frequent thoughts of death or suicide
Difficulty in concentrating
Change in pattern of appetite
Changes in body weight
Read – Depression Causes, Ayurvedic Treatment, Tips And Remedies

Symptoms of SAD variants

1. SAD occurring in winter and fall

This condition is also called as winter depression and presents with below mentioned specific symptoms –
Excessive drowsiness and oversleeping
Low energy
Tiredness
Variations in appetite / food crave
Crave for foods rich in carbohydrates
Gain in body weight
Read – Effective Obesity Treatment, Remedies, Ayurveda Tips

2. SAD occurring in spring and summer

SAD which starts in summer is often called as summer depression and presents with the below mentioned signs and symptoms –
Insomnia / trouble in falling asleep
Poor appetite and dislike towards food
Anxiety / agitation
Loss of bodyweight

Effect of seasonal changes in bipolar disorder

Symptoms of mania or hypomania may come on during spring and summer in some people with bipolar disorder. Some people with bipolar disorder may suffer from symptoms of depression during fall and winter.
Read – Ayurvedic Health Tips For Summer Season

When to consult doctor?

During seasonal changes it is normal to have some sickness, feel mentally low and unmotivated. But when one feels down for many days at a time and cannot get motivated and moving and doesn’t feel like doing any activities or when one doesn’t enjoy the same activities which he or she had enjoyed previously one should see the doctor. The other accompanying signs which should alert you to see the doctor are change in sleep and appetite patterns, when one consumes alcohol for comfort or relaxation or when one feels hopeless or get thoughts of suicide.
Read – Depression, Suicidal Tendency: Case Study, Counselling

Causes of Seasonal Affective Disorder

Specific causes of SAD remain unknown. But some of the below mentioned factors can be considered as causal –

• Circadian rhythm (biological clock) – reduced levels of sunlight and their influence in fall and winter will disrupt circadian rhythm and eventually cause symptoms of depression.
• Decrease of serotonin level – reduced sunlight in the winter might cause drop in serotonin which might cause or trigger depression.
• Melatonin levels – The melatonin levels of the body might go into imbalance due to the impact of seasonal changes. This plays an important role in sleep patterns and mood.
  Read – Somatoform Disorders Symptoms, Ayurveda Treatment

Risk Factors

Sex – SAD occurs more in women
Age – occur more frequently in younger adults
Family history – Those having SAD might have one or more blood relatives who are suffering from the same topic or another form of depression.
Major depression or bipolar disorder – If you have any one of these conditions the symptoms of depression might worsen seasonally.
Distance from the equator – SAD is found to be more common in people living far north or south of the equator. This might occur due to decreased sunlight during winter. It might also occur during longer days of summer.
Read – Ayurvedic Winter Regimen – 75 Diet And Lifestyle Tips

Complications of Seasonal Affective Disorder

If SAD is not treated properly and promptly it might cause many complications. They include –

• Substance abuse
• Suicidal thoughts and behaviour
• Problems at school or work
• Social withdrawal
• Anxiety, eating disorders and other mental health disorders

When promptly treated complications can be prevented. For this to happen, SAD needs to be diagnosed and treated at the earliest before the symptoms get worse.
Read – Social Anxiety Disorder Causes, Symptoms, Treatment, Ayurveda Concept

Diagnosis

Since other forms of depression or mental health disorders can cause similar symptoms it is not always easy for the physician or mental health professionals to diagnose SAD in spite of having conducted a thorough clinical evaluation.

Below mentioned tests may be preferred for making a precise diagnosis of SAD–

Physical examination – Physical examination and interrogation may be conducted on you by your doctor or health care / mental health professional. Depression in some cases may be linked to one or the other underlying physical health problem and the physician tries to rule out these conditions.
Laboratory tests – You may require to get your complete blood count and thyroid function tests done.
Psychological evaluation – You may be put into a thorough psychological evaluation by your consulting doctor or you may also be referred to a specialist / mental healthcare professional for the same in order to check or rule out the signs of depression.
DSM-5 – symptoms listed in DSM-5 (published by the American Psychiatric Association) may be used as criteria for diagnosis by your mental health professional.
Read – Separation Anxiety Disorder Causes, Symptoms, Treatment, Ayurveda Concept

Treatment

Light Therapy / Phototherapy – expose to bright light immediately after you wake up in the morning. This is believed to bring about changes in brain chemicals linked to your mood and provide the same effect of getting exposed to natural outdoor light if not the same. It is said to be the treatment of choice for SAD which begins in fall.
Medications – Antidepressant treatment
Psychotherapy – It is also called talk therapy. CBT i.e. cognitive behaviour therapy is a type of psychotherapy which helps in relieving the symptoms of SAD. This will help to manage stress, learn ways to cope with SAD and its symptoms, to schedule one’s activities, to identify and change negative thoughts and behaviours.

Note – Intimate your doctor if you have diagnosed bipolar disorder. Light therapy or antidepressant can trigger a manic episode.

Mind-body connection is a method used to cope up with SAD and it includes –

• Meditation
• Relaxation techniques
• Yoga or Tai Chi
• Music therapy
• Art therapy
• Guided imagery

Read – Stress Causes, Types, Tips On How To Handle Stress

Lifestyle, Home remedies

These measures shall be included into the treatment plan. They may not yield results when independently used.

Creating brighter and sunnier environment –

• open blinds
• trim out tree branches around your house which might block sunlight entering your home
• add skylights at home or work place
• sit closer to open windows from where the light enters at office or work office

Go outside and roam around – Make a habit of getting outside your office and practice the below said measures regularly –

• walk for long distances
• take daily lunch in a park nearby to office wherein you get good air and light
• soak up the sun by sitting on a bench
• spend time outdoor even on cold or cloudy days which will help you in utilizing outdoor light

Indulge in daily and regular exercise – Anxiety and stress helps in increasing SAD symptoms. Exercise and other physical activities when done regularly will help in relieving anxiety and stress. Fitness tapped from exercise will elevate your mood and helps in combating SAD.
Read – Exercise Timing, Benefits, Side Effects, Ayurvedic Management

Below mentioned steps might help you in managing SAD –

Stick to a treatment plan
Self-care – If you are a patient of SAD you need to follow the below mentioned as a part of self-care –

• sleep well so as to get good sleep, don’t oversleep
• take part in exercise program / other form of regular physical activity
• choose your meals and snacks sensibly
• avoid alcohol and recreational drugs for getting relief from SAD symptoms

Stress management – learn different techniques to manage stress in a better way. Depression, overeating or other unhealthy behaviors and thoughts are often caused by unmanaged stress.

Take a trip – go for winter vacations and choose sunny and warm locations for the same especially if you have winter SAD. You may prefer to go to cooler locations if you have summer SAD.

Socializing – connect with people and enjoy your life to the best possible extent. People whom you trust and hang out with will offer support when needed.
Read – Health Benefits Of Yoga: Mind And Body

Research

In a study ‘Seasonal sensitivity and psychiatric morbidity – study about SAD’ – it was found that there is a statistically significant association between psychiatric morbidity and SAD. (Read more)

Another study tells that the success in implementation of SAD prevention does not solely depend on the willingness of the patients but is also influenced by external factors. (Read more)

Another study showed that the light therapy has an antidepressant action by a nonspecific effect in SAD treatment. (Read more)

Ayurveda Concept of SAD

Rtucharya is a concept wherein Ayurveda has explained about the seasonal classification, changes, doshic variations taking place therein, possible diseases which might be caused due to seasonal changes and their impact / related dosha aggravation (seasonal disorders), dietetic and lifestyle adaptations to be made and followed during seasons and seasonal junctions for maintaining health and treatment of seasonal disorders.
Read – Ayurvedic Seasonal Regimen Based on Different Climatic Conditions

SAD as per Rtucharya explained in Ayurveda

As per explained in Ayurveda treatises each dosha undergoes a stage of accumulation in one season, a stage of aggravation in its next season following auto-pacification in the very next season.

A dosha can aggravate to severe proportions and tend to cause diseases (physical and mental) if –

• Seasonal regimen is not followed properly
• If one consumes foods and exposes to lifestyle practices which tend to aggravate the dosha to severe proportions in the season favorable for its aggravation
• If the person doesn’t make essential changes in diet and lifestyle practices for the upcoming season in the transition phase of a season i.e. when one season is about to finish and other season is about to start (rtu sandhi – seasonal junction)

The same rules are also applicable for SAD.
Read – Ritu Sandhi – Seasonal Junction, Meaning, Rules To Follow, Precautions

1. Autumn / fall onset SAD
The explanation of SAD says that it usually occurs during autumn or early winter and the symptoms go away in spring and summer.

SAD typically occurs in the junction of Sharad and Hemanta Rtu i.e. when the Sharad Rtu is making its transition into Hemanta Rtu.
Read – Ayurvedic Health Tips For Autumn Season

From the dosha perspective – pitta undergoes aggravation in sharad rtu and subsides naturally in hemanta rtu. In the same hemanta rtu and also in its subsequent season i.e. shishira rtu (late winter), kapha accumulates in the body. So in the late fall and early winter the heat component of pitta is gradually decreasing with seasonal transition and transformation and kapha is taking its authority over the body. This happens because the watery components (kapha) dominate the fiery (pitta) components in the seasonal junction and also the upcoming season. This happens in everyone immaterial of the body constitution.

Mechanism of SAD – As the kapha increases in the body with the onset of its accumulation things get slowed down in the body. The physical and mental functions and activities slow down. It is a natural process and will come back to normalcy when the kapha decreases in the spring season. But the increased kapha in late fall or winter will definitely have an influence on the body and mind in terms of slowing down things. If seasonal regimen is not properly followed the symptoms of kapha increase may be seen in a severe way. The aggravated kapha may go ahead to produce diseases in later periods of time. Increased kapha will have a depressing effect on the mind and will cause symptoms similar to SAD.
Read – Kapha Increase Symptoms – Kapha Vruddhi Lakshana

2. Variant of SAD (SAD occurring in spring and summer)

This is an opposite pattern of SAD and is less common. It occurs in spring or early summer.

Spring season is Vasanta Rtu. Summer season is Grishma Rtu. These two seasons occur in the same chronology even according to Ayurveda explanation of seasons. SAD typically occurs in the spring season or when this season transits into the next season summer – at the onset of summer (early summer) to be precise.

From the dosha perspective – In spring season kapha undergoes aggravation / vitiation naturally. Kapha naturally decreases in the next season i.e. grishma rtu i.e. summer season. Early summer falls in the junction period of spring and summer and few initial days of summer wherein the effect of spring is still there. This time period belongs to kapha predominance.

Mechanism of SAD – The mechanism of SAD and the manifestation of its symptoms will be similar to the ‘fall onset SAD’ since the events in this variant are also caused and triggered by kapha.

According to Ayurveda a particular dosha accumulates in a season and gets aggravated in its next season. Example – kapha accumulates in the winter season and aggravates in the spring season. Similar opinions are given in modern medicine in the explanation of SAD and its symptoms. It is said that in both the patterns of presentation of SAD the symptoms start in milder form and become more severe as the season progresses.
Read – 15 Ayurvedic Health Tips For Spring Season

Ayurveda Treatment

1. Rtucharya – following seasonal regimen

• Following the seasonal regimen in terms of diet and lifestyle choices in the fall and spring seasons i.e. sharad and vasanta rtu properly.
• Taking care of kapha increase in the above mentioned seasons by following kapha balancing diet and lifestyle activities
• Adapting to the seasonal transitions so as to get adjusted to the upcoming season

2. Manasika Roga Chikitsa – SAD should be treated on the lines of general treatment of mental disorders as explained in Ayurveda.

3. Manovaha Sroto Dushti Janya Vikara Chikitsa – SAD shall also be treated on the lines of treating ‘contamination of mind carrying channels’.
Click to Consult Dr Raghuram Y.S. MD (Ayu)