How to Avoid Having SAD Winter: Seasonal Affective Disorder

By Anna Kelman

As we coast through the end of apple picking and start dreaming of Thanksgiving pies, autumn comes to an end, and we are soon greeted every morning by gray winter skies; millions of people experience more than just a preference for warmer weather. Seasonal affective disorder (SAD) is a form of depression that follows the natural seasonal progression, emerging primarily during the end of fall and all through the winter months when sunlight exposure decreases. While commonly referred to as the "winter blues," this condition represents a genuine psychological phenomenon with significant impacts on mental health and daily functioning.

Clinical Classification and Diagnosis

From a clinical standpoint, SAD is classified as a subtype of major depressive disorder, characterized by recurrent episodes of depression that occur in a seasonal pattern. The official diagnostic term from the DSM-5-TR is major depressive disorder with seasonal pattern, emphasizing that this isn't simply feeling down during winter—it's a clinically significant form of depression.

To meet diagnostic criteria for SAD, individuals must first satisfy the requirements for major depressive disorder, which include experiencing five of nine symptoms plus anhedonia (loss of pleasure) for at least two weeks. Critically, this seasonal cycle must occur for two consecutive years to meet the specific criteria, distinguishing it from a single depressive episode that happens to coincide with winter.

Symptom Presentation

The psychological symptoms of SAD mirror those of major depressive disorder but often include distinctive features. Common manifestations include persistent sadness or low mood, loss of interest or pleasure in activities, disrupted sleep patterns (generally oversleeping), and changes in appetite and weight.

A particularly notable pattern is the tendency for people to "hibernate," with increased cravings for carbohydrate-rich foods, excessive snacking, weight gain, decreased energy and activity levels, fatigue, and difficulty concentrating. In severe cases, individuals may experience increased feelings of hopelessness, worthlessness, and suicidality. This cluster of symptoms—sometimes called "atypical" depression features—helps distinguish seasonal patterns from other forms of depression (Geddes 2025).

Gender Differences

Based on the research by Gagnon (2012), there are notable gender differences in Seasonal Affective Disorder (SAD) and seasonality. Women experience significantly higher prevalence rates of SAD, with approximately 80% of cases occurring in females, representing a 4:1 ratio compared to men. Women also reported higher levels of rumination and greater seasonal severity scores than men. The predictors of seasonality differed substantially between genders: for women, rumination, seasonal attitudes, negative automatic thoughts, and the impact of sunny weather were significant predictors, while for men, the predictors included negative automatic thoughts, mental disengagement, seasonal attitudes, social instrumental support, and, notably, the impact of cold weather as a negative predictor. Women also employ different coping strategies than men, reporting greater use of positive reinterpretation, social emotional support, mental disengagement, and emotional venting, while men reported using more humor and alcohol/drug use coping strategies. Particularly significant was the finding that rumination was a unique predictor of seasonality in women alone, not in men, which may help explain the substantial gender disparity in SAD prevalence rates.

Prevalence and Geographic Patterns

The diagnosis for SAD is still relatively new, but current epidemiological studies suggest approximately 5% of U.S. adults experience some version of the disorder (Berg, 2025). However, the reach extends further: up to one in five additional U.S. adults experience some neurovegetative symptoms of SAD that don't fully meet criteria for the complete disorder, such as decreased energy, sleep disruption, or reduced concentration without the full spectrum of symptoms.

The prevalence varies significantly based on geographical location, with higher rates reported in places where days are generally shorter. Higher latitudes, such as Scandinavian countries, tend to show a higher prevalence of SAD. In contrast, studies of Amish communities in the U.S.—who spend more time outdoors and less time exposed to artificial light at night—show some of the lowest SAD rates among Caucasian populations, while prevalence in New York reaches about 4.7% (Geddes 2025).

Biological and Psychological Mechanisms

While not fully understood, theories suggest SAD is linked to reduced sunlight exposure and circadian rhythm disruption during winter months. The condition appears to result from a combination of circadian rhythm disruption and serotonergic and melatonin imbalances that occur with the change in sunlight exposure, as both play crucial roles in mood regulation and sleep.

Recent scientific advances have revealed that seasonal changes in human mood are likely endogenous part of our fundamental physiology rather than just reaction to external circumstances. Light serves as one of the key regulators of our circadian clock, influencing hormone release timing, alertness, and mood; without sufficient daylight—especially when combined with excessive artificial light in evenings—these rhythms can drift out of sync with the external world.

The Social Isolation Cycle

Social isolation tends to coincide with neurovegetative symptoms; reduced interest in activities and low energy lead people to isolate because they don't want to interact with others, creating a self-reinforcing cycle. This psychological phenomenon compounds the biological aspects of SAD, as withdrawal from social support networks can intensify depressive symptoms while simultaneously removing potentially therapeutic social interactions.

Treatment Approaches

From a psychological treatment perspective, psychotherapy can work wonders for patients with depression or SAD, though accessing psychotherapists can be challenging. Cognitive behavioral therapy tailored for SAD can be as effective as light therapy, helping people reframe their relationship with winter rather than simply managing symptoms.

Light therapy using bright white lights remains a common treatment, with exposure ideally occurring first thing in the morning rather than at night to avoid disrupting sleep patterns. Other interventions include traditional lifestyle adjustments such as sleep hygiene, stress management, physical activity, and exercise, along with maximizing exposure to natural daylight during the day.

The Importance of Professional Support

Mental health professionals emphasize that people don't need to suffer for months; destigmatizing mental health care and surrounding conversations can help individuals seek timely treatment. All adults should be screened for depression at least once in their lifetime, using freely available instruments like the PHQ-9 or Geriatric Depression Scale.

Understanding SAD from a psychological perspective reveals it as a complex interplay of biological rhythms, environmental factors, and psychological responses. Recognition, proper diagnosis, and appropriate treatment can help those affected reclaim their well-being during the darker months, transforming winter from a period that can be filled with (literal and figurative) darkness into a season that is still full of cheer. 

References

Berg, S. (2023, November 3). What doctors wish patients knew about seasonal affective disorder. American Medical Association. https://www.ama-assn.org/public-health/prevention-wellness/what-doctors-wish-patients-knew-about-seasonal-affective-disorder

D., & Gagnon, A. (2012).  Coping and Gender Differences in Seasonality and Seasonal Affective Disorder Affective Disorder. https://digitalcommons.library.umaine.edu/cgi/viewcontent.cgi?article=1049&context=honors

‌Geddes, L. (2025, November 2). How scientists are shining light on the biology behind seasonal affective disorder. The Guardian; The Guardian. https://www.theguardian.com/society/2025/nov/02/how-to-beat-the-winter-blues-seasonal-affective-disorder