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When winter is here, don’t be SAD

When winter is here, don’t be SAD

Seasonal Affective Disorder (SAD) is a type of depression that mostly occurs during the fall season or winters
Seasonal Affective Disorder
Representational image | Shutterstock

Dark mornings, darker evenings and the windy chill of grey days with minimal sunlight can be challenging for many people. With the coldest months come the winter blues in the form of Seasonal Affective Disorder (SAD).  

According to UK’s National Health Services, SAD is sometimes known as “winter depression,” which gives you the blues because the symptoms are usually more apparent and severe during the winter. 

Clinically, there is no diagnosis for the “winter blues”, but mental health experts say that it is common. Feeling sad throughout the fall and winter seasons, trouble sleeping, oversleeping, and lack of motivation and energy usually mark the symptoms of the winter blues.  

The American Academy of Family Physicians states that 10 to 20 per cent of American adults at some level experience seasonal mood changes.  

“Some people experience mood changes with weather changes and are candidates of seasonal depression,” says Dr Vikram Jada, consultant neuropsychiatrist at Dr Vikram’s Brain and Body Clinic, Bengaluru. “Depressive mood with change in season, particularly when there’s less sunlight in winters, is a medical condition called SAD, he says.” 

The Diagnostic Manual of Mental Disorders (DSM-5) identifies SAD as a type of major depressive disorder with seasonal pattern. The National Institute of Mental Health explains SAD as a recurrent form of depression that begins or lasts when the season changes. The symptoms last for four to five months yearly. Feeling depressed most of the time, change in appetite, weight gain, trouble sleeping, hopelessness, agitation, and difficulty in concentrating are the primary symptoms that can affect the ability to function in daily life.  

Difference between SAD and winter blues
Illustration by: Syalima M Das

The internal clock and hormonal mess: 

Both the blues and SAD are related to the reduced amount of sunlight that people are exposed to during the winters. Experts and researchers have found ways that contribute to this sadness. These include: 

  • Circadian rhythm: Sunlight plays a crucial role in regulating the body’s internal clock, or circadian rhythm. This clock helps regulate several important processes in the body, including sleep patterns, mood, and energy levels. When sunlight levels are low as they are during winters, the body’s internal clock can become disrupted, giving the blues or symptoms of SAD. 
  • Melatonin: A sleep-regulating hormone that is produced in the darkness that makes one lethargic, tired, and sleepy at night. In the absence of sunlight in winter and fall, the body produces more melatonin making one feel more lethargic and tired – a hallmark symptom of depression. 
  • Serotonin: A happy hormone that is produced in the presence of light. Reduced sunlight exposure can drop its level. Clinically, a low level of serotonin triggers depressive moods. 

“Those living far from the equator, those having a family history of SAD or other types of depression, and women who have hormone dysfunction every month are at a higher risk of developing SAD,” says Dr Jada. 

Tackle SAD 

One may not be able to change the weather or the amount of sunlight exposure one gets,  there are several strategies that can help manage the symptoms of SAD or the winter blues.

Here are the seven best strategies to tackle it: 

  • Mood and food: Food is the fuel that drives the body to function at its full potential. Experts ask people to include ample amount of protein and complex carbohydrates in every meal and lessen the consumption of simple carbohydrates and sugary foods. A high carb diet or sugary foods and beverages induce a positive feeling. However, in the long term, it does the opposite. 
  • Activate happiness with vitamin D: Include good sources of vitamin D. Research has shown that a low level of vitamin D increases the risk of depression. While another meta-analysis that includes five cohorts and 11 case-controlled studies showed that an increase of 10 nanogram/millilitre vitamin D3 (vitamin D from dietary source) reduced the risk of depression in five of 11 case-controlled and two of five cohort studies.

“The preliminary data from clinical trials have shown improvement in depression with vitamin D supplementation,” says Dr Bharath Holla, department of psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS). “But most of those trials are not of good quality and dietary sources of vitamin D (D3) is always the ideal way to compensate instead of supplementation.”  

  • Lace up and get moving: Physical activity helps in physical outcomes.  But its effect on mental health  still needs awareness. 

When one exercises or simply walks, serotonin and endorphins shoot up while stress hormones are lowered, thereby leading to a happy energetic mood. According to Harvard Medical School, physical exercise for 30 minutes a day improves mood and mental functioning. 

A brisk walk also does the job. A 2022 meta-analysis published in JAMA showed that individuals who walk 2.5 hours each week have a lower risk of depression compared with those with no physical activity.  

  • Shine in the sun: Prioritise going outside during the winter. Experts recommend sitting for at least an hour or two near the windows where ample light comes in when one cannot go out. Natural light helps balance the melatonin, serotonin, and endorphins and therefore improves the emotional state.

“The sun is an important energy provider,” says Dr Kishore Kumar R, professor of Ayurveda at the department of integrative medicine, NIMHANS. “Sunlight gives enough motivation not only to the mind but the body as well.”   

  • Laugh out loud: A study found that humour can balance out negative emotions and  improve sleep quality, mood and reduce symptoms of depression. Moreover, several studies  showed that just thinking about funny events , or watching funny TV shows three to four times a  week can uplift one’s mood.

Laughter, it is said, is the best medicine. Do not underestimate its power. Even faking a smile for a minute can elevate one’s mood. A Kansas State University template suggests keeping one’s brain active in finding humour in situations, especially when one is in need of some relief from stress or frustration.   

  • Vacation and bonfire: Plan a vacation in the winters to a place with ample sunlight.  One  can also set and enjoy a bonfire. A study found that sitting by the fire decreases blood pressure.   The warmth, crackling sounds, smoky smell and light of the fire help soothe, comfort, and relax us, while elevating our mood, particularly in the cold weather.
  • Light therapy: Ever since it was established that light therapy positively affects SAD, the National Institute of Mental Health suggests it as the mainstay to treat SAD. The authority recommends starting one’s day by sitting in front of a light box for 30-45 minutes. 

The light box has a UV bulb, which is brighter than the normal indoor lights and mimics the UV spectrum of sunlight.  

“Light therapy is safe and effective in SAD,” says Dr Holla. “The mimicking of UV spectrum in light therapy tricks the brain to function as it should in the light. The light therapy does not have the harmful effects of UV rays as that of sunlight” 

Since the symptoms and its severity differ in different individuals, experts recommend talking to a mental health professional to diagnose, rule out the cause and to get customised therapy if one’s mental health is deteriorating. Moreover, DSM-5 stresses on proper evaluation as SAD can be misdiagnosed in the presence of hypothyroidism, hypoglycemia, infectious mononucleosis, and viral infections. 

Winter can be a challenging time for individuals with SAD. However, with the right strategies and support, it is possible to manage the symptoms of SAD or the blues and enjoy the season.

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