Seasonal affective disorder (SAD) – what are the signs and symptoms of Seasonal affective disorder?

Seasonal affective disorder
Seasonal affective disorder

The symptoms of seasonal affective disorder (SAD) are similar to those of normal depression, but they occur repetitively at a particular time of year.

They usually start in the autumn or winter and improve in the spring.

The nature and severity of SAD varies from person to person. Some people just find the condition a bit irritating, while for others it can be severe and have a significant impact on their day-to-day life.


Most people with SAD will feel depressed during the autumn and winter.

Signs that you may be depressed include:

a persistent low mood

a loss of pleasure or interest in normal everyday activities

feeling irritable

feelings of despair, guilt and worthlessness

low self-esteem


feeling stressed or anxious

a reduced sex drive

becoming less sociable

A small number of people will experience these symptoms in phases that are separated by “manic” periods where they feel happy, energetic and much more sociable.

Other symptoms

In addition to symptoms of depression, you may also:

be less active than normal

feel lethargic (lacking in energy) and sleepy during the day

sleep for longer than normal and find it hard to get up in the morning

find it difficult to concentrate

have an increased appetite – some people have a particular craving for foods containing lots of carbohydrates and end up gaining weight as a result

These symptoms may make everyday activities increasingly difficult.

When to see your GP

You should see your GP if you think you might have SAD and you’re finding it difficult to cope.

There are a number of helpful treatments your GP may be able to recommend.

Read more about diagnosing SAD and treating SAD.

How to beat the Winter Blues – Seasonal affective disorder (SAD)

Going into Winter seems a suitable time to cover the whole area of Seasonal affective disorder (SAD). Often called the Winter Blues.

Courtesy of: Norman Rosenthal



Seasonal affective disorder (SAD) is a type of depression that comes and goes in a seasonal pattern.

SAD is sometimes known as “winter depression” because the symptoms are more apparent and tend to be more severe during the winter.

The symptoms often begin in the autumn as the days start getting shorter. They’re typically most severe during December, January and February.

SAD often improves and disappears in the spring and summer, although it may return each autumn and winter in a repetitive pattern.

Symptoms of SAD

Symptoms of SAD can include:

a persistent low mood

a loss of pleasure or interest in normal everyday activities


feelings of despair, guilt and worthlessness

feeling lethargic (lacking in energy) and sleepy during the day

sleeping for longer than normal and finding it hard to get up in the morning

craving carbohydrates and gaining weight

For some people, these symptoms can be severe and have a significant impact on their day-to-day activities.

Read more about the symptoms of SAD.

When to see your GP

You should consider seeing your GP if you think you might have SAD and you’re struggling to cope.

Your GP can carry out an assessment to check your mental health. They may ask you about your mood, lifestyle, eating habits and sleeping patterns, plus any seasonal changes in your thoughts and behaviour.

Read more about diagnosing SAD.

What causes SAD?

The exact cause of SAD isn’t fully understood, but it’s often linked to reduced exposure to sunlight during the shorter autumn and winter days.

The main theory is that a lack of sunlight might stop a part of the brain called the hypothalamus working properly, which may affect the:

production of melatonin – melatonin is a hormone that makes you feel sleepy; in people with SAD, the body may produce it in higher than normal levels

production of serotonin – serotonin is a hormone that affects your mood, appetite and sleep; a lack of sunlight may lead to lower serotonin levels, which is linked to feelings of depression

body’s internal clock (circadian rhythm) – your body uses sunlight to time various important functions, such as when you wake up, so lower light levels during the winter may disrupt your body clock and lead to symptoms of SAD

It’s also possible that some people are more vulnerable to SAD as a result of their genes, as some cases appear to run in families.

Treatments for SAD

A range of treatments are available for SAD. Your GP will recommend the most suitable treatment programme for you.

The main treatments are:

lifestyle measures, including getting as much natural sunlight as possible, exercising regularly and managing your stress levels

light therapy – where a special lamp called a light box is used to simulate exposure to sunlight

talking therapies, such as cognitive behavioural therapy (CBT) or counselling

Read more about how seasonal affective disorder is treated.

National Seasonal Affective Disorder Awareness Day 2015 – check out this brilliant infographic to find out more

Out Like a Light: SAD and Winter Blues

This infographic was commissioned by First Choice.

Friday sees National Seasonal Affective Disorder Awareness Day 2015. We thought it would be useful to help promote awareness of Seasonal Affective Disorder (SAD) by sharing this excellent infographic.

You can recent a past interview with Dr Rob Hick about SAD entitled “Desperately seeking sun – Do you get the Winter Blues?

Do you know any Seasonal Affective Disorder online resources?

It would be great if you could share them in the comments section below.

Thanks very much in advance!

Desperately seeking sun – Do you get the Winter Blues?

Dr Rob Hicks
Dr Rob Hicks

We may not have had much of our own in recent years, so with summer holiday bookings now going into overdrive, first ever Sunshine Index launched to help Brits escape to warmer climes

In recent years we’ve had some of the worst and most extreme weather events in our recorded history, but while we never expect much from our climate, a recent study shows that many of us are expecting even worse in 2013. Last year was the second wettest on record and the previous year one of our coldest, and the study shows 52% of us believe that British summers are getting worse every year.

With many already dreaming of summer and the chance to escape the UK, holiday companies are expecting a huge surge in bookings this weekend as people start to look ahead to time in the sun.

Over a third (37%) of holidaymakers surveyed by Thomson admit their main reason for travelling abroad is to enjoy sunshine which they can’t be certain of getting in the UK.

More than a quarter of Brits (26%) admit that good weather is the most important factor in contributing to their holiday happiness, so much so, that almost half (45%) go online daily in the lead up to their holiday to get excited about how warm it’ll be on arrival.

To help people maximise their exposure to sunlight during their holidays Thomson has launched a sunshine index of the places people are likely to get the most sunshine hours.

It’s well documented how a lack of sunshine, which gives the body vitamin D, can be damaging to our health and wellbeing, so it’s no wonder so many of us are desperate to leave our wintery shores behind at the moment. As a result, Thomson have teamed up with Dr Rob Hicks to help explain the importance of sunshine on our wellbeing and the best ways to get our much needed dose of vitamin D

The study also saw half of those surveyed admit that bad weather leads to feelings of depression, while more than a quarter say it makes them feel unsociable, and more than one in seven say continued bad weather makes them feel angry.


More than a third (34%) can’t be bothered to get up in the morning and, startlingly, almost one in every twenty (4%) doesn’t go into work as they can’t face the journey.

So how important is good weather for our health and if we’re not getting enough of it here, where are the best places to get it?

Listen to our podcast with Dr Rob Hicks to find out you can do today for your health, to overcome the nasty weather outside right now.


Julian Fisher is the host and Dr Rob Hicks is fielding the questions

FISHER It’s well documented how a lack of sunshine which gives the body vitamin D can be damaging to our health and wellbeing so it’s no wonder many of us are desperate to leave our wintery shores behind at the moment. As a result Thomson has teamed up with Dr Rob Hicks to help explain the importance of sunshine on our wellbeing and the best way to get our much needed dose of vitamin D. Now Rob, tell us a bit more about the study first of all. What were the results?

DR HICKS Well the study that was carried out online of 2,000 people across the UK came up with some very interesting results. 50% of British people think that the summers over here in the UK are a washout and they’re getting worse. 37% of people said the main reason they go on holiday is to enjoy the sunshine they can’t guarantee getting here at home in the UK and from a health point of view, what I found interesting was that 48% of people say that bad weather makes them feel sad and depressed which is something which in practice we do see at this time of the year. A number of people with the winter blues and Seasonal Affective Disorder obviously is very high at this time of year. The other interesting thing from the survey by Thomson was that 50% of people say that the bad weather makes them angry and frustrated and of course with the snow that’s going to increase and people who are angry and frustrated tend to get stressed and we all know too well how stress affects the body physically and emotionally in a detrimental fashion.

FISHER Do we know to what extent people here in the UK are actually deficient in vitamin D?

DR HICKS  There are some figures which suggest that up to 50% of the UK population could be deficient. Over the last couple of years I think we’ve increasingly identified that more people than we expected are vitamin D deficient. We’ve seen a reoccurrence of rickets in children, something that we haven’t seen in a long time, the condition that causes pain in the bones, tenderness in limbs, sometimes bone deformity and also muscle weakness. So it’s something that’s really being looked into in depth because a lot of people who might complain of general tiredness increasingly we’re finding are vitamin D deficient, something that can be corrected obviously. Vitamin D as I’m sure you know is made in the skin in response to sunlight and we can also get some vitamin D in our diet, oily fish, eggs, fortified cereals for example. But vitamin D is a very important vitamin. It’s not just for the bones and teeth, it does support the immune system and it helps the heart and circulation function properly. So it’s something that has attracted a lot of interest.

FISHER Is vitamin D deficiency related to other conditions, for example multiple sclerosis?

DR HICKS Yes, vitamin D deficiency is related to diabetes for example, it’s related to multiple sclerosis, people with multiple sclerosis are often found to be vitamin D deficient but they’re unclear what exactly that link is and how they are associated. Vitamin D deficiency is also related to high blood pressure as well so vitamin D deficiency goes beyond rickets in children and the bone condition osteomalacia in adults. So it is an area that’s attracting a great interest and I think we’re going to learn more and more about the importance of this very simple vitamin in time to come.

FISHER And how do you spot the signs of vitamin D deficiency?

DR HICKS Well from a symptom point of view in mild cases it might be somebody feels tired, they may have some aches and pains in their limbs that they really can’t put down to any other reason and of course you have a blood test and you’re found to be deficient in vitamin D. In more severe cases somebody would find that they are suffering with bone pain, bone tenderness, they might even develop the bowing of the legs which is a characteristic of vitamin D deficiency and rickets. So I think nowadays certainly in general practice when somebody comes with those sorts of symptoms, vitamin D deficiency is very much on the radar and it’s something that we’re on the lookout for.

FISHER So it’s mainly diet and exposure to sunlight that are the best ways of curing a deficiency

DR HICKS Well really for somebody with a confirmed deficiency obviously we’ll give them vitamin D supplementation but for somebody to try and avoid deficiency in the first place, about 90% of the vitamin D that we get in the body is from exposure to sunlight and is manufactured in the skin. We can get it in foods but it’s much less that we get from foods. The balance of course has to be against not over doing it in the sun and not getting sun burnt so generally speaking the recommendation is about fifteen minutes on three days of the week throughout the spring and summer should be sufficient to gain the benefit of vitamin D production whist avoiding the risks of too much sun and UV exposure.

FISHER So are the symptoms of Vitamin D deficiently the same symptoms for what we know as SAD or Seasonal Affective Disorder?

DR HICKS Not specifically.  There’s a cross over in that obviously with Seasonal Affected Disorder and vitamin D deficiency people may describe tiredness and fatigue but generally with Seasonal Affective Disorder it’s more emotional symptoms, so people’s mood is low, they feel unhappy and depressed they find themselves over sleeping, over eating, that they are much less active, their concentration is poor, their mood may swing from anger to tearfulness for no apparent reason.  The thing with Seasonal Affective Disorder is that it is a specific type of depression that occurs at the same time of year.  So people will get into a pattern and they say, ‘well, every time that the days start to get short, every time of year, sort of October, November time I start to feel down and then come to January I really feel low’ and that’s one of the key ways of identifying Seasonal Affective Disorder, its’ the annual pattern of these symptoms.

FISHER I know you say exposure to sunlight but many of us that say who maybe commute and work on a working week may never see the sun.  We work in the dark we come home in the dark.  Is it UV lights are they the answer?

DR HICKS Well, one of the answers is simply to get out in the day time as much as you can during the winter.  So even if you are commuting in the dark then at lunch time maybe go out into the daylight.  If you can’t get outside, then sit near a window.  Certainly for those people who have Seasonal Affective Disorder then using light therapy seems to help a lot of people.  I think, obviously one of the things to overcome the winter blues is to have something, is to get outside, keep active, have a healthy diet but also plan things that you’ve got to look forward to.  So events where you can see friends and family and ideally those might be outdoor events.  Think about taking up a new hobby or planning a holiday and certainly Thomson have created the Sunshine Index which is available on their website for listeners to have a look at where you can actually see the countries where you’re more likely to be guaranteed good weather during the different seasons.  So we need sunshine, obviously we need it in moderation but a dose of sunshine is healthy for us, it helps lift our mood, it helps keep us active and it helps keep on top of stress.  The bottom line is, I think it’s fair to say, that the majority of us, if not all of us feel a lot happier with a little bit of sun.

FISHER I understand in some Scandinavian countries the health providers actually offer holidays to people with SAD.  Do you think that’s something the NHS should be considering?

DR HICKS Wouldn’t it be nice if we could do that at the NHS.  I think with the current financial challenges that the NHS are facing I can’t think that that’s on the immediate agenda but in the meantime that doesn’t mean that people can’t take their own steps to make sure that they either get a holiday or indeed get some sun exposure.  Simple activities like getting outside in the day time, sitting near a window for example but it would be really nice, I’d much rather write a prescription for a holiday than I would for other treatments.

FISHER So finally really, any top, quick tips on just how to make sure that you keep you vitamin D levels at a good level throughout these particularly dark times.

DR HICKS Yes.  Certainly get outside as much as you can.  Make sure your diet is rich in oily fish, eggs and cereals that are fortified with vitamin D.  You may want to consider taking a vitamin D supplement and if you feel that you may be at risk of vitamin D deficiency then have a chat with your doctor and ask about getting tested because if you are deficient then that could be corrected with supplement treatment and in the meantime, look forward to getting some sunshine, think about where you might want to go on holiday and lift spirits that way.

FISHER Dr Rob Hicks that’s great advice thanks very much indeed.

DR HICKS Thank you.