537. You don't have to suffer through the winter months. In this episode, Dr. Monica Johnson looks at how to create a multi-faceted approach to wellness for SAD. She looks at the importance of regulating your sleep schedule, boosting natural light exposure, and using behavioral activation to combat the urge to withdraw and isolate yourself.
537. You don't have to suffer through the winter months. In this episode, Dr. Monica Johnson looks at how to create a multi-faceted approach to wellness for SAD. She looks at the importance of regulating your sleep schedule, boosting natural light exposure, and using behavioral activation to combat the urge to withdraw and isolate yourself.
Find a transcript here.
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When the days get short and the sunlight dips out before you even get home from work, a lot of people feel a little blah. They talk about dragging themselves out of bed, craving carbs like never before, begging for the sweet embrace of sweatpants, and feeling a heaviness that seems to lift only when spring arrives. For many, winter doesn’t just dull the vibe, it drops it to the floor. And not in a fun–we be clubbin’--kind of way. That’s Seasonal Affective Disorder (SAD): a recurrent, seasonal pattern of major depression that returns around the same time each year and lifts when seasons change. Today, I want to talk about SAD, what it is, how it manifests, and most importantly, what we can do about it.
Welcome back to Savvy Psychologist, I'm your host, Dr. Monica Johnson. Every week on this show, I'll help you face life's challenges with evidence-based approaches, a sympathetic ear, and zero judgment.
SAD is a subtype of depression with a predictable seasonal rhythm. For most people in the U.S., symptoms intensify in late fall and winter and improve in spring; a smaller group has a summer-onset version. The symptoms of SAD mirror those of major depression.
Hypersomnia: Unlike the insomnia often seen in other forms of depression, people with SAD tend to sleep excessively. I've had clients tell me they can sleep 10, 12, even 14 hours and still wake up exhausted.
Increased appetite and carbohydrate cravings: There's often a marked increase in appetite, particularly for carbohydrates and sweet foods. This isn't about lacking willpower, it's your body's response to changes in brain chemistry. Research suggests this may be related to serotonin regulation.
Weight gain: As a result of increased appetite and decreased activity, weight gain is common during winter months for those with SAD.
Social withdrawal: Many of my clients describe wanting to "cocoon" or isolate themselves. Social activities that normally bring joy feel like enormous undertakings.
Fatigue and low energy: A pervasive sense of heaviness and lethargy that makes even simple tasks feel overwhelming.
Difficulty concentrating: Mental fog, trouble focusing, and decreased productivity are frequently reported.
Mood changes: Persistent feelings of sadness, hopelessness, irritability, and loss of interest in activities once enjoyed.
The exact mechanisms underlying SAD are complex, but research has identified several contributing factors. The reduction in sunlight exposure during fall and winter months appears to disrupt our circadian rhythms, our internal biological clock that regulates sleep-wake cycles, hormone release, and other bodily functions.
Decreased sunlight also affects serotonin levels. Serotonin is a neurotransmitter that plays a crucial role in mood regulation. When sunlight exposure decreases, serotonin levels can drop, potentially triggering depressive symptoms. Additionally, the change in season can disrupt melatonin levels, which affects sleep patterns and mood.
From my perspective as a clinician, I also consider the psychosocial aspects. Winter can bring additional stressors, less time outdoors in community spaces, increased isolation, and sometimes heightened experiences of the "winter blues" compounded by other systemic stressors we navigate daily.
Now for the most important part: what can you actually do about SAD? The good news is that we have several evidence-based treatment approaches that have been shown to be effective. I always tell my clients that managing SAD often requires a multi-faceted approach.
Bright light therapy is considered a first-line treatment for SAD and has been extensively studied.Multiple systematic reviews confirm its effectiveness. Light therapy involves daily exposure to a special light box that emits bright light (typically 10,000 lux) for about 20-30 minutes, usually in the morning.
The mechanism is straightforward: the bright light compensates for the decreased sunlight exposure during winter months, helping to regulate circadian rhythms and boost serotonin levels. Studies have shown that light therapy can produce symptom improvement comparable to antidepressant medications for many people with SAD.
When recommending light therapy to my clients, I emphasize several key points:
Use the light box in the morning, ideally soon after waking. This helps regulate your circadian rhythm most effectively. You don't stare directly at the light instead, position it at an angle while you have breakfast, read, or work. Consistency is crucial. Daily use throughout the winter months yields the best results. Some people notice improvement within a few days, while others may take two to four weeks to experience significant benefits.
It's important to invest in a quality light box that's designed specifically for SAD treatment. Not all light boxes are created equal, and you want one that filters out UV light while providing the appropriate intensity.
Research has demonstrated that Cognitive-Behavioral Therapy specifically adapted for SAD (CBT-SAD) is highly effective.
CBT-SAD focuses on two main components:
Behavioral activation: This involves identifying and scheduling activities that provide a sense of accomplishment or pleasure, even when you don't feel like doing them. Depression tells us to withdraw and conserve energy, but this often makes symptoms worse. In my practice, I work with clients to create a hierarchy of activities—starting small and building up. This might mean committing to a five-minute walk outside, calling a friend, or engaging in a hobby that used to bring joy.
I often encourage my patients to have seasonal hobbies. What you like to do or have access to in the warmer months may be different in the cold season. At times it may be as simple as switching from outdoor to indoor basketball or a larger shift like perhaps you enjoy hiking in the warm months and board games with friends in the winter. Either way, pleasant events and social interaction lead to positive changes with mood.
Cognitive restructuring: This addresses the negative thought patterns that often accompany SAD. Many of my clients have thoughts like "I can't handle winter" or "I'm going to feel miserable for the next four months." We work together to identify these thoughts, examine the evidence for and against them, and develop more balanced, realistic perspectives.
The beauty of CBT-SAD is that it provides you with skills you can use year after year. You're not just treating symptoms; you're learning to change your relationship with winter and developing strategies that become second nature over time.
The evidence supporting exercise for depression, including SAD, is robust. Physical activity has been shown to boost mood, increase energy levels, reduce stress, and improve sleep quality. A study examining physical activity engagement among adults in Alaska found significant associations between physical activity and reduced SAD symptoms.
I understand that when you're experiencing SAD, the last thing you may want to do is exercise. The fatigue and low motivation make it feel impossible. This is where behavioral activation principles come in. Start small, a 10-minute walk around the block. Exercise outdoors during daylight hours when possible to get the added benefit of natural light exposure.
Find activities you genuinely enjoy rather than forcing yourself to do exercise you hate. This might be dancing to your favorite music, taking a winter nature walk, joining a community fitness class, or doing yoga at home. The key is consistency and finding what works for your body and lifestyle.
Beyond formal light therapy, maximizing your exposure to natural daylight is crucial. Open your curtains and blinds during the day to let in as much natural light as possible. Take breaks outside during daylight hours, even if it's cold—bundle up and get that sunlight exposure. Position your workspace near windows when possible.
I also discuss sleep hygiene with my clients, as maintaining a consistent sleep-wake schedule helps regulate circadian rhythms. This means going to bed and waking up at the same time each day, even on weekends. I know this can be challenging when you're sleeping excessively, but it's an important part of the recovery process.
While it's tempting to give in completely to food cravings, working toward a balanced diet can help stabilize mood and energy levels. I'm not suggesting strict dieting that often backfires. Instead, I encourage clients to think about adding nourishing foods rather than restricting. Include protein with meals to help stabilize blood sugar, incorporate omega-3 fatty acids (found in fish, walnuts, and flaxseeds), which have been associated with improved mood, and stay hydrated.
Vitamin D supplementation is worth discussing with your healthcare provider. Many people have low vitamin D levels during winter, and some research suggests supplementation may help with mood, though the evidence is mixed.
Despite the strong urge to isolate, maintaining social connections is vital. In my work, I've seen how community and connection are particularly important for our well-being. The urge to withdraw is a symptom of depression, not a reflection of what you truly need.
Schedule regular check-ins with friends or family, even if it's just a phone call or video chat. Join support groups, either in-person or online, where you can connect with others who understand what you're experiencing. Plan activities with others to help with accountability and motivation.
Seasonal Affective Disorder is real, it's treatable, and you don't have to suffer through it alone. If you recognize yourself in this description, I encourage you to reach out to a mental health professional for a proper evaluation. Keep track of your symptoms and their timing to help establish if they follow a seasonal pattern.
Remember that managing SAD is often about finding the right combination of strategies that work for you. What works beautifully for one person may not be as effective for another. Be patient with yourself as you figure out your own path to wellness.
The winter months don't have to be a time of suffering and survival mode. With the right tools and support, you can reclaim this season and find ways to thrive, even when the days are short and the nights are long. You deserve to feel well, regardless of the season.
How are you planning to prepare for winter? Let me know! You can contact me via Instagram @kindmindpsych or via my email at psychologist@quickanddirtytips.com.
The Savvy Psychologist is a Quick and Dirty Tips podcast. It's audio engineered by Steve Riekeberg. The Director of Podcasts is Holly Hutchings. Our Podcast and Advertising Operations Specialist is Morgan Christiansen, Rebekah Sebastian is our marketing manager, and Nathaniel Hoopes is our Marketing contractor. Follow Savvy Psychologist on Apple Podcasts, Spotify, or wherever you listen to podcasts. That's all for this episode of Savvy Psychologist. Thanks for listening! I'll see you next week.