For many, fall and winter are a time of holidays, warmth and togetherness with families. For others, it represents a time of sadness: shorter days, less light and colder weather.

So-called “winter blues” are very common, especially in colder, more northern areas, such as Michigan. When winter blues reach the point of disrupting functioning or causing significant distress, they may become a condition known as “seasonal affective disorder,” or SAD.

The lifetime prevalence of SAD ranges from 0.5 to 3 percent.

There are multiple potential causes of SAD, including disturbances of one’s circadian rhythm (the natural waking and sleeping rhythm of the human body), genetic factors and neurochemical imbalances.

There are several symptoms to look out for if you are concerned that you or a loved one may have SAD. In addition to feeling sad or depressed, people with SAD will often experience an inability to derive joy or pleasure from their usual hobbies or interests. They may notice changes in their sleep, for example, difficulty falling or staying asleep, or more commonly, feeling overly sleepy throughout the day.

Appetite changes are also common and may include a decrease in appetite, or more commonly an increase in appetite with particular cravings for carbohydrates. Energy may be low, and people may find it a struggle to concentrate on things. There may be feelings of worthlessness or excessive guilt. Others may notice that people experiencing SAD appear particularly slowed down or sped up. Of particular concern, people experiencing SAD may have thoughts of death or suicide, and this warrants immediate intervention.

Fortunately, SAD is a treatable condition. There are currently three potential treatment modalities that can be used separately or together: light therapy, psychotherapy and medications.

Light therapy imitates the extended daytime of summer months. Light boxes can be purchased from many major retailers. It is important not to look directly at the light and to keep your eyes open. Light therapy appears to be most effective when done in the morning upon waking. It can be done while watching TV, reading or surfing the web. The effects of light therapy can be seen within a few days to a few weeks, and it is generally well-tolerated.

Psychotherapy can also be very effective for SAD. There are many different types of psychotherapy. One that works particularly well for SAD is cognitive-behavioral therapy, or CBT. CBT focuses on how one’s thoughts and feelings affect their behaviors, and vice versa. It targets negative thoughts and behaviors and helps to reframe them into productive thoughts and behaviors. There is also emphasis on increased daytime activity and better sleep hygiene to minimize excessive tiredness, amotivation and lack of energy often seen with SAD.

Lastly, for some people medications can be very helpful for SAD. There is one medication that is FDA-approved for SAD, called bupropion (Wellbutrin, Aplenzin). There are many other medication options in addition to bupropion. Your healthcare provider can help you choose the most appropriate medication based on your symptoms, preferences, side effect profiles, and family history, among other factors.

Although SAD can be debilitating for some, there are treatment options available as summarized above. If you or a loved one is experiencing symptoms consistent with SAD, please seek professional help. The Cruz Clinic in Livonia and Ann Arbor has a team of trained mental health professionals who are well-equipped to treat this common condition. We can be reached at (734) 462-3210 or via the web at www.cruzclinic.com.


Dr. Wedes is a board-certified Psychiatrist who specializes in General Adult Psychiatry. Conditions he commonly sees include depression, bipolar disorder, anxiety, ADHD, and schizophrenia, among others. He strives to create a safe environment free from judgment. Dr. Wedes graduated from the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and completed residency at University of Pittsburgh Medical Center. He has over 10 years of experience.