Taking Back the SAD Season

UVM Research on Seasonal Affective Disorder Aims to Change Your Mind About Winter

If you could become a bear and hibernate until Spring, would you? Your answer might be a clue to a condition that’s remarkably common in Northern climes: seasonal affective disorder, or SAD. It’s often characterized by negative attitudes related to the weather, withdrawal from social activities, carb-craving, and weight gain. Sound familiar? You’re not alone. SAD affects about 50 percent of New Englanders, returning like clockwork every year and dominating lives for months.

But what if you could talk yourself out of the blues, so to speak? If you could recognize the patterns of negative thinking and shift them to something more neutral, could the heaviness of winter depression be lifted? Research from the UVM laboratory of research psychologist Kelly Rohan, Ph.D., suggests it can. 

More Than the Winter Blues

Rohan’s work was featured in a recent webinar on SAD research by the National Institute for Mental Health (NIMH), in which NIMH research psychiatrist Matthew Rudorfer, M.D., underscored the serious nature of the disorder. SAD is more than the “winter blues,” he said. SAD refers to a specific clinical diagnosis of recurrent depression with a seasonal pattern. The symptoms are the same as with major depressive disorder (see graphic), but appear seasonally. Winter blues is commonly used to describe the general lethargy and dreariness of “stick season,” but with less impairment on functioning and social activities than SAD.  Holiday-related stressors can exacerbate both.

At UVM, Rohan and her colleagues developed a form of cognitive-behavioral therapy (CBT), a talk therapy, tailored to changing negative attitudes about winter — if not embracing it. CBT for SAD focuses on identifying, challenging and changing negative self-chatter into “something a little more neutral,” Rohan said in an interview. That’s the cognitive part of CBT. The behavioral piece of the therapy looks at how people are spending their time and empowers them to be more socially and physically active. 

Rohan’s laboratory is currently recruiting participants for an ongoing study comparing CBT-SAD with light therapy. She said more than 1,500 people have been screened for the available 160 spots in the study. Thirty-seven more participants are needed.

Currently Recruiting for UVM SAD Study: Visit the study website for more information.

New Approach to SAD Treatment

CBT is typically administered one-on-one with a psychiatrist over many months, but Rohan’s CBT for SAD uses a more condensed schedule. Participants meet in group sessions  for 90 minutes twice a week for six weeks. Rohan’s team has fine-tuned and validated their SAD therapy over years of rigorous study funded by the NIMH. Findings reported so far show that CBT-SAD can be as effective as light therapy, the gold standard for treating SAD.

Light therapy involves daily morning treatment with bright, full-spectrum light, delivered from a box to the eyes (not the skin). It must be done in the morning, typically for 30-60 minutes. The timing, duration, and “dose” of light therapy is critical, and should be customized to the individual’s needs in concert with a health professional. This makes it inconvenient for some people. Taking antidepressant medications is also an option for managing SAD. Vitamin D supplementation and dietary changes – eating less refined carbohydrates and more good fats like fish oils and monounsaturated fats – can support treatment, but are usually insufficient alone, Rudorfer said.

Early Identification, Prevention is Key

Perhaps due to the success of light therapy for SAD, Rudorfer said psychosocial interventions have been “late in coming.” Cognitive-behavioral therapy offers a non-drug alternative that, importantly, may have a more lasting effect. Rohan found fewer relapses in the second winter of follow-up in people treated with CBT-SAD vs. light therapy. 

Prevention is easier than treatment, Rohan emphasized. The trick is to start early, before the seasonal sluggishness sets in too deep. “SAD has an insidious onset,” she said. “The symptoms trickle in over days to weeks. It sneaks up on us. People may not recognize until they’re in the depths of despair, when it’s more difficult to dig out.” 

Six Ways to Fight SAD

Rohan cautions that CBT “is really hard to do on yourself,” and recommends seeking a trained psychologist. Still, she says the principles behind the therapy offer guidance for anyone managing winter sadness. 

Keep a thought diary. Articulate your thoughts and describe the mood associated with it, so you can keep track over time.

Challenge negative thoughts. Bring them to consciousness and subject them to questioning. What’s behind them? What emotions arise? How might you lessen their emotional edge?

Reframe it. Try negotiating a new thought that’s more neutral. Instead of “I hate winter,” try “I prefer summer over winter but I can cope with this.” Try it on and see how it feels.

Notice changes early. Be mindful and attentive to symptoms early in the season. Have a plan to actively counter negative habits like social withdrawal before they’ve set in.

Find what brings you joy. Take inventory of all the things you do enjoy about winter and make plans for these things. Be really deliberate about scheduling them into your routine. Gather any equipment you need for winter activities in one place so you have no excuses.

Get outside early in the day. A 30-minute walk after sunrise is ideal. Make sure you have proper clothing to stay warm and comfortable. If you can’t do 30, start with 10.

Stay indoors if you want. Rohan doesn’t push people to get outdoors if doing so makes them miserable. Indoor activities are great too, whether at home or in the community. Seek out safe spaces and purposeful activities you can do regardless of weather.

Learn More and Find Resources

Learn more about the UVM research study investigating cognitive behavioral therapy for SAD, including how to register for a screening, here. You can also call the study phone at 802-656-9890 or email sadstudy@uvm.edu

Read a Q&A with Kelly Rohan, M.D. published in Goop: A New Approach to Seasonal Affective Disorder.

Watch the NIMH webinar and live Q&A on Seasonal Affective Disorder with NIMH research scientist Matthew Rudorfer, M.D.  

Find more resources about SAD at the NIMH information page.

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Blog written by Brenda Patoine on behalf of VCN/Vermont Care Partners for COVID Support Vermont, a grant funded by FEMA and the Vermont Department of Mental Health

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