Nearly everyone knows what it’s like to feel a little low during the long Midwest winters. But for some, they can feel like they’ve bottomed out. The reason for this can be a type of depression called seasonal affective disorder (SAD).

“SAD is recognized as a disease, and it looks like major depression in some people,” says Dr. Austin Williams, a family physician with Kettering Health. “SAD typically occurs during the winter months, and affects people who don’t necessarily experience depressive symptoms at other times of the year.”

Dr. Williams says that lack of sunlight plays a role in SAD. Decreased sunlight can

• Disrupt our sleep/wake cycles, leading to poor sleep.
• Lower levels of serotonin in the brain, a feel-good chemical that affects mood.
• Lower vitamin D levels, making us feel more tired than usual.

People who live farther from the equator have a higher risk for SAD, and women are two to three times more likely to feel depressed in winter than men.

When it’s time to talk to a doctor

Dr. Williams encourages people to talk to their doctor if they have

• Increased or unusual levels of anxiety, sadness, loss of interest in normal activities, and mood swings
• Excess sleepiness or difficulty sleeping
• Feelings of failure or a desire to self-harm
• Appetite changes, significant weight gain, or weight loss
• Irritability or social isolation

Finding help for SAD

Antidepressant medication can be a good option, especially if symptoms are severe or affect you three or more days a week. Dr. Williams also recommends the following:

• Exercise: A short walk can increase mood-boosting brain chemicals such as serotonin, dopamine, and endorphins.
• Practice good sleep habits: This can include going to bed and waking up at the same time every day. Avoiding computer and phone screens two hours before bedtime can also help. Artificial lighting—especially the blue light from many electronic devices—suppresses melatonin production, making it more difficult to wind down.
• Light therapy: Light therapy boxes mimic outdoor light, which can help regulate your body’s sleep/wake schedule.
• Counseling: SAD can make daily life seem overwhelming. A trained counselor can help you identify and change negative thought patterns, manage your stress, and improve your outlook.

“Whenever patients share a concern about their mental health, I make a point to thank them,” Dr. Williams says. “It’s difficult to reach out to someone for help. There’s an element of bravery there—but it’s also the first step toward feeling better.”