We might be past the midpoint of winter, but for many people, it seems like the cold and dark days of winter will never end. About 26 percent of American adults have some form of seasonal affective disorder (SAD), a medically diagnosable condition marked by symptoms of depression that are tied to the seasons. Most people with SAD experience symptoms beginning in late fall or early winter, and experience relief in the spring when the days get longer again. However, there are some people who experience summer depression, with symptoms brought on or exacerbated by the increased temperatures and sunlight.
Some experts suspect that the actual number of people living with SAD is higher than reported, since many people dismiss their symptoms as just the “winter funk” and never seek help from a doctor. Instead, they manage their symptoms on their own, choosing to “hibernate” instead — they might spend more time in bed, avoid social contact, or turn to forms of self-medication, such as alcohol, until they feel better.
Others choose to get help for their symptoms. Doctors suspect that light levels play a significant role in SAD; the angle and lower intensity of the sun’s rays during the winter months can wreak havoc on melatonin and serotonin production in the brain, negatively affecting mood, sleep patterns, and energy level. For that reason, light therapy, in which patients are exposed to broad-spectrum lights for a set amount of time each day, is one of the most common treatments for SAD. In extreme cases, medication and psychotherapy have proven effective for overcoming symptoms of SAD.
However, in some cases, the treatments aren’t very effective, or don’t work at all. In those cases, there could be another serious underlying psychological mood disorder causing cyclical mood changes.
Bipolar Disorder and SAD
Bipolar disorder, often called “manic depression,” is a serious mood disorder marked by changes in moods. A bipolar patient alternates between episodes of mania, an extreme “high” marked by hyperactivity, extreme happiness, little need for sleep, and quick-trigger tempers, and episodes of depression, marked by sadness, lack of energy, withdrawal, and feelings of helplessness. While individuals may have patterns to their moods, in general, every bipolar patient is different. Some people might have years of “normal” moods before experiencing a swing in either direction, while others may experience episodes that last only a few days — or even hours.
Research shows that about 20 percent of bipolar patients are able to track their moods based on the season. That is, many report transitioning into a down or depressive episode during the winter months, and experiencing mania during the spring. In fact, seasonally driven mood swings are common enough that many doctors refer to the month of May as “manic May.” The reason for the seasons’ effect on bipolar patients is suspected to be the same as with anyone else: Changes in sunlight influence hormone production, making mood regulation more difficult.
Do I Have SAD or Bipolar Disorder?
Currently, the only means of diagnosing SAD and bipolar disorder is via interviews and mental health history review. There are no physical tests to determine whether the condition is present.
That being said, doctors can distinguish between the two conditions. While both SAD and bipolar are influenced by the changing seasons, SAD patients only experience their symptoms during the winter months (or in some cases summer) and experience relief when the seasons change. The symptoms are predictable and consistent, and the patient experiences stable moods for the rest of the year without any other medical interventions.
Bipolar disorder, on the other hand, is not as consistent. While the seasons influence mood, to be considered bipolar, one must have at least one episode of mania between depressive episodes. In other words, if you get depressed during the winter months, but then experience normal moods until a manic episode in the late summer, followed by a normal mood and then a return to depression in December, you could be bipolar. Symptoms of seasonally influenced bipolar disorder can be eased with light therapy, but the condition generally requires prescription medication treatment (such as Seroquel) as well as psychotherapy.
However, it’s important to note that bipolar mood swings are not your typical mood fluctuations. Everyone experiences mood changes, sometimes several times during the same day. You might head to work in a great mood but have a spat with a co-worker that puts you in a foul mood, only to have our spirits lifted by a phone call with a friend. Those are normal mood fluctuations. Bipolar disorder mood, on the other hand, are extreme and affect one’s ability to engage in normal activities; for example, the patient might demonstrate unrealistically high or low opinions of his or her abilities, or engage in dangerous or self-destructive behaviors. Usually this extreme behavior spurs a patient (or his or her loved ones) to seek help.
Only a doctor can make a definitive diagnosis of SAD or bipolar disorder. However, if you or a loved one is having difficulty regulating your mood, there is help — you do not have to suffer alone.