Ask the doctors: How to know whether you have seasonal affective disorder and what to do

Dear Doctor: My boyfriend and I live in northern Ohio, and I think we have that thing where you get depressed from not enough light. He’s kind of skeptical, but I really do think it’s happening. Can you describe the symptoms? Is there anything we can do?

Answer: You’re referring to a condition known as seasonal affective disorder, or SAD.

Sometimes referred to as the winter blues, it’s a mental health condition that has been linked to the shorter days and longer nights of fall and winter.

Though the cause isn’t known, the possibilities include the idea that reduced levels of sunlight have an adverse effect on circadian rhythms, on levels of the brain chemical serotonin or on the hormone melatonin.

There’s also a link between distance from the equator and incidences of SAD. People living in the northern reaches of the United States are at greater risk of developing SAD than those in the South.

It’s estimated up to 20 million people in the United States experience some degree of seasonally related depression. Symptoms include persistent low mood, lack of energy, sleep disruption, irritability, loss of interest in daily activities, feelings of hopelessness, difficulty concentrating, anxiety and weight gain. Episodes can start out mild and intensify.

If you suspect you’re experiencing seasonal affective disorder, you should see your health care provider. Other medical issues, such as thyroid conditions, anemia or clinical depression, can have similar symptoms. Diagnosis involves a physical exam, including a detailed discussion about symptoms relating to mental health. To rule out thyroid issues, a blood test might be done.

Treatment can include light therapy, psychotherapy or medication. With light therapy, you sit in front of a specially designed light box for 30 to 45 minutes a day. Since they are up to 20 times brighter than natural light, they might not be right for everyone. People with certain eye conditions or who take medications that increase light sensitivity should be under medical supervision to use light therapy. Psychotherapy offers a time and place to share feelings and learn coping techniques. Medications that affect serotonin metabolism also can be helpful.

Meanwhile, try to spend time outdoors each day, get regular exercise and eat a healthful diet. Keep screen time to a minimum.

Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health.