What is Major Depressive Disorder With Seasonal Pattern?

Major depressive disorder with seasonal pattern is another term used to refer to seasonal affective disorder, which is a type of depression that is associated with changes in seasons. This type of depression tends to begin and end at more or less the same time each year, with the symptoms beginning usually in the fall or winter. The condition is estimated to affect nearly 0.5 to 2.4 percent of people in the United States alone. Young adults and women are the most affected.^{(1, 2, 3, 4)}

Like most people with major depressive symptoms with seasonal pattern, the symptoms tend to begin in the fall months and continue well into the winter months. Seasonal affective disorder is going to leave you feeling moody and drained of energy. The symptoms sometimes resolve during the spring and summer months. Less commonly, some people may experience depression in the spring and early summer months, and feel better during the fall or winter months.^(5, 6)

It is important that if you feel down during the same time every year, or you think you have the winter blues, you should never brush it aside. It is nice to think that you can battle it out on your own, but it is better to consult a doctor and take the right steps to keep your mood and health steady throughout the year, regardless of the season.⁽⁷⁾

Symptoms of major depressive disorder with seasonal pattern tend to start around late fall or in the early winter. People get relief once the spring season begins. However, it is possible for some people to experience symptoms at other times of the year as well. It is also not necessary to experience the symptoms every year. Usually, there are two types of this disorder – winter-pattern, with winter-pattern seasonal affective disorder being more common. The summer-pattern seasonal affective disorder only occurs in just ten percent of cases.^(8, 9)

Symptoms of either type of seasonal affective disorder last for approximately four to five months. The common symptoms include:

• Persistent feelings of extreme sadness
• Difficulty sleeping
• Trouble concentrating
• Lack of energy
• Thoughts of suicide

Some of the additional symptoms of the winter-pattern seasonal affective disorder may also include:

• Overeating
• Daytime fatigue
• Weight gain⁽¹⁰⁾
• Lack of interest in social activities

On the other hand, here are the symptoms of summer-pattern seasonal affective disorder:

• Difficulty sleeping
• Feeling agitated
• Lack of appetite
• Weight loss
• Increased restlessness
• Acting violently

The exact cause of major depressive disorder with seasonal pattern remains unknown. At the same time, the contributing factors for the condition also vary from person to person. The biggest trigger of this condition is believed to be light. One theory says that reduced sunlight exposure in the winter or fall season and greater exposure in the spring and summer months have an impact on the body’s natural biological clock. The body’s biological clock is known to control your sleep, hormones, and moods. People who are affected by major depressive disorder with seasonal pattern usually have difficulty in the regulation of their biological clock or their circadian rhythm.^{(11, 12, 13)}

Abnormal levels of the hormones melatonin and serotonin are also known to disrupt the circadian rhythm in people with major depressive disorder with seasonal pattern, contributing to the condition. According to a study carried out in 2016, seasonal affective disorder is more likely to develop in people whose brains have high levels of serotonin transporters, which causes a fall in the levels of serotonin.⁽¹⁴⁾ People with major depressive disorder with a seasonal pattern are also known to produce very high levels of melatonin, which is a hormone that regulates and promotes sleep.⁽¹⁵⁾

People who reside in higher latitudes and have long winter nights with less sunlight in the day as well are more likely to experience seasonal affective disorder. For example, it is more common to find people in Alaska or Canada suffering from major depressive disorder with seasonal pattern than those who live in Hawaii or Florida.

The condition is also more frequently observed in women than men, and the condition most likely starts in young adults between the ages of 18 to 30 years. Those who have a family history of seasonal affective disorder or any other mental health condition are at a higher risk of developing the condition. It is estimated that nearly 25 percent of people with bipolar disorder and 10 to 20% of people with major depressive disorder also have seasonal affective disorder.^{(16, 17, 18)}

Your doctor will begin the diagnosis process by asking you several questions about your medical history and your symptoms, especially when you first started noticing them. A diagnosis of seasonal affective disorder typically requires the following:

• Symptoms of depression
• Frequent depressive episodes experienced in that particular season
• Episodes of depression that occur only during a particular season for at least two years in a row

If you only experience minor mood swings in the seasons, it is possible that you suffer from subsyndromal seasonal affective disorder rather than seasonal affective disorder.⁽¹⁹⁾

If your symptoms persist even when the season has changed, your doctor may diagnose you with major depressive disorder or bipolar disorder.

Major depressive disorder with seasonal pattern is treated with medications, therapy, and counseling. One of the most common treatments for seasonal affective disorder is cognitive behavioral therapy (CBT), which can help people with the condition learn how to focus on positive and helpful thoughts instead of negative ones.⁽²⁰⁾

Some people with the condition may also benefit from taking antidepressants. Some of these include Prozac (fluoxetine, Zoloft (sertraline), Paxil (paroxetine), and Wellbutrin (bupropion).

You should talk to your doctor about which medication might be best for treating your symptoms.

Supplements of vitamin D have also been used to treat major depressive disorder with seasonal pattern. However, some studies have shown that these supplements might not be that effective, and further research is needed to confirm this.⁽²¹⁾

Another popular treatment for winter-pattern seasonal affective disorder is light therapy which involves the use of a specialized light box for around half an hour every day during the winter to replicate the presence of natural light. However, light therapy is not for everyone and you may not be a good candidate for light therapy if you have:

Certain types of eye diseases

• Bipolar disorder
• Are sensitive to light due to certain medications you take
• Recently had eye surgery
• Having a healthy lifestyle, exercising regularly, and getting sun exposure in the winter can help reduce the symptoms of major depressive disorder with seasonal pattern.

If you find yourself feeling regularly depressed and experiencing trouble sleeping during certain seasons, especially in the winter months, you could be experiencing major depressive disorder with a seasonal pattern. There are treatments like light therapy, medications, and counseling available that are known to be effective in alleviating the symptoms of seasonal affective disorder. Increasing your exposure to natural light and exercising regularly can also help you tide over the seasons without feeling depressed. If you experience symptoms of depression during a particular season repeatedly for at least two years, it is best to bring it up with your doctor. Your doctor will work with you to come up with the best treatment plan to manage your condition.

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