Seasonal Affective Disorder (SAD)

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Latest Edit: Iva Lloyd, ND 2014-01-24 (EDT)

Seasonal Affective Disorder (SAD) refers to bouts of depression during specific periods of time of the year. SAD is most common in the winter months and is also known as winter blues or winter depression and typically involves an increase in depressive symptoms and hypersomnia. It is more common at latitudes farther from the equator and is associated with decreased hours of sunlight exposure.[1]

See Also Mental/Emotional or Psychological Conditions
Books Books on Mental / Emotional Health
Articles Articles on Mental/Emotional or Psychological Conditions

Naturopathic Assessment

Article Epidemiology, Etiology, and Natural Treatment of Seasonal Affective Disorder , Alt Med; 2005;Vol10(1)

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With Seasonal Affective Disorder the main cause is a change in seasons, typically due to the decreased sunlight in the winter months. Other factors include:


  • Those individuals that decrease their outside activities in the winter are more prone to SAD.


  • Social Activities
  • Decreased social activities in the winter can increase the likelihood of SAD.


  • The shortening of daylight hours in the winter causes a shift in normal circadian rhythms which leads to increased production of melatonin and cortisol. A increase in melatonin can result in a decrease in serotonin which is a mood-elevating neurotransmitter.[2]
  • Geographical Location
  • In nortern latitudes, daylight hours are significantly shorter in the winger, and the geographic distribution of SAD parallels this lack of sun.[2]

Diagnostic Testing

Evaluation is similar to workup for depression. Based on presentation, testing to rule out endocrine dysfunction may be necessary, especially TSH, T3, and T4 testing to rule out hypothyroidism.

A thorough medical history and clinical interview is required for diagnosis. Rating tools used in depression such as the Hamilton Depression Rating Scale, Seasonal Pattern Questionaire (SPAQ), and Beck Inventory may be useful as well.[3], [4]

Related Symptoms and Conditions

Conditions related to seasonal affective disorder include:[5][6]


Common Symptoms

Individuals suffering from SAD often experience symptoms of depression which are aggravated in the winter months. In the summer months individuals with SAD generally improve and experience increased energy and elevated mood. Common winter symptoms include:[7], [2]

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:[2]

  • Keep drapes and blinds open in the home.
  • Sit near windows and gaze outside frequently.
  • Turn on bright lights on cloudy days. Better still, use full-spectrum light bulbs in the rooms that you spend the most time.
  • Get outside as much as possible, especially in the early morning light. Try to spend 1 hour in the sun each day.


Lifestyle recommendations include:

  • Exercise regularly - a minimum of 30 minutes, at least three times a week, preferably outside.
  • The best exercises are strength training and/or aerobic activities such as walking briskly, jogging, bicycling, cross-country skiing, swimming, aerobic dance and racquet sports.[2]

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for seasonal affective disorder include:

  • Homeopathy can be effective in the treatment of SAD.
  • Phototherapy (light therapy). Controlled exposure to bright light has been shown to help restore proper circadian rhythm.[2]
  • Other Therapies
  • Cognitive behavioural therapy may be effective in the treatment of SAD.[10]


Reviewed by Iva Lloyd, BScH, RPE, ND [1]

  1. Murray MT, Bongiorno PB. (2006) Pizzorno Textbook of Natural Medicine 3rd ed Chap 144 Affective Disorder Elsevier.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Pizzorno LU, Pizzorno JE, Murray MT (2002) Affective disorders: seasonal affective disorder Natural Medicine Instructions for Patients, Elsevier.
  3. Ferri (2012) Ferri's Clinical Advisor, 1st ed. Section S. Seasonal Affective Disorder Mosby.
  4. Miller AL. (2005) Epidemiology, Etiology, and Natural Treatment of Seasonal Affective Disorder. Alt Med Rev 10(1);p.5-13
  5. Kim DR, et al (2011) The relationship between bipolar disorder, seasonality, and premenstrual symptoms. Curr Pyschiatry Rep; 13(6):500-3
  6. Lee HJ, et al (2011) Delayed sleep phase syndrome is related to seasonal affective disorder. J Affect Disord; 133(3):573-9
  7. Salguero ML (2007) Rakel: Integrative Medicine 2nd ed Chap 3 Environment and Genes Saunders
  8. Schneider C, Lovett (2007) Rakel: Integrative Medicine 2nd ed Chap 9 Depression Saunders
  9. Sarris J, Kavanagh DJ (2009) Kava and St. John's Wort: current evidence for use in mood and anxiety disorders. J Altern Complement Med; 15(8);827-36
  10. Rojan KJ, et al (2009) Winter Depression Recurrence One Year After Cognitive-Behavioral Therapy, Light Therapy, or Combination Treatment. Behavior Therapy; 40(3);225-38