Coping with SAD, the seasonal disorder that can bring on months of depression

As the seasons change and days shorten, sunset commutes can become somber after-dark travels. Early evening dog walks can start to feel gloomy.  Hobbies can seem less inspiring.

For many Long Islanders, the onset of colder, longer nights  is a manageable adjustment during fall and winter. But for others, the transition can bring about a major depressive condition called seasonal affective disorder (SAD) that can lead to symptoms such as low energy, carbohydrate cravings, and hopelessness.

"They may have low energy," said Melissa Tuomi, a psychologist at Stony Brook Medicine. "They may be sleeping too much or sleeping not enough. They may want to isolate or just not find pleasure in the things that they normally would. But instead of those sorts of things occurring year-round, they typically would occur in the fall and winter months."

About 5% of Americans are estimated to experience the condition, which typically eases in warmer weather, research shows. But some experts said that is likely an undercount, as many suffer in silence until spring arrives.

What causes SAD?

In the 1980s, Dr. Norman Rosenthal named the condition, which humans had likely experienced for a long time, after he noticed his own mood changes when he moved from his South African homeland to the U.S., experts say, and research shows.

Although there is no one definitive cause, changes in sunlight exposure play a key role in the condition, which physicians say is diagnosed after the depression occurs in a seasonal way for two consecutive years.

People who live farther from the equator tend to experience it more. In Florida — the Sunshine State — the percentage of residents with SAD has been estimated to be 1%, while it is about 10% in New Hampshire, research shows. 

Researchers note that a lack of sunlight affects circadian rhythms, which can negatively impact sleep and mood.

"Getting sunlight helps," said Dr. Robin Tassinari, a professor of psychiatry and internal medicine at the Albany Medical Center and Albany Medical College. "It maintains serotonin levels, which helps with depression, and it helps with sleep cycles."

How is it treated?

In addition to increasing sun exposure, mental health experts say treating SAD can involve deliberately increasing social bonds during the colder months when people tend to isolate, as well as talk therapy, or even taking prescribed antidepressant medication. 

Christopher Fisher, director of behavioral health at Northwell Health’s Zucker Hillside Hospital, said going outside can be key to feeling better. Being in sunlight, he said, can  make people feel more active and stimulate the release of motivation-inducing dopamine.

"We get outside, we feel better, we feel more motivated to get outside to feel better, and we continue forward with that more positive, productive habit," he said.

Sitting in front of a light therapy box is another common way to treat SAD. Light boxes can provide 10,000 lux, or the same amount of light as a spring day. Amazon and other online retailers list some for around $70; others cost about $200.

"It's the combined treatment of all of this: light therapy, CBT [cognitive behavioral therapy] and the medication may be actually the best way of treating the disorder," Dr. Ronald Brenner, chief of the behavioral health service line at Catholic Health.

Whatever the treatment route, Fisher noted, "You don’t have to accept that for four to five months out of the year that you're just going to be in this slumped place."

"We can actually do more to be proactive, to plan, and to strategize how we're going to live during these months, so that we don't have to take a dip or, you know, kind of a drastic hit to our mood," he said.

By Tiffany Cusaac-Smith

tiffany.cusaac-smith@newsday.com@T_Cusaac

Tiffany Cusaac-Smith is a general assignment reporter for Newsday. She previously worked at USA TODAY and is an alum of Howard University.