Seasonal affective disorder (SAD): coping with the dark UK winter months

When the clocks go back at the end of October and it's dark by half past four, plenty of people across the UK notice their energy and mood sink. For some, it's more than the winter blues. Seasonal affective disorder is a type of depression that follows the seasons, and there are practical things that can help.

What seasonal affective disorder is

Seasonal affective disorder is depression that follows the seasons. For most people with SAD, symptoms start in autumn, are at their worst in the darkest months and ease off in spring and summer. Less commonly, some people have the opposite pattern and feel worse in summer.

In Scotland and the north of England, winter days are especially short. Someone working in an office in Aberdeen might arrive in the dark and leave in the dark for weeks on end. Taking a walk outside at lunchtime, sitting near a window and keeping regular sleep times are simple ways to make the most of the daylight there is.

The exact cause isn't fully understood. The main theory is that reduced sunlight affects a part of the brain involved in mood, appetite and sleep. Less light may change levels of melatonin, the hormone that makes you sleepy, and serotonin, which is linked to mood, and it can unsettle your body clock. With short days and long, grey stretches, it is not surprising that many people in the UK notice the change.

Signs and symptoms of SAD

SAD has many of the same symptoms as other types of depression. The difference is that they return around the same time each year. You might notice:

• a persistent low mood that is hard to shake;
• losing interest or pleasure in everyday activities;
• feeling irritable, tearful or anxious;
• feelings of guilt, worthlessness or despair;
• feeling lethargic and sleepy during the day;
• sleeping for longer than usual and finding it hard to get up;
• craving carbohydrates and putting on weight;
• finding it harder to concentrate;
• wanting to withdraw from friends and family.

Symptoms can range from mild to severe. If you ever have thoughts of not wanting to be here, please reach out straight away; the numbers are at the end of this article.

Winter blues or SAD?

Feeling a bit sluggish when the weather turns is very common, and it doesn't automatically mean you have SAD. The key questions are how strong the feelings are, how long they last and how much they get in the way of your life.

Only a doctor can diagnose SAD, usually after the pattern has repeated for a couple of years. You don't need a diagnosis to start looking after yourself, though, and the steps below help with both.

What helps with SAD

1. Get as much natural light as you can. Go outside in the middle of the day, even when it is cloudy. A lunchtime walk is often more helpful than you would expect.
2. Make your space lighter. Open curtains and blinds as soon as you get up and sit near a window to work or read.
3. Keep a steady routine. Get up and go to bed at similar times every day, including weekends. It helps keep your body clock on track.
4. Stay active. Regular exercise, especially outdoors, is good for mood and energy. Small amounts count.
5. Eat regular, balanced meals. Carbohydrate cravings are common. Rather than fighting them, include plenty of fruit, vegetables and wholegrains.
6. Stay connected. Low mood makes you want to hide away, which usually makes it worse. Keep up small plans with people you like.
7. Plan ahead. If you know winter is hard, arrange things to look forward to and try to avoid big stressful changes during the darkest months.

Some people with SAD find light therapy helpful. It involves sitting near a special light box for a set time each day. Light boxes aren't suitable for everyone, for example people with certain eye conditions or who take medicines that make them sensitive to light, so speak to your GP before trying one. The NHS also advises everyone to consider taking a vitamin D supplement in autumn and winter for general health, though this isn't a treatment for SAD.

When to see your GP

See your GP if you think you might have SAD and you are struggling to cope, particularly if:

• low mood or tiredness has lasted for more than a couple of weeks;
• it is affecting your work, relationships or ability to look after yourself;
• it happens every year and you dread the winter months.

Your GP can talk through treatments, which may include talking therapies such as cognitive behavioural therapy (CBT). In England you can refer yourself to NHS Talking Therapies. Winter exhaustion can also look a lot like burnout, so our article on the signs of burnout may be useful too. If you feel you can't cope, ring Samaritans free on 116 123, text SHOUT to 85258 or call NHS 111. In an emergency, call 999 or go to A&E.

Frequently asked questions

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