Darker Evenings, Lower Mood? A Short Adjustment, the Holiday Blues or SAD

When the clocks fall back in early November, the evenings turn dark by suppertime. Plenty of people notice a dip in energy for a week or two and then settle in. For others, the dip keeps going until spring. Knowing which one you are dealing with helps you decide what to do next.

Three things that can feel alike

• A short adjustment. Darker evenings and a shifted schedule can leave you sluggish for a little while, then you adapt.
• The holiday blues. The National Institute of Mental Health (NIMH) says winter-pattern seasonal affective disorder should not be confused with the holiday blues, the stress and sadness tied to a busy or hard time of year.
• Seasonal affective disorder (SAD). NIMH describes SAD as depression related to changes in daylight hours, not the calendar. It comes back around the same season year after year.

Questions to ask yourself this month

• Has my low mood lasted most days for a couple of weeks or longer?
• Did something like this happen last winter, or the winter before?
• Am I sleeping much more, craving carbohydrates or pulling back from people?
• Has it become harder to keep up with work, family or the things I usually enjoy?

If you answered yes to several of these, it is worth talking with a provider. NIMH advises anyone worried about these symptoms to talk to a health care provider or a mental health specialist.

Plan pleasant things on purpose

One part of the talk therapy NIMH describes for SAD, called CBT-SAD, is behavioral activation: identifying and scheduling pleasant, engaging activities, indoors or outdoors. Short days make it easy to stop doing the things that keep mood steady, so putting them on the calendar matters. A walk at lunch while it is still light, a standing call with a friend or a weekly class can all count. In NIMH's account, CBT-SAD usually runs as two group sessions a week for 6 weeks.

What treatment can look like

NIMH lists light therapy, talk therapy, medication and vitamin D as the main options, alone or together. In studies NIMH cites, light therapy and CBT-SAD worked about equally well, some symptoms eased slightly faster with light therapy, and the benefits of CBT seemed to last longer when patients were followed for two winters.

Light therapy means sitting in front of a very bright 10,000-lux light box for about 30 to 45 minutes a day, according to NIMH. People with certain eye diseases, or who take medicines that increase sensitivity to sunlight, may need another option or medical supervision, so ask before you start. Vitamin D can also interact with some medicines, and study results on it are mixed. Medication is considered when indicated, decided jointly with you.

If this happens every year

Because SAD tends to arrive on schedule, NIMH says people with a history of it might benefit from starting treatment before fall. Few studies have tested whether SAD can be prevented, so a provider can help you choose both the approach and the timing. If winter is already here and you are struggling, the right time to call is now.

Getting help at Hope Behavioral Medicine

We evaluate seasonal and year-round depression in West Ashley and by secure video anywhere in South Carolina. Read more about our seasonal affective disorder care and our counseling. Request an appointment.

If you are having thoughts of suicide, call or text 988. In an emergency, call 911.

Source: NIMH, Seasonal Affective Disorder (revised 2023).

This article is general information, not medical advice, and does not create a patient–provider relationship. Every situation is different, so see a provider who can evaluate yours and develop a plan of care. Any medication discussed here may not be right for you: the right choice depends on your diagnoses, other health conditions and current medicines, so take medication only as directed by the provider managing your care. If you are ever in doubt about an emergency, call 911 or go to the nearest emergency room.