Seasonal Affective Disorder Care in West Ashley, Charleston
Evaluation, counseling and medication management for depression that returns with the seasons, in person or by secure video.
Understanding Seasonal Affective Disorder
Seasonal affective disorder (SAD) is depression that keeps returning on a seasonal schedule, with symptoms lasting about 4 to 5 months of the year, according to the National Institute of Mental Health (NIMH). In the winter form, which is the more common one, symptoms usually set in during late fall or early winter and fade in spring and summer. A smaller group has the reverse, with symptoms arriving in spring and summer.
SAD differs from the holiday blues. NIMH describes those as sadness or anxiety brought on by stressful times of year, while SAD follows the amount of daylight.
Signs We Ask About
Because SAD is a form of depression, it can bring a low, anxious or empty mood, feelings of hopelessness, irritability, guilt or worthlessness, lost interest in favorite activities, low energy, poor concentration, changes in sleep and appetite, aches with no clear physical cause, and thoughts of death or suicide. NIMH describes these symptoms as present for much of the day for at least 2 weeks. That is a diagnostic detail, and you do not need to count days before you call us. If thoughts of suicide are part of this, call or text 988 now, and if there is immediate danger, call 911 or go to the nearest emergency room now.
The winter form often adds sleeping too much, overeating with strong cravings for bread, pasta and sweets, weight gain, and pulling away from friends and family. The summer form can look quite different, with poor sleep, low appetite and weight loss, restlessness, agitation, anxiety, and violent or aggressive behavior.
If You Are in Crisis
Thoughts of death or suicide need help right now, in any season. If you or someone you know is thinking about suicide or self-harm, call or text 988 now to reach the 988 Suicide & Crisis Lifeline, which is free and confidential at any hour. If there is immediate danger, including from violent or aggressive behavior, call 911 or go to the nearest emergency room now. Veterans and service members can reach the Veterans Crisis Line by dialing 988 and pressing 1. Hope Behavioral Medicine is not an emergency service.
How Common Is Seasonal Affective Disorder?
By NIMH's estimate, SAD touches millions of Americans. It often begins in young adulthood and affects women much more often than men. Certain other diagnoses make it more likely: bipolar disorder, especially bipolar II, along with depression, ADHD, anxiety, panic disorder and eating disorders. It can run in families.
Geography plays a part as well. NIMH notes a higher likelihood in places such as Alaska or New England than in Texas or Florida. Living in South Carolina may lower the odds compared with living farther north, but it does not rule SAD out, and our winter days get shorter too.
How We Evaluate a Seasonal Pattern
The DSM-5-TR, the American Psychiatric Association's diagnostic manual, identifies SAD as major depressive disorder with a seasonal pattern, and that diagnosis is made by a qualified clinician using the manual. You may start with a brief questionnaire. In plain words, NIMH describes three things behind a diagnosis. You have symptoms of depression or the seasonal signs above. Your episodes have landed in one particular season for at least 2 years running, although some people skip a year. And those seasonal episodes outnumber any episodes at other times of year.
It helps to think back over the last few years before your visit. When did your mood start to change, and when did it lift? What happened to your sleep, your appetite and your plans with other people?
Your provider will also consider other explanations. Certain medicines and medical conditions, including viruses and thyroid disorders, can look just like depression, and NIMH says a physical exam, an interview and lab tests can rule these out. If you have bipolar disorder or have ever had periods of unusually high energy, please mention it, since that can change the plan.
Treatment Options
NIMH names four main treatments, which can be used alone or in combination. Your provider can go over which ones fit you.
Light therapy is used for the winter form. It usually involves sitting in front of a 10,000-lux light box, lux being a measure of brightness, usually early in the morning, between fall and spring. Check with your provider first if you have bipolar disorder or certain eye conditions, or if any medicine you take raises your sensitivity to sunlight.
Sources vary on this. NIMH says about 30 to 45 minutes a day and another National Institutes of Health source says 20 to 60 minutes. That's why seeing a licensed, experienced provider who knows you is essential. They can review the evidence, risks and benefits for your situation, and decide with you.
Medication when indicated, decided jointly with the patient, is another option. Some treatment takes weeks to work, and NIMH says some people need to try more than one option, which is one reason to raise the subject before the days shorten. Your provider will talk through the benefits and side effects with you.
Talk therapy is the third option. NIMH describes a version of cognitive behavioral therapy adapted for SAD, called CBT-SAD, which worked about as well as light therapy in one direct comparison. Our licensed counselors can talk with you about what fits, and we coordinate a referral when a specialized approach makes more sense.
Vitamin D is the fourth. Many people with the winter form run low, so a supplement may help, but study results are mixed, and a National Institutes of Health source says it is not considered effective on its own. It can interact with some medicines, so ask your provider before starting it.
Getting Care in the Charleston Area
Charleston County has about one mental health provider for every 214 residents, compared with one for every 437 across South Carolina. Our office is on Gardner Road in West Ashley, and we also see adults anywhere in South Carolina by secure video, so you do not have to wait for a local opening or take time off to drive.
We accept Medicare, most major commercial plans, and all South Carolina Medicaid managed care plans except Select Health (First Choice). New patients are often able to be scheduled within a week of requesting an appointment.
Sources
The facts on this page come from: National Institute of Mental Health, Seasonal Affective Disorder (2023); American Psychiatric Association, patient information on seasonal affective disorder; National Institutes of Health, public information on seasonal affective disorder; CMS National Provider Identification file, 2024, via County Health Rankings & Roadmaps, 2025.
Common Symptoms
Treatment Options
Frequently Asked Questions
NIMH describes the holiday blues as sadness or anxiety brought on by stressful times of year. SAD is a type of depression that returns on a seasonal schedule and follows daylight.
Yes. SAD is more common farther north, but living here does not rule it out. If your mood follows the seasons, it is worth bringing up.
Not always. NIMH says a diagnosis looks for episodes in one season for at least 2 years in a row, although some people skip a year.
Before the days get short. Some treatment takes weeks to work, so fall or earlier is a good time to talk with your provider. If you are struggling now, you can call us now.
Talk with your provider first, especially if you have bipolar disorder or certain eye conditions, or if any medicine you take raises your sensitivity to sunlight.
By NIMH's estimate, it touches millions of Americans. It is much more common in women than in men and often begins in young adulthood.