Seasonal Affective Disorder: How to Cope as a Highly Sensitive Person
You know that feeling when the days start getting shorter and you just can't shake the blues? I get it. Here in Quebec City, where I live, we're at latitude 46.8°N, and the sun sets as early as 3:00 pm in winter. That's rough. And with those shorter days comes something more serious than just feeling a bit down—it's called Seasonal Affective Disorder.
What Exactly Is SAD?
Seasonal Affective Disorder (and yes, the acronym really is SAD) is a form of depression that follows the seasons. You might also hear it called seasonal depression or winter depression. In the official diagnostic manual that mental health professionals use (the DSM-5-TR), it's classified as major depressive disorder with seasonal pattern. So it's the real deal.
Most people with SAD experience symptoms during fall and winter when there's less sunlight, and things typically improve when spring rolls around. Though it's much less common, some people actually experience it in summer. According to French-Canadian SAD researcher Marie-Pier Lavoie, some people start noticing symptoms as early as August.
Here's the thing: SAD isn't just "winter blues" or feeling a bit meh because it's cold outside. The symptoms can be truly distressing and overwhelming, interfering with your day-to-day life. The good news? It can be treated.
About 5% of adults in the U.S. deal with SAD, and it typically hangs around for about 40% of the year. Where you live makes a difference too. The farther you are from the equator, the more common SAD becomes. Young people aged 20-25, children, and adolescents are most at risk. Women are also more susceptible because SAD is connected to hormonal fluctuations.
What Causes SAD?
Scientists have linked SAD to changes in the brain triggered by shorter daylight hours and less sunlight in winter. When the seasons change, your biological internal clock (your circadian rhythm) shifts, which can throw you out of sync with your daily schedule.
Both SAD and high sensitivity have been linked to serotonin imbalances, which suggests serotonin might be the common thread connecting the two.
The Connection Between SAD and High Sensitivity
Now, here's where things get really interesting if you're a highly sensitive person (HSP). Researchers in Denmark investigated the link between high sensitivity and seasonal affective disorder, conducting studies both in summer (when SAD symptoms are in remission) and winter (when symptoms appear).
What they found is pretty striking: people with SAD were much more likely to be highly sensitive. Specifically, 25% of people with SAD were also HSPs, compared to only 5% of people without SAD.
Even more fascinating? People with higher HSP scores in the summer had more severe SAD symptoms come winter. It was almost like their HSP score was predicting how rough their winter would be.
What Does SAD Feel Like?
Common symptoms include fatigue (even when you're sleeping way too much) and weight gain from overeating and craving carbs. But SAD symptoms can range from mild to severe and might include:
Feeling sad or depressed most of the day
Losing interest in things you used to enjoy
Changes in appetite—usually eating more and craving carbohydrates
Sleeping too much
Feeling exhausted despite all that sleep
Either feeling restless and unable to sit still, or feeling slowed down (and it's noticeable to other people)
Feeling worthless or guilty
Having trouble thinking, concentrating, or making decisions
In severe cases, thoughts of death or suicide
How to Treat SAD
The encouraging news is that SAD can be effectively treated in several ways: light therapy, antidepressant medications, talk therapy, or some combination of these. While symptoms generally improve on their own when the season changes, treatment can speed up that improvement significantly, especially if symptoms have become severe.
Light Therapy
This involves sitting in front of a special light therapy box that emits very bright light while filtering out harmful UV rays. You usually need to do this for 20 minutes or more per day, typically first thing in the morning, throughout the winter months. Most people see improvements within one or two weeks. To maintain the benefits and prevent relapse, you'd continue treatment through winter. Some people even start in early fall to head off symptoms before they begin.
Talk Therapy
Cognitive behavioral therapy (CBT) can be particularly effective for treating SAD.
Medication
Selective serotonin reuptake inhibitors (SSRIs) are the antidepressants most commonly prescribed for SAD.
Making Friends with Winter
For some people, just getting more sunlight can help. Marie-Pier Lavoie recommends spending one hour outside during the day, preferably in the morning.
She also suggests something that might sound counterintuitive: make friends with winter by doing winter sports. Now, I know some of you are thinking, "Go out in the cold? Are you kidding?" But hear me out. I've always lived in cold climates and done lots of winter sports, and winter is actually my favorite season. Here's why it might work for you too.
Winter feels coldest mainly because of the wind. But if you're out in the forest, the trees protect you from the wind. Activities like snowshoeing, cross-country skiing, or winter hiking actually feel much warmer than walking around in a city. Plus, many winter sports use a lot of energy, so you generate your own heat. Just make sure to dress in layers you can remove, or you'll get too hot and sweaty, then cold when you stop moving.
If you live somewhere without much snow but it's still cold, skating is always an option. Many cities in Canada and the U.S. maintain outdoor rinks.
Here's another tip: winter feels colder when it's humid. A game-changer for me was investing in lightweight ski underwear (wool or polyester that breathes) and wearing it under regular clothing. It makes such a difference.
If you prefer just walking, winter can be absolutely beautiful, especially with a light snowfall. Holiday decorations in neighborhoods add to the festive atmosphere and can make walks surprisingly pleasant.
And speaking of gear—if you live somewhere cold and dark, invest in a good winter coat, so that you will be toasty when you are outside. A proper wind-resistant, well-insulated, breathable winter coat is absolutely worth the investment. Get it from a sporting goods store, not a fashion store (those are made for looks, not warmth). When I first moved to Quebec City, I was miserable outside because it's much colder here than where I came from. Even my warmest coat felt like I was wearing just a t-shirt. That all changed once I bought a long well-insulated long parka.
When to Get Help
If you think you have symptoms of SAD, please see a trained medical professional. Just like with other forms of depression, it's important to rule out other medical conditions that might be causing your symptoms. SAD can be misdiagnosed in the presence of hypothyroidism, hypoglycemia, infectious mononucleosis, and other viral infections, so proper evaluation is essential. A mental health professional can diagnose the condition and discuss your treatment options. With the right treatment, SAD is absolutely manageable.
Important: If your depression feels severe or you're experiencing suicidal thoughts, consult a physician immediately or go to the nearest emergency room. You can also contact a suicide crisis line—these provide 24/7, free, and confidential support for people in distress. In the U.S., you can chat at 988lifeline.org for free (though you may incur phone charges).
Remember: you don't have to tough it out alone. SAD is real, it's treatable, and you deserve to feel better.