Fast Five Quiz: Holidays and Mental Health

Stephen Soreff, MD


December 14, 2020

SAD typically describes a recurrent, seasonal pattern of depressive episodes. It is not named in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a separate condition. Instead, it is listed as a specifier — "with seasonal pattern" — under major depressive disorder, recurrent and the bipolar disorders. Research has indicated a strong connection between SAD and bipolar disorder. The main age of onset for SAD is 18-30 years; SAD is less likely to occur in older adults. Most individuals who experience SAD are women.

Many people with depression describe more intense symptoms during the winter and less intense symptoms during the summer. To meet the DSM-5 diagnostic criteria for major depressive disorder with seasonal pattern, depression should be present only at a specific time of year (eg, in the fall or winter), and full remission occurs at a characteristic time of year (eg, spring). An individual should demonstrate at least two episodes of depressive disturbance in the previous 2 years, and seasonal episodes should substantially outnumber nonseasonal episodes.

Winter-onset SAD is more common and is often characterized by atypical depressive symptoms, including hypersomnia, increased appetite, and craving for carbohydrates. Spring/summer SAD is more frequently associated with insomnia and loss of appetite.

Read more about the presentation of SAD.


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