Do I Have Seasonal Affective Disorder or Depression? What Seattle's Big Dark Can Tell You

By November in Seattle, getting out of bed can feel harder. It's dark when you wake up, dark when you're done with work, and another gray weekend makes staying home awfully appealing.

But when does feeling worn down by The Big Dark become depression? And how can you tell whether it's seasonal?

Ann Husak, a therapist at Puget Sound Psychotherapy, says the most useful clue is what happens over time.

"Come March, I'm definitely feeling in the dumps because it's been raining and gray for months," Ann says. "But there's a big difference between feeling irritable because the weather has been crap and seasonal affective disorder."

The distinction has a lot to do with how much your daily life changes, and whether the same thing happens winter after winter.

Seasonal affective disorder is a form of depression

Despite the way people often frame the question, seasonal affective disorder, or SAD, is a form of clinical depression. The American Psychiatric Association describes it as major depressive disorder with a seasonal pattern.

About 5 percent of U.S. adults experience SAD, with higher rates in places farther from the equator such as Seattle.

Ann says that both can interfere with everyday life, but SAD follows a recurring pattern. Depression without a seasonal pattern can bring episodes at different times throughout the year.

With winter-pattern SAD, symptoms typically arrive in fall or winter and ease in spring. A clinician looks for that pattern across at least two consecutive years, but you don't need to wait two years to get help.

How to spot a seasonal pattern

Ann recommends looking back rather than focusing only on how you feel today. When did things start getting harder? When did you begin feeling like yourself again?

Ann suggests looking for changes that return during the same months each year:

• Pulling away from friends or turning down plans.
• Struggling to leave the house, even for activities you usually enjoy.
• Sleeping more than usual.
• Noticing increased appetite or carbohydrate cravings.

These symptoms can also occur in other forms of depression. The recurring seasonal pattern helps a clinician distinguish what's happening.

A normal winter slowdown might mean choosing quieter evenings. Losing interest in things you usually care about, or finding everyday responsibilities increasingly difficult, deserves closer attention.

Can existing depression get worse in winter?

Yes. For clients who are in therapy for depression and know winter tends to be difficult, Ann brings it into the conversation before their mood starts slipping.

But feeling worse during darker months doesn't automatically establish SAD, either. If symptoms continue through spring and summer, that's important information to bring to an appointment.

So is whether winter introduces a distinct episode or intensifies symptoms already there. A professional assessment can also check for other explanations. Thyroid problems, for example, can cause symptoms that resemble depression.

How treatment differs for SAD and other depression

Treatment for both situations overlaps. Psychotherapy and antidepressants can help with both seasonal and nonseasonal depression, but the plan will depend on how much symptoms affect your daily life and your medical history.

Ann stressed that if you know you suffer from SAD, it's best to prepare before the difficult months arrive. With clients who recognize a seasonal pattern, she looks at what became difficult last winter and makes a practical plan for those specific problems.

• Identify your early warning signs, such as staying home more or struggling with sleep.
• Make a checklist of things that have helped before.
• If getting outside became hard, plan a manageable daily walk.
• If your sleep suffered, work on a consistent bedtime before winter makes it harder.

For winter-pattern SAD, bright-light therapy is a common additional treatment. It typically involves a UV-filtering, 10,000-lux light box used in the morning. Ask a health care provider about the right schedule and equipment.

For more practical ideas, see our guide to coping with seasonal affective disorder in Seattle.

Clinically reviewed by Haley Boscolo, LMFT at Puget Sound Psychotherapy and Psychiatry