Seasonal Affective Disorder: A Nurse’s Guide to Combating the Winter Blues

As daylight fades and winter settles in, many people experience a dip in energy, motivation, and mood. For some, this seasonal change develops into a form of depression linked to reduced sunlight exposure known as Seasonal Affective Disorder (SAD).

Understanding SAD is essential for nurses to support patients who show signs of seasonal depression and also to safeguard their own mental health during winter months.

Understanding Seasonal Affective Disorder

For nurses to effectively recognize and manage SAD, they must first understand the condition’s causes, risk factors, and presenting symptoms.

What’s Seasonal Affective Disorder?

SAD is a recurrent type of major depression that follows a seasonal pattern, with typical onset in late fall or winter and resolution in the spring. The lack of sunlight associated with seasonal changes can alter brain chemistry, leading to mood and energy changes that interfere with daily functioning. 

What Causes SAD?

Individuals develop seasonal depression as a result of several biological and environmental factors which occur in response to seasonal changes. These factors include: 

• Disruptions in one’s circadian rhythms which impact sleep and mood.
• Decreased serotonin levels causing sadness and low mood symptoms
• Increased production of melatonin leading to fatigue and sleepiness.

Risk Factors

Genetic factors and previous mental health conditions can increase someone’s likelihood to develop seasonal depression. Nurses should also be aware of high-risk populations for this condition which include: 

• Assigned female gender at birth
• Increased age
• Individuals with major depressive disorder or bipolar disorder
• Those who live in northern regions with limited sunlight
• Someone with a family history of mood disorders
• Healthcare workers facing chronic stress and night shifts

Common Symptoms

The symptoms of SAD are similar to other depressive disorders and may include:

• Low mood
• Irritability
• Loss of energy or fatigue
• Changes in sleep patterns, specifically oversleeping or difficulty waking up
• Carbohydrate cravings and weight gain
• Loss of interest in normal activities
• Difficulty concentrating

The key to differentiating SAD from situational depression is recognizing the recurring pattern of seasonal symptom presentation. 

Recognizing SAD in Patients

Nurses are often the first to recognize behavioral and emotional changes in their patients. By using specific screening tools and assessment strategies nurses can identify individuals who are experiencing symptoms of seasonal depression.

Screening and Assessment Tools

A formal depression screening should be performed when a nurse suspects mood changes or depression symptoms in a patient. 

The Patient Health Questionnaire (PHQ-9) is a common survey used in clinical practice for depression screening. Its shorter version—the PHQ-2—is regularly used as a part of appointment check-in, allowing health care professionals to flag patients who may need further assessment. 

The Seasonal Pattern Assessment Questionnaire (SPAQ) may be preferred over generalized screening when trying to differentiate seasonal depression from other depressive disorders as it’s more specfic to screening for symptoms linked to seasonal changes.. 

Other Nursing Considerations

In addition to formal screening tools, nurses can also assess for signs and symptoms of SAD by:

• Observing mood changes
• Asking open-ended questions
• Encouraging patients to share emotional experiences
• Collaborating with healthcare providers for mental health referrals
• Documenting any seasonal patterns in mood or energy

Early recognition allows for timely intervention, reducing the impact of SAD on a patient’s quality of life.

Supporting Patients with Seasonal Affective Disorder

Nurses should support patients experiencing symptoms by educating them on valuable tools, strategies, and treatments to manage their conditions. 

Evidence-Based Treatments

There are many treatment options for seasonal depression that have proven effective.

Phototherapy

Cognitive Behavioral Therapy (CBT)

This form of psychotherapy helps patients challenge negative thinking and develop healthy coping skills. Recent studies suggest that CBT may have better long-term outcomes than phototherapy alone. 

Antidepressants

Selective Serotonin Reuptake Inhibitors(SSRIs) can alleviate moderate to severe symptoms. Wellbutrin XL, a norepinephrine-dopamine reuptake inhibitor, is also indicated for use as a preventative, prior to seasonal changes and symptom onset. 

Vitamin D Supplementation

Increasing vitamin d intake through supplements or dietary intake may help improve symptoms of SAD. It’s recommended to take up to 5000iu daily supplementation or incorporate foods high in vitamin d such as:

• Dairy products
• Salmon and tuna
• Eggs

Lifestyle Modifications

Patients experiencing seasonal depression often benefit from the following lifestyle modifications along with other treatment methods: 

• Taking outdoor walks during daylight hours
• Maintaining balanced nutrition and limiting processed sugars
• Performing exercise routines that enhance endorphin release
• Incorporating mindfulness and relaxation techniques 

Education and Support

Nurses can empower patients by providing them with additional knowledge and tools to manage their condition. This may include:

• Providing educational materials on SAD prevention and management.
  
• Recommending mood-tracking journals or apps.
  
• Connecting patients with mental health professionals or support groups.

Care for Nurses With SAD

Nurses themselves aren’t immune to the effects of seasonal depression, so it’s important for nurses to recognize common symptoms in themselves as well. The effects of long shifts, limited sunlight, and emotional exhaustion can mimic SAD symptoms. Nurses who think they have depression symptoms should be encouraged to seek help just as they would recommend their patients.

Self-Care Strategies for Nurses

Nurses that identify symptoms or risk factors for SAD in themselves should use the following self-care strategies to manage this condition:

• Get sunlight exposure: Take short outdoor breaks during daylight hours.
  
• Try light therapy: Use a light box at home before early shifts.
  
• Exercise regularly: Even 20 minutes of physical activity can improve mood.
  
• Maintain a healthy diet: Focus on protein-rich and high-fiber foods.
  
• Stay socially connected: Build peer support to reduce isolation.
  
• Seek help early: Consult a healthcare provider if symptoms persist.
  

Creating Supportive Work Environments

Healthcare leaders can support their nursing staff by incorporating programs and systems that promote employee mental health and reduce SAD in nurses. These work environment strategies may include:

• Offering mental health education and stress management workshops.
  
• Providing access to Employee Assistance Programs (EAPs).
  
• Encouraging flexible scheduling that allows daylight exposure.

The Nurse’s Role in Promoting Mental Health Awareness

Nurses play a vital role in recognizing Seasonal Affective Disorder and reducing the stigma surrounding mental health. Through compassionate care and open dialogue, nurses can foster healthier communities for their patients, themselves, and their colleagues.

Seasonal Affective Disorder is a treatable condition that affects patients and nurses alike. By recognizing early signs, understanding treatment options, and practicing self-care, nurses can lead the way in promoting mental wellness through every season.

FAQ: What Nurses Want to Know About Seasonal Affective Disorder

1. How can I tell if a patient’s low mood is SAD or regular depression?
SAD is acute depression that follows a predictable seasonal pattern—symptoms worsen in winter and improve in spring.

2. Is light therapy safe for everyone?
Light therapy is generally safe, but patients with certain eye conditions(glaucoma or cataracts) or bipolar disorder should seek medical advice prior to treatment.

3. Can Seasonal Affective Disorder occur in summer?
Yes, though rare, it is possible to have seasonal affective disorder that starts in the spring and summer and resolves in winter, though symptoms differ.

4. What should I do if I suspect I have SAD?
Talk to a healthcare provider, maintain healthy habits, and consider light therapy or counseling.

5. How can nurses support coworkers during winter months?
Encourage breaks, discuss mental health openly, and plan morale-boosting activities.

References

Cleveland Clinic. “How Light Therapy Can Help With Seasonal Affective Disorder.” December 9, 2024. https://health.clevelandclinic.org/light-therapy

Dietary Guidelines for Americans. “Food Sources of Vitamin D.” (n.d.) https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials/food-sources-select-nutrients/food-sources-vitamin-d

Goodrx. “Seasonal Affective Disorder Medications: 4 Drugs Available for Use.” October 21, 2025. https://www.goodrx.com/conditions/seasonal-affective-disorder/medications

Johns Hopkins Medicine. “Seasonal Affective Disorder.” (n.d.) https://www.hopkinsmedicine.org/health/conditions-and-diseases/seasonal-affective-disorder

Mayo Clinic. “Seasonal Affective Disorder.” December, 14, 2021. https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651

Melton, S., Wieland, S., Bastounis, A., and Carter, T. (2025). Cognitive behavioural therapy for seasonal affective disorder: a systematic review and meta-analysis. The Cognitive Behaviour Therapist, 18:e41. Doi: 10.1017/S1754470X2510024X

Caitlin Pratz, MSN-RN

Caitlin Pratz, MSN-RN, is a registered nurse who brings over 14 years of clinical experience in different settings including: med-surg, school nursing, and primary care to her writing. She aims to improve health literacy and health outcomes by bringing evidence-based insights to patients and health care providers bridging gaps between complex medical information and accessible, actionable knowledge.

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