Seasonal affective disorder

Seasonal affective disorder is not considered to be a unique diagnostic entity in itself, but rather a subtype specifier used to describe temporal variations in recurrent major depressive or bipolar disorders over at least a 2-year period.

Most commonly presents with onset of depression in the fall or winter, and full remission of symptoms in the spring or summer.

Atypical vegetative symptoms of depression are common, such as hypersomnia, hyperphagia, and weight gain.

Assessment is based on self-report, clinical interview, and behavioral observation.

Light therapy, selective serotonin-reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors are considered the initial treatment options. Light therapy may be used in combination with pharmacotherapy.

Longer-term clinical management and monitoring are typically required. Light therapy and/or bupropion may be used as prophylactic therapy.

All patients must meet the diagnostic criteria for recurrent major depression or bipolar mood disorder. Seasonal affective disorder (SAD) is then a subtype specifier used to describe temporal variations of these disorders. As such, SAD is not considered a stand-alone diagnosis or comorbid condition to recurrent major depression or bipolar disorder. Common presentations include the initiation or worsening of depressive symptoms during the fall or winter months, and full remission during the spring or summer months, or hypomanic or manic symptoms presenting during spring or summer months.