When the Days Get Dark and Your Spark Fades: Let's Talk About SAD
Exploring the Root Causes of Hormonal Health
Let's be real: October hits, the clocks fall back, and suddenly you're driving home from work in the dark wondering when exactly you signed up to live like a nocturnal creature.
By December, you're eating carbs like it's your job, sleeping 10+ hours a night and still waking up exhausted, and your friends are like, "Want to go out?" and you're like, "Hard pass. I'll be on my couch under seven blankets, thanks."
If this sounds familiar, you may have Seasonal Affective Disorder or SAD. And no, it's not just the "winter blues" or being bummed about cold weather. It's a type of depression that shows up like clockwork when the seasons change, messes with your mood, energy, sleep, and appetite, and makes you feel like you're slowly turning into a hibernating bear.
At Red Hill Medical and Wellness, we see this every fall and winter: women (because yes, SAD affects women 4 times more than men) who go from feeling totally normal in summer to feeling like they're wading through molasses come November. Let's talk about what's actually happening in your body, why it's not "all in your head," and what you can actually do about it.
SAD vs. Winter Blues: What's the Difference?
Winter Blues: You feel a little down when it's dark and cold. Maybe you're less motivated, you miss the sun, and winter feels long. But you're still functioning pretty normally. About 10-20% of people experience this—it's annoying but manageable.
Seasonal Affective Disorder (SAD): This is clinical depression that shows up seasonally. We're talking symptoms that significantly impact your ability to function day-to-day. About 2-6% of people deal with this, and it's no joke.
How Do You Know If You Have SAD?
SAD is diagnosed when you've had symptoms of depression that show up AND go away with the seasons for at least two consecutive years. The symptoms are the same as regular depression, but winter SAD specifically looks like:
Feeling depressed most of the day, nearly every day
Losing interest in stuff you used to enjoy
Oversleeping but never feeling rested (hello, 12-hour sleep sessions)
Overeating and weight gain (especially craving carbs and sugar)
Social withdrawal (you basically want to hibernate and avoid all humans)
Feeling sluggish with zero energy
Brain fog and difficulty concentrating
Feeling hopeless or worthless
If you're having thoughts of death or suicide, please call 988 or talk to someone TODAY. This is serious and help is available. See resources at the end of this post.
What's Actually Causing This?
SAD is a combination of events triggered by lack of light exposure, which results in hormonal and biological changes that impact brain chemistry. Let's break this down:
1. Serotonin Takes a Nosedive
Serotonin is your brain's "feel good" neurotransmitter. When sunlight enters your eyes, it stimulates your retina to signal your brain to produce serotonin. Less sunlight in winter = less signal to make serotonin.
Research shows that serotonin production is directly related to bright sunlight exposure—your brain's serotonin levels are lowest in winter and rise rapidly when exposed to bright light. Lower serotonin can trigger depressed mood, increased carb cravings (because your brain is desperately trying to boost serotonin through food), and general misery. Essentially, your brain is running on low battery all winter.
2. Melatonin Goes Into Overdrive
Melatonin is your "time for bed" hormone. People with SAD produce TOO MUCH melatonin during fall and winter. More darkness triggers more melatonin production, which can make you feel sleepy ALL THE TIME. Your body is basically getting the signal that it's bedtime 24/7, making you feel sluggish and exhausted no matter how much you sleep.
3. Vitamin D Plummets
You make most of your vitamin D from sun exposure on your skin. During fall and winter, your vitamin D levels tank. Vitamin D is a hormone that activates the gene that makes TPH2, the key enzyme your brain needs to convert tryptophan (from food) into serotonin.
Without enough vitamin D, you can't efficiently produce serotonin even if you're eating all the right foods. It's like having all the ingredients for a recipe but no working oven. Plus, vitamin D helps keep the serotonin you do have available longer by reducing how quickly it gets broken down or reabsorbed.
4. Your Diet Changes (And Not in a Good Way)
When you're low on serotonin, your body craves carbs and sugar to temporarily boost serotonin. The problem? This creates a blood sugar rollercoaster that can trigger mood swings, increase inflammation, and leave you feeling even worse. It's a vicious cycle.
5. Estrogen Gets In On the Action
For women, estrogen fluctuations throughout your menstrual cycle already affect mood. Add in seasonal changes in serotonin and melatonin, and you've got a perfect storm. This is why SAD is 4 times more common in women than men.
So What Can You Do About It?
Here's the good news: SAD is very treatable. You don't have to white-knuckle your way through winter feeling miserable.
1. Light Therapy: Not Woo-Woo, Actually Science
Bright light therapy is one of the most effective treatments for winter SAD—we're talking about 75% improvement rates in research studies. You sit in front of a specialized light box (10,000 lux) for 30 minutes every morning.
How it works: The bright light mimics natural sunlight, which increases serotonin production, helps regulate melatonin (so you're not drowsy all day), and resets your circadian rhythm.
When to do it: First thing in the morning, ideally between 6-9 AM. Make it part of your morning routine while you drink your coffee or tea, or check emails.
Important: You need a proper 10,000 lux light box—your regular lamp doesn't cut it. Position it at arm's length (about 20-24 inches away), and you don't need to stare at it; just keep it in your field of vision while you do other things.
2. Get Outside in Actual Sunlight (Yes, Even When It's Cold)
Morning sunshine is a game-changer. Even on cloudy days, outdoor light is significantly brighter than indoor lighting. Bundle up and get outside for at least 15-30 minutes in the morning. Walk the dog, drink your coffee on the porch—whatever gets you out there.
3. Move Your Body (But Make It Fun)
Exercise increases serotonin and dopamine. You don't need to become a CrossFit warrior—just move in ways you actually enjoy. Walk in the morning sunshine (two-for-one!), dance in your kitchen, do yoga, swim—whatever makes you feel good. The key is consistency, not intensity.
4. Feed Your Brain (Not Just Your Cravings)
Yes, you're going to crave carbs. That's biology. But HOW you handle those cravings matters.
Protein-rich foods
Protein provides the amino acid tryptophan, which your body uses to make serotonin (like eggs, tofu, salmon, or nuts). Try to aim for 60+ grams daily.
Eliminate inflammatory foods
Inflammation makes everything worse, including mood!
Stabilize blood sugar
Eat balanced meals with protein, healthy fats, and fiber to avoid the crash-and-crave cycle.
Omega-3 fatty acids
Think fatty fish, walnuts, flaxseeds for brain health and mood!
When you DO eat carbs (and you will, and should), choose whole-grain carbs and pair them with protein and fat to avoid blood sugar spikes and crashes.
5. Support Your Neurotransmitters
Vitamin D supplementation: Get your levels tested and supplement appropriately. Most people with SAD are deficient and need to supplement during the winter months.
Targeted supplements (work with a practitioner to figure out what YOU specifically need):
Omega-3s (EPA/DHA)
B vitamins (support neurotransmitter production)
Magnesium (helps with sleep and stress)
5-HTP or tryptophan (serotonin precursors) may be appropriate for some people
6. Regulate Your Sleep-Wake Cycle
Morning: Get bright light exposure right away (light box + outdoor time)
Evening: Dim the lights, limit screen time, create a wind-down routine
Consistency: Go to bed and wake up at the same time every day, even weekends
7. Stay Connected (Even When You Want to Hibernate)
Social withdrawal is a classic SAD symptom, but isolation makes depression worse. You don't have to be the life of the party but just don't completely disappear into your blanket fort. Schedule regular hangouts, join a group activity, or just talk to people.
8. Consider Professional Support
Cognitive Behavioral Therapy (CBT): CBT specifically for SAD has been shown to be very effective. A therapist can help you identify and change thought patterns and behaviors that worsen depression.
Medication: If other interventions aren't enough, talk to your doctor about whether medication might be helpful as part of your treatment plan. At Red Hill, we see medication as a bridge while you're working through your integrative functional medicine program.
The Bottom Line
If you spend October through March feeling like a completely different (and significantly more miserable) person, you're not imagining it. SAD is real, it's biological, and it's treatable.
You don't have to just "push through" or "think positive" your way out of clinical depression. That's not how brain chemistry works.
At Red Hill Medical and Wellness, we take a comprehensive approach to SAD:
Assess your hormone levels (especially estrogen, which affects mood)
Check vitamin D and other nutrient levels
Evaluate your gut health (your gut makes most of your serotonin!)
Create a personalized treatment plan using light therapy, nutrition, targeted supplementation, and lifestyle modifications
Support you with terrain medicine modalities like acupuncture, homeopathy, and biomagnetic therapy to regulate mood and energy
Because SAD isn't just about serotonin—it's about your whole system. And treating it effectively means addressing all the pieces.
If you're struggling this fall/winter season: You don't have to wait until spring to feel like yourself again. Book a consultation with us and let's create a plan that actually works.
Important Resources:
If you're having thoughts of suicide or self-harm, please reach out for help immediately:
988 Suicide & Crisis Lifeline: Call or text 988
NAMI HelpLine: 1-800-950-NAMI (6264), Mon-Fri 10am-10pm ET
You are not alone, and help is available.