Postpartum Depression and Seasonal Affective Disorder

Baby Blues and Winter Blues: The Lesser Publicized Depression Subtypes

Major life events are a well-known trigger for depression in many individuals. The winter months can precipitate excessive sadness in some people because of the shorter days, less sunlight, and change in routine. Likewise, the arrival of a baby can bring about more than temporary mood disturbances in new mothers. Recognizing the risk factors for Seasonal Affective Disorder (SAD) and Postpartum Depression (PPD), as well as understanding their common symptoms and triggers can help individuals manage major seasonal and life transitions.

Key Points:

• Biological Risk Factors
• Symptoms and Ways to Manage
• Treatment and Prevention

Overview of SAD and PPD:

Seasonal Affective Disorder is the DSM-5 recognized name for a form of depression in which the onset corresponds with a specific change in season, most commonly in the winter. It affects 1.5% to 10% of the general population. Postpartum Depression is a subtype of Major Depression occurring in new mothers following pregnancy and childbirth. Although the lesser-severe “baby blues” can occur in up to 80% of new mothers, clinical PPD affects 10-15% of new mothers.

Biological Risk Factors:

Both SAD and PPD have biological and social risk factors which make it more likely for an individual to develop the condition.

• SAD Risk Factors: Genetic predisposition, where someone lives on the globe, Vitamin D levels, and sex contribute to SAD. Genetic factors such as a family history of SAD or mood disorders, can make an individual more likely to develop this type of depression. Those living farther from the equator have a higher prevalence of SAD likely due to the reduced sunlight and shorter days in winter. Likewise, low Vitamin D levels, typically obtained through sunlight, is linked to SAD. Women are approximately 1.5 times as likely to experience SAD. One explanation for this sex difference may be due to females’ fluctuating hormone levels that can exacerbate symptoms during the winter.
• PPD Risk Factors: Anxiety or depression during pregnancy, having a history of depression, excessive maternal stress, partner conflict, and lack of social support are the major risk factors for PPD. Uncontrollable influences, such as a baby who cries a lot or is born with a disability, also increase the risk of developing PPD.

Symptoms and Ways to Manage

In the DSM-5, both SAD and PPD are categorized as Major Depressive Disorders with either a “seasonal pattern” or “with peripartum onset.” SAD and PPD share many of the same symptoms. These often include feelings of sadness, loss of interest in daily activities, changes in appetite, sleep disturbances, difficulty concentrating, and decreased energy levels. For SAD, sadness, changes in appetite, and low energy are the most commonly reported symptoms. For PPD, mood swings, anxiety, and sleep disturbances are common.

Treatment and Prevention

It is important to recognize that many of the risk factors for SAD and PPD are beyond one’s control and prevention is not always possible. Self compassion and acknowledging you are not to blame can make it easier to seek support and learn strategies to cope.

For Seasonal Affective Disorder:

• Light therapy – Research shows that 30-minute morning exposure to 10,000 lux artificial light can greatly improve SAD symptoms in the winter months. Light boxes can be purchased online, in a range of sizes, some compact enough to be placed on a desk or travel with.
• Antidepressant medications – Individuals with SAD struggle to regulate serotonin levels, a neurotransmitter involved in regulating mood. SSRIs such as Prozac and NDRIs such as Wellbutrin have been shown to be effective in treating SAD. Talking with your doctor about options for medications can be one option to improve depressed mood.
• Vitamin D Supplementation – Shoulder days and access to sunlight diminishes during the winter months, especially in Northern latitudes. Dietary supplemention of Vitamin D may alleviate SAD symptoms in individuals whose levels are low.

For Postpartum Depression:

• Psychotherapy and Support Groups – Individual therapy or support groups can be incredibly beneficial for mothers struggling with postpartum depression. Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), and group therapy can create a support system for new mothers experiencing PPD and validate anxious and depressed feelings.
• Antidepressant Medications – SSRIs and SNRIs are options for new mothers struggling with PPD. It is important to talk with your doctor if breast feeding to ensure the safest options and minimize potential risks to the infant. However, many of these medications have low-risk profiles for mothers in need.
• Self-care – Sleep and routine are often the first things to go when a baby arrives. Although not always feasible, engaging in activities that relax you, leaning on your partner, family, and friends to support childcare, and finding time to rest when possible can make a big difference and improve PPD symptoms.

Recognizing onset and duration

Lifestyle and seasonal changes are inevitable. Understanding risk factors and taking precautionary measures can help individuals susceptible to SAD or PPD lessen the severity of these conditions.