When it’s more than just winter blues…

Wednesday, August 16 2023

The seasons and weather can affect our moods, and for certain individuals seasonal changes can trigger significant deterioration in mental health. It is worthwhile to remain vigilant to spot symptoms early on and plan ahead to manage recurring episodes of mental distress when the seasons change, both for those who are directly at risk and for those who support them.  

“Researchers have suggested that our brains developed sensitivity to seasonal change as a survival mechanism during our evolution,” says Sandy Lewis, Netcare's mental wellness coach.

Seasonal changes alter our brain chemistry, and for most people the effects are manageable, but anyone with a known history of psychiatric illness could be at risk. 

“In winter, shorter daylight hours stimulate the brain to produce more melatonin and less serotonin, which can result in the symptoms of depression emerging in predisposed individuals. In spring and summer, it is the opposite, and more serotonin is produced to the point of inducing mania in some people. 

“It is important not to confuse this with just ‘winter blues’ or ‘spring fever’ that many people may experience transiently. For some people, these are severe medical conditions. What started out as adaptation in our distant ancestors to ensure the human species could cope with and live through extreme changes in weather and light, now may be at the root of seasonal mental disorders in certain vulnerable individuals.”

All the leaves are brown
“Traditionally, winter is often associated with metaphorical death and the natural world is at its lowest ebb, which subconsciously can affect how we feel at this time of year. The dry winter months in South Africa’s summer rainfall regions may also trigger primeval survival anxiety, as water is something we cannot live without. 

“Winter may feel depressing for many of us, but clinical depressive episodes are characterised by marked changes such as loss of interest or pleasure in usual activities; extreme fatigue; brain fog; changes in appetite or sleeping patterns; withdrawal and greater sensitivity to social rejection among others, for two weeks consecutively or more.

“For some people moving into spring can trigger other mental wellbeing issues. We expect to feel low in winter, and if we still feel hopeless come spring, it may become unbearable. For others, the exuberance of spring may tip over into mania, where the person often feels ecstatically happy; talks rapidly; is easily distracted or jumps from one subject to another.

Dangers and diagnosis
“A person having a manic episode may have feelings of invincibility, irritability or impulsive desires, which may lead to reckless behaviour. These highs are also soon followed by depression, which may put the person at increased risk of suicide during seasonal changes.”

Previously, seasonal symptoms were classified as seasonal affective disorder or ‘SAD’, mostly referring to seasonal depression. More recently, SAD has been classified as major depressive disorder with seasonal patterns. In addition, marked seasonal mood swings are now categorised as a subtype of bipolar mood disorder. The clinical diagnosis for either can only be made if the episode of illness recurs at the same time, coinciding with the change in seasons, for at least two years.

“Urgently seek medical care if the symptoms of depression are experienced for more than two weeks or if they intensify, and, for manic symptoms, if they do not resolve within one week. There is definite cause for concern, especially if the person has already been clinically diagnosed with a mental health disorder,” Lewis says. 

Reach for help
If you or a loved one are at risk or have experienced significant disruption from seasonal patterns of mental disorder in previous years, it may be helpful to plan ahead to ensure adequate support and professional help are in place before they are needed, she advises. 

“It is most helpful to anticipate that you may experience an episode of depression or mania linked to the seasons and prepare yourself and the people around you for it. Then, if or when it happens, you are not in shock or denial, but prepared to immediately step into compassionate action to address the symptoms that emerge constructively, seek immediate help and treatment and make the necessary lifestyle changes required to ride out the episode,” Lewis says. 

“Having a plan in place before the episode hits is very empowering for everyone involved. Acceptance is key: work with the reality that presents itself. Don’t waste time with judgments or shame or preferences that things could or should be different. Our best course is to acknowledge truthfully, clear-eyed, whatever is actually emerging in our lives, wanted or unwanted. Then we face it head on, we lean into it, and we work with it to make whatever change is required to reduce harm and facilitate recovery as quickly as possible”.

For information about mental health services and accessing care, Netcare Akeso is here to help. In the event of a psychological crisis, individuals can also phone the Netcare Akeso crisis helpline on 0861 435 787, 24 hours a day, to talk to an experienced counsellor. The South African Depression and Anxiety Group (SADAG) is also available to assist on 0800 205 026 or 011 234 4837.


About Netcare Akeso

Netcare Akeso operates a network of private inpatient mental health facilities and is part of the Netcare Group. Netcare Akeso provides individual, integrated and family oriented treatment in specialised inpatient treatment facilities, as well as certain outpatient services, for a range of psychiatric, psychological and substance use conditions. Please visit or contact [email protected] for further information.
In the event of a psychological crisis, call 0861 435 787, 24 hours a day for emergency support. Psychiatrist consultations can be made through Netcare appointmed™, online at or by calling 0861 555 565.
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