Seasonal Affective Disorder (SAD) Differential Diagnoses

Updated: Dec 09, 2020
  • Author: David R Michael, DO; Chief Editor: Ana Hategan, MD, FRCPC  more...
  • Print

Diagnostic Considerations

The primary diagnostic consideration is to differentiate “regular” major depressive disorder or bipolar spectrum disorder from the additional specifier of “with seasonal variation.” To meet the DSM-5 diagnostic criteria for major depressive disorder with seasonal pattern, depression should be present only at a specific time of year (eg, in the fall or winter) and full remission occurs at a characteristic time of year (eg, spring). An individual should demonstrate at least 2 episodes of depressive disturbance in the previous 2 years, and seasonal episodes should substantially outnumber nonseasonal episodes. [1]  Additionally, cases where there is an obvious effect of seasonally related psychosocial stressors (eg, seasonal unemployment) do not meet the diagnostic criteria.