An Integral Care clinician shares warning signs, daily habits and low-cost help.
As days get shorter and calendars fill up, some Travis County residents may notice more than a passing slump.
Seasonal affective disorder, or SAD, is a type of depression tied to changes in daylight, according to the National Institute of Mental Health. Roxanne Dudley, a psychiatric nurse practitioner and licensed professional counselor with Integral Care’s Mobile Crisis Outreach Team, said fall can also bring added stress that can worsen both anxiety and seasonal depression.
The big picture
About 19% to 20% of U.S. adults may experience major depressive disorder, Dudley said. She put SAD at about 5% to 6% nationally, about 9% in Alaska and closer to 1% in Florida.
Rates in Texas are lower, but SAD is still a concern, especially in fall and winter, when it's most common, Dudley said.
The cause
Fall stacks up stressors, from games and sports to the holidays, Dudley said. Meanwhile, daylight shrinks from about 14 hours in summer to 10 hours or less in fall and winter.
That change disrupts the circadian rhythm, the body's natural clock, she said. The loss of light matters more than the time change itself. That daylight link sets SAD apart from the "holiday blues," which stem from holiday stress, according to NIMH.
Many people also feel more stress and worry in the fall, which Dudley called "autumn anxiety." It's not a diagnosis, she said, but that dread can feed a negative cycle. Triggers include schedule changes, such as going from summer break back to school, plus higher expectations and reflecting on the past as the year ends.
Colder, darker days can also increase isolation and avoidance, Dudley said, making self-care, exercise and everyday responsibilities feel harder.
What residents should know
Dudley said signs of seasonal depression can include:
Feeling sad most of the day, nearly every day, for at least two weeks
Losing interest in activities you usually enjoy
Pulling away from friends and family
Irritability or restlessness
Sleeping much more than usual
Appetite changes, such as carb cravings
Low energy
Everyone has bad days, she said. The concern is when symptoms start interfering with daily life, such as school or work.
If symptoms last more than two or three weeks and take up multiple hours of the day, get help, Dudley said.
"That's not just business as usual," she said.
Managing the impact
Prevention
Dudley recommended three daily habits that matter even more for people with SAD.
First is exercise. The usual 20-30 minutes a day can feel impossible with low energy or packed schedules, Dudley said. "I'm a big fan of exercise snacks," she said. Five or 10 minutes twice a day adds up.
Next is nutrition. Carb cravings are common with SAD, and Halloween and Thanksgiving don't help, Dudley said. She recommended adding vegetables and protein to avoid feeling sluggish, and giving yourself grace.
Third is sleep. A cool, dark bedroom helps but can make mornings harder, she said. Morning sunlight helps reset the body's clock, as does cutting back on screens at night.
Whatever people try, Dudley recommended self-compassion. "It's progress, right? Not perfection," she said.
In the moment
For anxiety, Dudley suggested 5-4-3-2-1 grounding: Name five things you can see, four you can feel and so on. Focusing on your surroundings crowds out anxious thoughts.
Box breathing also helps: Breathe in through the nose for four counts, hold for four and breathe out for four, for about four minutes. Slowing your breathing and heart rate eases anxiety, she said.
Panic attacks can last from a few minutes to about 30 minutes, based on what her patients describe, Dudley said.
Treatment options
Treatment for SAD can look similar to treatment for other depression, Dudley said, including CBT-SAD, a talk therapy that targets the dread and negative thoughts that build heading into fall, and antidepressants called SSRIs.
Light therapy is another option. Light boxes for SAD put out about 10,000 lux, compared with under 1,000 for typical indoor lighting, Dudley said. NIMH recommends 30-45 minutes a day, usually first thing in the morning, from fall to spring. People with certain eye diseases or those taking light-sensitizing medications should check with a provider first, according to NIMH.
How to help others
If someone nearby is struggling, first ask whether they want help and introduce yourself, Dudley said. Then help them move somewhere quieter if needed and ask about a safety plan or someone to contact. Integral Care's 24/7 helpline at 512-472-HELP (4357) can also help.
For thoughts of self-harm or intense distress, call 911, Dudley said. Austin callers can ask for mental health services, and those calls can go to Integral Care clinicians at the 911 call center, according to Integral Care.
Reaching out
Stigma keeps many people from seeking care, Dudley said. Integral Care is Travis County's mental health safety net, so cost and insurance should not be barriers to care.
Integral Care has four walk-in clinics, open Monday-Friday, 8 a.m.-5 p.m., and offers 24/7 psychiatric emergency services at 1165 Airport Blvd. for adults and children in crisis.
In fiscal year 2025, Integral Care served more than 30,000 people across Travis County and delivered more than 486,000 services, Eldridge said. Residents who want to support Integral Care’s work can donate online.
The 988 Suicide & Crisis Lifeline is also available 24/7 by call or text.
Dudley recommended the following resources:
