During the past year, we have all been learning to cope with the isolation due to the restrictive lifestyle brought about by COVID-19. There is light at the end of the tunnel with the discovery and manufacturing of vaccines, but the medical experts are predicting this will be a long dark winter.
For those who struggle every year with Seasonal Affective Disorder (SAD), this long dark winter is all too familiar. This long dark winter has both literal and emotional significance. Combining SAD with the quarantine due to COVID and the difficulties of receiving a vaccination for the virus, there is potential for additional problems this year.
What is Seasonal Affective Disorder?
The staff of the website Psychology Today notes: “Seasonal Affective Disorder, or SAD, is a type of recurrent major depressive disorder in which episodes of depression occur during the same season each year. This condition is sometimes called the ‘winter blues,’ because the most common seasonal pattern is for depressive episodes to appear in the fall or winter and remit in the spring. Less commonly, SAD occurs as summer depression, typically beginning in the late spring or early summer and remitting in the fall. SAD may be related to changes in the amount of daylight a person receives.”
It is estimated that roughly about 10 million Americans are influenced by SAD and there are perhaps another 20% of the population who may have a mild form of the condition. It seems women are four times as likely to have the condition as men. “the age of onset is estimated to be between the age of 18 and 30” according to Psychology Today. For many, the symptoms are severe enough to affect the quality of their lives, and about 6% of these have conditions requiring hospitalization.
In her report, Carrie MacMillan of yalemedicine.org comments: “SAD is more common in women and in people who live far from the equator. For example, it affects an estimated 1% of people in Florida and 9% of those in Alaska.” Continuing on MacMillan also reports: “In the Northeast, most studies suggest that SAD, in its most marked form, affects 3 to 5% of the population.” SAD also seems to occur more often in young adults than it does in older adults.
SAD is not only restricted to merely the cold-weather season, but there is also Summer-Onset-affective disorder or summer depression and the symptoms may include:
- Trouble Sleeping
- Poor appetite
- Weight loss
- Agitation or anxiety
For those people living with bipolar disorder, there seems to be seasonal changes as well. The Mayo Clinic suggests: “In some people with bipolar disorder, spring and summer can bring on symptoms of mania or a less intense form of mania (hypomania), and fall and winter can be a time of depression.”
The exact cause of SAD is unknown at this time, as mayocinic.org notes, several factors might come into play, and they may include:
- “Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may cause winter-onset SAD. This decrease in sunlight may disrupt your body’s internal clock and lead to feelings of depression.”
- “Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression.”
- “Melatonin levels. The change in season can disrupt the balance of the body’s level of melatonin, which plays a role in sleep patterns and mood.”
Not everyone experiences the same symptoms associated with SAD and making a proper diagnosis will require the assistance of a mental health professional, but below is a list of the most common SAD warning signs to look for:
- Mood Swings. Feelings of hopelessness and sadness. An energetic person may become lethargic and socially withdrawn.
- Increased sensitivity to social rejection, and increased anxiety levels leading to a decrease in the ability to tolerate stress. Increased lack of willingness to be seen in public and increased irritability, a refusing to talk. Increased thoughts of suicide.
- Problems with sleeping
- Problem with concentration and focus
- A drop in energy level is a symptom people frequently struggle with. They find it hard to complete simple daily tasks.
- A heavy feeling in the arms and legs and fatigue.
- Experiencing changes in your appetite or weight
- Feeling sluggish or agitated
- Losing interest in activities you once enjoyed
- Feelings of hopelessness, worthlessness or guilt
- Having frequent thoughts of death or suicide
To manage seasonal affective disorder try to:
- Experience as much daylight as possible. It is thought the lack of sun exposure is part of what causes SAD and soaking up as much sunlight as you can lessen your symptoms. Sit by a window, or better yet get out for a walk if you can.
- Eat Healthily. Comfort foods do not have to be loaded with salt, sugar, fat, and lots of unnecessary calories to be enjoyable. There are plenty of other healthier choices out there, be creative, try making a dessert using seasonal fruits. They may surprise you.
- Spend time with your friends and family. During this pandemic, this has become difficult. Zooming has become very popular with families to stay in touch and to see and visit with one another. This can be an opportunity to hone those computer skills you’ve been putting off. Zooming is not a substitute for personal contact, but it is safer, so stay in touch.
- Stay Active. Covid has limited what we can do safely, but there is no reason you can’t go for a walk with a friend or family member or you could go ice skating. Routine exercise has been shown to be effective in lessening the effects of SAD.
- Seek professional help. If your feelings of depression continue, you might consider seeking professional help such as a psychologist who can best determine if your condition is truly SAD and recommend effective treatment.
As with all conditions, self-care is an important aspect of any treatment. As for those with SAD, it is important to:
- Monitor mood and energy level
- Take advantage of available sunlight
- Plan pleasurable activities for the winter season
- Plan physical activities
- Approach the winter season with a positive attitude
- When symptoms develop seek help sooner rather than later
As discussed previously, no one is sure of the cause of this condition, but some believe there may be a connection between the reduction of sunlight in the winter months and the increase in the depression associated with SAD. As a result, it is not uncommon for typical therapy to be a combination of antidepressant medication, vitamin D supplementation, counseling, and some form of light therapy.
Light therapy involves exposure to a bright artificial light that mimics outdoor light. This requires the use of a lightbox or light visor which is worn on the head like a cap and usually takes place first thing in the morning for a prescribed length of time which is generally between 30 and 60 minutes during the fall and winter months. The time varies with each individual and stopping the treatment too soon can bring about the return of the symptoms. The therapy normally continues until springtime as the volume of natural light increases.
When properly administered, there are few if any side effects. The side effects that do arise can include eyestrain, headaches, possible fatigue, or irritability. The inability to sleep has been known to occur if administered too late in the day.
If light therapy does not improve symptoms within a few days, medication and behavioral therapy may be recommended.
Finally, Carrie MacMillan suggests: “In addition to calling your primary care physician or psychologist, if you have one, resources include the Substance Abuse and Mental Health Services Administration Disaster Distress hotline, 1-800-985-5990, or text TalkWithUs; the National Domestic Violence Hotline, 1-800-799-7233 (TTY: 1-800-787-3224); and the National Suicide Prevention Lifeline, 1-800-273-8255, or call 911.”
Cardoza, Kavitha. (2021). ‘Tis The Season: Coping With SAD, Or Seasonal Affective Disorder. Retrieved from: https://www.npr.org/2020/10/23/927135639/tis-the-season-coping-with-sad-or-seasonal-affective-disorder
MacMillan, Carrie. (2020). Will COVID-19 Make Seasonal Affective Disorder Worse? Retrieved from: https://www.yalemedicine.org/news/covid-19-seasonal-affective-disorder-sad
Mayo Clinic Staff. (2021). Seasonal affective disorder (SAD)-Symptoms and causes. Retrieved from: https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651
Unknown. (2020). Seasonal Affective Disorder. Retrieved from: https://www.psychologytoday.com/us/conditions/seasonal-affective-disorder
National Alliance of Mental Illness
National Institute of Mental Health
National Mental Health Association
Substance Abuse and Mental Health Services Administration
National Environmental Education Foundation
Robson, David. (2020). Dreading a Dark Winter Lockdown? Think like a Norwegian.