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By Marissa Katrin Maldonado, Founder, The Treatment Specialist
Already, about 5% of the adult population is said to struggle with seasonal affective disorder, or SAD. SAD is a type of depression that emerges in the fall and winter months. Dwindling sunlight and colder temperatures keep us holed up indoors at this time of year, which can trigger this type of depression.
Now add SAD to the COVID-19 pandemic. Many Americans have been feeling the mental health effects of this crisis, with rates of depression and anxiety on a steady rise all year. The effects of SAD this winter are likely to compound an existing mental health condition, making this year’s experience with winter depression worse than usual.
Learn About Seasonal Affective Disorder (SAD)
SAD is listed in the DSM-5 as “Major Depressive Disorder with Seasonal Pattern.” The seasonal pattern pertains to someone developing the symptoms of depression when the days become shorter. Some of the factors that contribute to SAD include:
- Reduced sunlight affects serotonin levels, which impacts mood
- Diminished exposure to sunlight leads to vitamin D deficiency, a factor in depression
- Shortened days lead to increase in melatonin production, which causes sleepiness and fatigue
SAD affects four times as many women than men. Further, the greater the distance from the equator, the higher the risk of developing the seasonal depression. Some regions in the US, such as Alaska and the northern states have a 10% prevalence of SAD.
What are the Signs and Symptoms of SAD?
Because SAD is a depressive disorder, the same diagnostic criteria for major depressive disorder will apply. The diagnosis of SAD depends on the symptoms occurring during the winter months for at least two consecutive years. Symptoms of major depressive disorder include:
- Persistent low mood, sadness, and feelings of despair
- Fatigue
- Sleep disturbances
- Change in eating habits leading to weight gain or loss
- Feeling worthless or hopeless
- Slowed movements
- Trouble concentrating
- Loss of interest in activities, hobbies, or social events
- Thoughts of suicide
In addition to the above symptoms of major depression, the symptoms specific to SAD include:
- Excessive sleeping
- Emotional hypersensitivity
- Irritability
- Weight gain
- Craving carbohydrates and sugary foods
- Extreme fatigue
- Social withdrawal or isolating behaviors
- Reduced libido
Another risk of SAD is the increased use of alcohol during the winter months. Some mistakenly believe that the alcohol will ease their depression symptoms, when in reality alcohol only makes the depression worse. Plus, there is the increased risk of developing an alcohol use disorder as a result of self-medicating.
How the Pandemic May Worsen Seasonal Affective Disorder
The pandemic has been highly disruptive to daily life and mental wellness. The physical distancing policies have led to intense feelings of isolation and loneliness, in addition to increased stress and anxiety. The holiday season is sure to increase these problems as people struggle to accept they will have limited time with family and friends this year. All of this sets up a difficult scenario for individuals that already struggle with seasonal depression.
With the possibility for more pronounced SAD this winter it is important to reach out for help when symptoms emerge. To help offset the impact of social distancing policies, it is essential to stay connected to close friends and family. There are several safe ways to maintain connection with loved ones:
- Meet up with a friend for a walk, and also enjoy the benefits of sunlight and exercise.
- Pick up the phone and call someone.
- If you don’t feel up to a live conversation, have a text conversation or mingle on social media.
Just be proactive in protecting your mental health this winter if you are struggling with depression.
Treatment for Seasonal Affective Disorder
During the COVID-19 pandemic people still have access to mental health treatment. At this time, most psychotherapists and psychiatrists are able to see people in office for therapy sessions. In the event of another lockdown this winter, note that therapy is still going to be available, albeit through a digital platform such as Zoom.
Treatment for SAD may include the following interventions:
Antidepressant drug therapy
The usual first line of treatment for a depressive disorder is antidepressant drug therapy. Antidepressants work by rebalancing neurotransmitters, specifically serotonin, dopamine, and norepinephrine. These brain chemicals are associated with mood and emotions, energy, concentration, and memory. While Wellbutrin XL is typically prescribed for SAD, other antidepressants like Prozac or Paxil are also effective.
Psychotherapy
In some cases, the severe SAD symptoms may be also related to a negative life event. This could involve the loss of a loved one to Covid or other causes, marital problems or divorce, a job loss, moving, or any serious or disruptive life event. Psychotherapy provides an outlet for discussing the emotional pain associated with the event and allows the therapist to guide the person through the healing process.
Light therapy. Because a lack of light or sun exposure is at the heart of SAD, light therapy, or phototherapy, is a first line of defense. If you already know you suffer from SAD during the winter, start the light therapy now. Light therapy involves the use of a “light box” for 1.5-4 hours per day. The light box mimics natural outdoor light, and can be used while working from home, reading, watching TV. The extra light exposure tricks the body into adjusting neurotransmitter production.
Vitamin D supplements. Vitamin D deficiency is a common feature in individuals with SAD. Dosing of 400-800 IU each day is the usual recommended for individuals with SAD. One bit of positive news about vitamin D this year is that many people are taking the supplements to help improve immunity against COVID-19.
Exercise. Regular exercise is essential for battling SAD. Physical activity provides multiple benefits for individuals with SAD, being shown to improve mood, sleep quality, energy level, and cognitive functioning. To benefit from both the exercise and the sunlight exposure, folks should aim to get outside during daylight hours for a brisk 20-minute walk, bike ride, or hike each day.
Anyone who has a history of SAD in the past should be prepared for a potentially worse version of the depression this winter due to the pandemic. Be proactive in seeking mental health guidance if you begin to experience the symptoms, as there are several ways to successfully manage this condition.
About the Author
Marissa Katrin Maldonado has been working in the behavioral healthcare industry for over 12 years. She is the founder of The Treatment Specialist, a national online resource for helpful articles about mental health conditions for adults, teens, and families. Dedicated to guiding individuals to the help they seek, Marissa believes that with the right support and guidance, those struggling will have the opportunity to turn their lives around and enjoy a healthy and happy life. She is a proud mother and wife and enjoys long distance running, traveling, and music.