Depression

Seasonal Affective Disorder + COVID + Politics = What?

Will seasonal depression be worse this year?

Posted Sep 28, 2020

Shutterstock, Theera Disayarat
Source: Shutterstock, Theera Disayarat

When Seasonal Meets Situational…

With fall and winter, our days get shorter, and, for many people, seasonal affective disorder (SAD) sets in. Typically, SAD is a depressive disorder that kicks in during the fall and winter months and abates in spring and summer. It is generally believed that SAD is caused by a neurochemical imbalance in the brain prompted by lessened exposure to sunlight, which directly impacts levels of melatonin, asleep and mood-related hormone

Unsurprisingly, the further north a person lives (in the northern hemisphere), the more likely he or she is to experience SAD. (The further north one is, the shorter the days are during the fall and winter months.) Moreover, the worst months for SAD tend to be January and February, the months with the least amount of daylight.

SAD symptoms are usually mild to moderate, but they can become severe. The most common symptoms of SAD include:

  • Sadness
  • Hopelessness
  • Social withdrawal
  • Pessimism
  • Anxiety
  • Restlessness
  • Irritability
  • Loss of interest in normally pleasurable activities (hobbies, socialization, etc.)
  • Difficulty concentrating
  • Fatigue
  • Sleep issues (inability to fall asleep, difficulty waking up, etc.)
  • Lack of focus
  • Lack of self-care
  • Thoughts of death or suicide

But what happens when SAD occurs in conjunction with other forms of depression, especially the situational depression we’re currently seeing related to the COVID-19 pandemic, political strife, large-scale fires, hurricanes, racial divides, and other major societal issues? As of now, we don’t really know how SAD will interact with pre-existing situational depression, but individuals who struggle with SAD (and the clinicians who work with them) could be facing a difficult fall and winter.

What Are the Options?

Standard treatment for depression typically involves a combination of focused self-care, medication, and psychotherapy. With SAD, because it is believed to be linked to a lack of sunlight and decreased melatonin levels, lightboxes are also used. In cases where SAD pairs with situational and other forms of depression, all of these approaches may be needed.

Self-Care: The onus for improved self-care is on the client (often with help from the client’s family). This may include (but is hardly limited to) the following:

  • Regular Sleep: Going to bed and waking up at the same time every day no matter what is the easiest way to regulate sleep. Starting this process may result in a few sleepless nights, but if the individual can stick with the routine, it nearly always takes hold.
  • Exercise: Regular exercise, especially aerobic exercise, is a proven way to combat depression. If that exercise can be done outdoors, all the better. If not, trips to the gym are great. If going to the gym is not an option (perhaps related to the pandemic), online aerobics, stationary bikes, masked-up walks through the neighborhood, and similar exercise can be done at home.
  • Healthy Eating: Most people facing depression crave sweets, junk food, and soft drinks. These can provide a sugar/carb rush, but typically that rush is followed by a physical and sometimes emotional crash. Switching to complex carbs (pasta, rice) and natural sugars (fruit and juices) slows the rush/crash process, negating or at least lessening the impact.
  • Natural Remedies: Anecdotal evidence suggests the herbal remedy St. John’s Wort may help with depression. However, St. John’s Wort increases the sensitivity of the skin and eyes to sunlight, so it should not be taken without first consulting a doctor, especially if you’re using a lightbox. Omega-3 fatty acids such as those found in salmon and other fish and in certain nuts and grains can also help with symptoms of depression.

Lightboxes: Lightboxes are a SAD-specific treatment. Lightboxes typically emit 2,500 to 10,000 lux (lumens per square meter), as compared with the 100 to 500 lux emitted by standard interior light sources. Lightboxes are best used in the morning for anywhere from 15 minutes to 2 hours. They’ve proven to be an effective treatment for SAD, mostly like because they raise melatonin levels.

Medication: Antidepressant medications can be useful in the treatment of depression, especially when used in conjunction with talk therapy.

Psychotherapy: Psychotherapy can be helpful with all forms of depression. Both individual and group therapy can help depressed individuals identify and change negative thoughts and behaviors. In this unusual social timeframe, therapists may want to consider creating specialized groups specifically to deal with combined seasonal and situational depressions.

References

For more information about Seasonal Affective Disorder, visit the websites of the National Institute of Mental Health and the American Psychiatric Association. For help with all forms of depression, visit the websites of the Substance Abuse and Mental Health Services Administration and the National Institute of Mental Health. If you or a loved one are feeling suicidal, seek immediate assistance by calling Emergency Medical Services at 911. You can also call the National Suicide Prevention Lifeline at 1.800.273.8255 or by clicking Live Online Chat. People are available to help you 24/7/365. Your confidential call or chat is directed to the nearest crisis center in the Lifeline national network. These Lifeline centers provide both crisis counseling and mental health referrals.