What is Seasonal Affective Disorder (SAD)?
Also known as major depressive disorder with a seasonal pattern, seasonal affective disorder (SAD) is a type of depression that occurs in the same season every year. It usually affects people during the winter more than in any other season. The symptoms of seasonal affective disorder include the typical symptoms of depression such as persistent feelings of sadness, feeling sluggish, having low energy levels, losing interest in activities you once enjoyed, excessive sleep and daytime drowsiness, feelings of hopelessness and guilt, anxiety and grouchiness, fatigue, changes in weight or appetite, and having problems with concentration. Apart from depression, seasonal affective disorder can also include overeating, especially binging on carbs, and a strong desire to withdraw oneself from social interactions.(1,2,3,4)
Since there is less sunlight in the winter, it is believed to disrupt the body’s circadian rhythms. Circadian rhythms are the 24-hour cycles that work as our internal clock and regulate many of the biological processes in the body, including our sleep-wake cycle. It is the disruption of this internal clock that causes feelings of depression in people affected by SAD.(5,6,7)
According to the American Psychiatric Association, it is estimated that nearly five percent of adults in the US have seasonal affective disorder, and the duration the disorder lasts for is generally 40 percent of the year. It is also known that the condition affects women four times more than men.(8)
Coping with Seasonal Affective Disorder During the Pandemic Winter
As we go through another pandemic winter, the impact of seasonal affective disorder is being compounded by COVID-19 anxiety for most people. With the Omicron variant of the novel coronavirus raging on around the world, there are many concerns and stresses that people have related to continued social distancing or isolation, economic uncertainty, job loss, and of course, their health and the health of their family. These concerns are affecting almost everybody around the world. As a result, no one is truly immune anymore to experiencing symptoms of depression, high levels of anxiety, and feelings of hopelessness and despair during this stressful time.
For those who are already feeling down due to seasonal affective disorder, the prospect of another chilling winter in which the pandemic continues to be an issue is a recipe for more depressive episodes and for increased panic and anxiety.
People all over the world are still reeling from the events of the last year and a half, with the staggering COVID-19 death toll that has left countless families grieving in its wake.(9)
One must also factor in the lasting effects of social distancing/isolation, combined with huge financial upheavals owing to the continued lockdowns and the collective stress of always being on edge with so much to worry about. Even though many countries are in a better position this winter with the COVID-19 vaccine being administered and the booster shots being rolled out everywhere, but the underlying uncertainty of where the pandemic is heading has made the mental anguish seem never-ending for many people.(10)
This vicious cycle has made it even more challenging for people with seasonal affective disorder to deal with the anxiety of the pandemic. It is only logical to assume that the pandemic would worsen the situation for people having SAD, given that people are having to spend more time at home and that too in isolation and socializing less than ever before, which are effectively the exact opposite of what medical experts typically advice for preventing SAD.
Since seasonal affective disorder only gets diagnosed in people who have experienced the symptoms for at least two years in a row, it is difficult to say for sure whether the pandemic has caused an increase in the prevalence of the condition. However, for those who regularly have the condition, it has been found to have hit harder than usual during the previous pandemic winter.
While it is expected that widespread vaccination will make it easier and safer for people to start socializing again this winter as compared to the last one, but the Omicron variant is known to be highly contagious and more likely to lead to breakthrough infections which might change this equation.(13) This is why people who are predisposed to seasonal affective depression should mentally prepare themselves for COVID roadblocks, such as breakthrough infections or changes in COVID-related restrictions, which may force them to go into temporary isolation again, causing psychological difficulties.
Here are some tips to help you manage seasonal affective disorder and the combined anxiety caused by the COVID-19 pandemic.
Tips to Manage Seasonal Affective Disorder and Anxiety Due to COVID-19
If you are feeling the multiplied effects of seasonal depression and pandemic-related anxiety, experts recommend some coping mechanisms that may help alleviate the symptoms of both conditions. In assisting people with seasonal affective disorder, medical experts still stress on the importance of using the effective and tried and tested treatments for the disorder, which include:
- Increased exposure to sunlight, including spending time near a window or outside on a balcony.
- Light therapy, in which a person works or sits near a light therapy box, which is a device that gives out bright levels of light that mimics natural sunlight. This is best if done in the mornings. You only need to do this for 20 to 30 minutes every day, but it is best to do it after consulting your doctor.(14,15)
- Psychotherapy, which includes interpersonal therapeutic approaches and cognitive behavioral therapy.(16)
- Antidepressants, if prescribed by your doctor.(17,18)
In addition to these, doctors recommend some other helpful tips for those suffering from the symptoms of seasonal depression as well as anxiety due to the pandemic. These include:
Follow a Routine
It is important that you have a daily routine. It is especially important to follow a routine when things seem to be getting overwhelming. Set some small and achievable goals to work towards at the end of each day. For many people with seasonal affective disorder, it might start to feel overwhelming the moment they open their eyes in the morning. They may get overwhelmed by the demands of the day. This is why it is better to identify a few small goals and cross them off your to-do list. The fact that you have accomplished some tasks during the day can make you feel better about yourself.
These goals do not have to be anything big. They can even be as simple as taking out ten minutes every morning to stretch and practice deep breathing. This is not a huge task to accomplish, but it is still something that you can cross off the list. At the same time, having ten minutes to yourself will make you feel more energized at the beginning of the day.(19)
Indulge in Some Physical Activity
Many studies have shown that regular physical activity or exercise can bring about a dramatic improvement in your mental health and overall health. Exercise does not mean that you have to start taking a fitness class or join the gym. All it means is that you indulge in some type of physical activity, even if it means taking a walk around the block. (20,21)
Stay Connected to Others
Even if there are social distancing rules in place, it does not stop you from working on your relationships with your friends and family. Do phone calls, video chats, texting, and stay connected through social media. Being connected to other people can help you feel that you are socially connected, and make you feel less alone or isolated, which will help your mental health.
It might be easy to give in and have your comfort foods that include plenty of sugar, unhealthy fats, and refined carbs, along with excessive intake of caffeine and alcohol. However, all these are only going to adversely impact your mood. Instead of this, try to include more fresh and wholesome foods in your diet. Increase the consumption of mood-boosting nutrients like omega-3 fatty acids. You should also take a vitamin D supplement since reduced exposure to sunlight during the winter reduces the levels of this vitamin in the body. Vitamin D plays an important role in regulating your moods.(22,23)
There are many therapies, medications, and behavioral modifications that can be used to successfully manage the symptoms of seasonal affective disorder during the COVID-19 pandemic winter. You should also keep in mind that the symptoms of many other mental health conditions tend to mimic those of SAD, which is why it is always a good idea to visit a proper mental health professional to receive a proper diagnosis if you believe you have seasonal affective disorder.
- Partonen, T. and Lönnqvist, J., 1998. Seasonal affective disorder. CNS drugs, 9(3), pp.203-212.
- Kurlansik, S.L. and Ibay, A.D., 2012. Seasonal affective disorder. American family physician, 86(11), pp.1037-1041.
- Rosen, L.N., Targum, S.D., Terman, M., Bryant, M.J., Hoffman, H., Kasper, S.F., Hamovit, J.R., Docherty, J.P., Welch, B. and Rosenthal, N.E., 1990. Prevalence of seasonal affective disorder at four latitudes. Psychiatry research, 31(2), pp.131-144.
- Magnusson, A. and Boivin, D., 2003. Seasonal affective disorder: an overview. Chronobiology international, 20(2), pp.189-207.
- Levitan, R.D., 2007. The chronobiology and neurobiology of winter seasonal affective disorder. Dialogues in clinical neuroscience, 9(3), p.315.
- Wehr, T.A., Sack, D.A. and Rosenthal, N.E., 1987. Seasonal affective disorder with summer depression and winter hypomania. The American journal of psychiatry.
- Meesters, Y. and Gordijn, M., 2016. Seasonal affective disorder, winter type: current insights and treatment options. Psychology research and behavior management.
- Anon, Seasonal affective disorder (SAD). Available at: https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder [Accessed February 9, 2022].
- Anon, Coronavirus death toll. Worldometer. Available at: https://www.worldometers.info/coronavirus/coronavirus-death-toll/ [Accessed February 9, 2022].
- Tenforde, M.W., 2021. Effectiveness of Pfizer-BioNTech and Moderna vaccines against COVID-19 among hospitalized adults aged≥ 65 years—United States, January–March 2021. MMWR. Morbidity and mortality weekly report, 70.
- Postolache, T.T., Benros, M.E. and Brenner, L.A., 2021. Targetable biological mechanisms implicated in emergent psychiatric conditions associated with SARS-CoV-2 infection. JAMA psychiatry, 78(4), pp.353-354.
- Ducharme, J., 2020. Neurologic symptoms common among U.S. COVID-19 patients. Time. Available at: https://time.com/5896393/coronavirus-neurologic-symptoms/ [Accessed February 9, 2022].
- Park, A., 2021. Pfizer-BioNTech says booster protects against Omicron. Time. Available at: https://time.com/6126612/omicron-pfizer-booster/ [Accessed February 9, 2022].
- Lam, R.W., Buchanan, A., Mador, J.A., Corral, M.R. and Remick, R.A., 1992. The effects of ultraviolet-A wavelengths in light therapy for seasonal depression. Journal of Affective Disorders, 24(4), pp.237-243.
- Prasko, J., 2008. Bright light therapy. Neuro endocrinology letters, 29, pp.33-64.
- Forneris, C.A., Nussbaumer‐Streit, B., Morgan, L.C., Greenblatt, A., Van Noord, M.G., Gaynes, B.N., Wipplinger, J., Lux, L.J., Winkler, D. and Gartlehner, G., 2019. Psychological therapies for preventing seasonal affective disorder. Cochrane Database of Systematic Reviews, (5).
- Thaler, K., Delivuk, M., Chapman, A., Gaynes, B.N., Kaminski, A. and Gartlehner, G., 2011. Second‐generation antidepressants for seasonal affective disorder. Cochrane Database of Systematic Reviews, (12).
- Gartlehner, G., Nussbaumer‐Streit, B., Gaynes, B.N., Forneris, C.A., Morgan, L.C., Greenblatt, A., Wipplinger, J., Lux, L.J., Van Noord, M.G. and Winkler, D., 2019. Second‐generation antidepressants for preventing seasonal affective disorder in adults. Cochrane Database of Systematic Reviews, (3).
- Anon, 2021. The mental health benefits of having a daily routine. Therapy Group of NYC. Available at: https://nyctherapy.com/therapists-nyc-blog/the-mental-health-benefits-of-having-a-daily-routine/#:~:text=They%20help%20us%20cope%20with,symptoms%20of%20other%20mental%20disorders. [Accessed February 9, 2022].
- Dunn, A.L. and Jewell, J.S., 2010. The effect of exercise on mental health. Current Sports Medicine Reports, 9(4), pp.202-207.
- Paluska, S.A. and Schwenk, T.L., 2000. Physical activity and mental health. Sports medicine, 29(3), pp.167-180.
- Choukri, M.A., Conner, T.S., Haszard, J.J., Harper, M.J. and Houghton, L.A., 2018. Effect of vitamin D supplementation on depressive symptoms and psychological wellbeing in healthy adult women: a double-blind randomised controlled clinical trial. Journal of nutritional science, 7.
- Kemper, K.J. and Shannon, S., 2007. Complementary and alternative medicine therapies to promote healthy moods. Pediatric Clinics of North America, 54(6), pp.901-926.