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Will the pandemic make Seasonal Affective Disorder worse?

The depression millions suffer when the days grow short could be compounded as COVID-19 cases soar and lockdowns return, says this psychiatrist and cofounder of a mental health telemedicine service.

Will the pandemic make Seasonal Affective Disorder worse?
[Source image: JoyTasa/iStock]
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If you’ve been feeling off since daylight savings time, you aren’t alone. With shorter days and colder temperatures, as we work our way through fall and winter, many people find themselves experiencing symptoms typically associated with depression. For a good portion of these individuals, these symptoms return around the same time every year. And that’s not a coincidence. It’s actually diagnosable.

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Seasonal Affective Disorder—the abbreviation for which is, yes, SAD—is a type of depressive mood disorder that’s related to changes in season. Symptoms can include feeling sluggish and moody and having difficulty concentrating. It begins and ends at around the same time every year, most often in the fall, and continues through the winter months.

In a typical year, it’s estimated SAD affects 10 million Americans. But 2020 isn’t a typical year and the holiday activities people ordinarily might look forward to—which can help offset symptoms associated with SAD—may now be out of reach. With COVID-19 case counts skyrocketing across the country, many local governments are implementing lockdowns similar to those from the spring. As a result, things like family gatherings with friends and family, corporate holiday parties, and holiday travel are either not possible or strongly ill-advised. And trying to decide whether an activity is acceptable or not is a stressful experience in and of itself given the inconsistency around changing public health guidelines. People are consequently facing yet another period of adjustment as we reckon with a holiday season that is far different from any before.

Clinically speaking, we’ve never had a set of variables quite like those from this year, so it’s not yet clear how COVID-19 might affect the number of people who will suffer from SAD. The best thing you can do is arm yourself with the facts about SAD so you can do what you can to avoid it and, if you can’t, seek treatment if necessary. Let’s break it down.

What is SAD and what causes it?

As noted above, SAD can feel a lot like depression but isn’t persistent throughout the year. People with SAD may experience a consistently gloomy mood, loss of interest in activities they once enjoyed, trouble sleeping, and low sex drive. Changes in appetite and weight are also not uncommon. In particularly bad cases, symptoms can be cognitive—like having trouble recalling just-learned information or a difficulty in finding the right words when speaking. SAD is four times more common in women than it is in men and the age of onset is usually between 18 and 30.

The exact cause of SAD is unknown, but research points to decreased exposure to daylight as the main contributor. Sunlight exposure stimulates the hypothalamus, a part of the brain that helps control your circadian rhythm. Lack of light throws the circadian rhythm off, which can cause the brain to produce too much melatonin and release less serotonin. The result leaves many people feeling low and lethargic.

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Beyond daylight and brain function, we don’t yet know how the stresses that people have endured this year might make them more susceptible to SAD than previous years. With restrictions being recommended on holiday travel after a year spent mostly in social isolation, there’s no shortage of reasons for people to not feel their best.

Is there anything I can do to avoid it?

Getting out once a day, ideally in the middle of the day, for a short walk can be very helpful—especially if you’re prone to depressive episodes or have a history of depression in your family. Treat time in daylight as something just as important as everything else on your calendar.

It’s also important to keep a well-balanced diet and not consume too much alcohol. SAD can cause cravings for comfort foods that tend to be high in calories and carbohydrates, which may make people feel worse. Maintaining physical activity and exercise through the season is also beneficial. Around 30 minutes of moderate exercise three times a week should do the trick. You’ll also want to prioritize sleep and make sure you’ve created an environment that fosters it. I recommend keeping devices like phones outside of your bedroom and eliminating all screen time within 30 minutes of going to bed.

If you’re able to, maintain social interactions virtually and find time for things you can look forward to. Something as simple but enjoyable as gardening, reading a good book, or cooking can keep your mood under control. Whatever brings you joy that you’re able to do at home, make time for it.

What can I do to feel better?

The things you can do to avoid SAD can also make you feel better when experiencing symptoms. Treat these items with intention and priority. If your symptoms are severe, you should speak with a medical professional to determine what treatment plan makes the most sense for you.

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If your job requires you to be indoors during the daylight hours, find a room with as much natural daylight as possible. If there is poor access to natural light, you might want to consider light therapy. Using a lightbox within the first hour of waking has proven to be effective. It’s important to speak with a healthcare professional regarding light therapy before using a light box, but it should deliver 10,000 lux of light and emit as little UV light as possible. 20-30min per day is the recommended dose, at a distance of 2 feet, with eyes open but not looking directly at the light.

How do I know if I need to seek treatment?

When symptoms enter the moderate to severe range and begin to interfere with social and occupational functioning, it’s time to speak to an expert. If you are unsure where on the range your symptoms fall, taking a free online evaluation can help figure out the best immediate next step. Brightside, the telemedicine platform that I co-founded, offers one on our website for free. 

What can employers do?

The mental health of your employees is just as important as their physical health. The two are intrinsically intertwined and maintaining healthy habits for each is essential to productivity. Now more than ever, it’s important to meet your employees where they are and create an environment where they’re comfortable talking about mental health. If possible, allow for more flexibility while your employees juggle what could be their first holiday season away from family on top of a particularly challenging year.

You might also consider proactively addressing SAD with staff so they know it is a legitimate experience and feel comfortable talking with their manager about it should symptoms arise. If you don’t want to be that specific, simply encourage the team to find time throughout the day for some fresh air (weather permitting). You might even put it on the company-wide calendar to hold everyone, yourself included, accountable. 


Dr. Mimi Winsberg is cofounder and chief medical officer of Brightside, a mental health telemedicine service.

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