Many within the United States experience seasonal changes. The once welcoming warmth of summer shifts into cloudy, shorter days. When the daylight is significantly limited, temperatures plummet, and the drab color of winter comes, it can leave you feeling grouchy, melancholy, or even exhausted.
One thing to pay attention to is if these feelings recur every year, to the extent they make it difficult to function when the winter months hit. If you notice that when spring or the early summer months roll around, you spring back, you may be suffering from seasonal affective disorder (SAD). Seasonal depression can greatly impact your health, relationships, your day-to-day tasks, and put you at greater risk of developing a substance use disorder.
What Is Seasonal Affective Disorder?
Seasonal affective disorder is a type of depression occurring at the exact same time every year, normally in the winter months. It is also known as seasonal depression, and can drastically affect your moods, appetite, sleep patterns, and energy levels. This disorder will take its toll on many parts of your life, including your relationships, social life, work life, school, and your sense of self-worth. A personality flip seems to happen, and you end up feeling like a different person compared to the summer months.
Seasonal affective disorder directly impacts about four to six percent of the population, with the percentage being higher in more northern climates. For instance, the National Institute of Mental Health (NIMH) tells us that one percent of Florida’s population experiences it, whereas nine percent of individuals living in either Alaska or New England do. SAD may affect certain individuals more, including women, younger people, those with a family history, those with depression or bipolar disorder, and those who live farther away from the equator.
It begins when the days start getting shorter and there is less naturally occurring sunlight—such as in the late fall or early winter months. Usually people who live at least 30 degrees north or south from the equator experience SAD to a greater extent. There is a milder form of SAD which affects up to 10-20% of people. This also can be responsible for causing depression during the summer months, however, it is far less common.
What Is The Cause Of SAD?
No one knows for sure the exact cause of seasonal affective disorder, but there are many theories, and research has offered us some insight. It is most widely thought that it is related to the decline in daylight hours and sunlight throughout the winter months. This decrease affects the body by disrupting circadian rhythms and changing levels of critical neurotransmitters within your brain.
Your circadian rhythm is your body’s natural internal clock which dictates sleeping and waking up. It is associated with light and darkness, and responsible for balancing your sleep, mood, and appetite. When the nights are long and the days are shorter, your internal clock may become discordant, creating feelings of disorientation, grogginess, and feeling tired at the wrong times.
When the sun goes away, your brain produces a natural hormone called melatonin to help you feel sleepy, and when it rises, this production ceases, so that you begin to feel awake and alert. With the short days and long nights during the winter months, your body pumps out increased levels of melatonin, creating these feelings of fatigue and low energy.
On the other hand, an important neurotransmitter that is critical for proper mood functioning decreases. Serotonin declines from lack of sunlight, so that feelings of depression settle in. This may also be tied to Vitamin D levels, due to the fact that Vitamin D is produced from exposure to the sun, and during winter months people have very little of this crucial sunlight. The National Institute of Mental Health notes that “Vitamin D insufficiency may be associated with clinically significant depression symptoms.”
Despite where you live, or how cold, dark, and brutal it gets outside, there is treatment for SAD. The more you understand, the more well-equipped you’ll be to face it.
Signs Of SAD
If you’ve noticed a pattern you fall into every year around certain seasons, you may be suffering from SAD. Symptoms of this disorder may be worse in the morning. In order to qualify as having this disorder, you must meet the symptoms of major depression corresponding to a certain season, for two years or more. Here are some of the signs, as explained by Mayo Clinic:
- Experiencing depression for the majority of the day on most days
- Losing hope and your sense of self-worth
- Feeling fatigue, making it difficult to do any daily tasks
- Becoming indifferent to activities that you once loved
- Struggling to get a good night’s rest or other sleep concerns
- Fluctuating weight or an altered appetite
- Becoming lethargic or distressed
- Trouble concentrating
- Recurrent suicidal ideation
In addition to these, NIMH tells us that there are certain symptoms that are specific to the winter pattern of SAD, including:
- Struggling to find energy
- Extreme sleepiness during the day and trouble waking up (hypersomnia)
- Eating more food than is necessary for a meal
- Putting on weight
- Craving sugary or starchy foods (carbohydrates)
- Avoiding your friends and loved ones (wanting to “hibernate”)
A person may be overcome by tension, stress, feelings of sadness, guilt, low self-esteem, or become overly critical of themselves. They may have unexplainable aches and pains and find that they are not interested in sex or other physical contact. As a person becomes increasingly overwhelmed by this host of debilitating symptoms, they may turn to drugs or alcohol for comfort, or to self-medicate.
Despite the fact that most symptoms are those of major depression, one thing that is different about SAD, is when the spring and summer months come back around, there is a change, and the depression lifts. Similar to major depression, the intensity of SAD symptoms can be different from person to person. Despite the fact that these things disappear, what might not, is the substance abuse or addiction that rose during this period of time.
How Seasonal Affective Disorder Can Lead To Addiction
There are many signs that substance abuse and addiction are linked to SAD. Many of these links occur for the same reasons that a person suffering from major depression throughout the year is more disposed to developing these concerns. Foremost, many individuals that are overcome with the oppression of these symptoms may seek to console themselves, or self-medicate with drugs or alcohol. Unfortunately, these substances may actually exacerbate the symptoms, and as they continue, a person consumes more of these substances in an attempt to further control them. As this use becomes more compulsive, an addiction could develop.
One example of this cycle is alcohol abuse. Alcohol is actually a depressant, thus a person becomes more depressed as they continue to drink. A Comprehensive Psychiatry article discusses the prevalence of alcohol addiction and SAD, stating “Seasonal changes in mood and behavior (seasonality) may be closely related to alcoholism. Some patients with alcoholism have a seasonal pattern to their alcohol misuse. They may be self-medicating an underlying seasonal affective disorder (SAD) with alcohol or manifesting a seasonal pattern to alcohol-induced depression.” Alcohol is not the only drug linked to SAD. Any drug of abuse has the potential to seem like a quick “fix” when someone is struggling with this disorder.
Another possible link is the disruption of the circadian rhythm that results in the winter months. A normal circadian rhythm is needed for consistent and healthy physiological and behavioral functions. The disruption of the circadian system can have numerous health risks, including addiction. In many clinical studies, patients with substance abuse were shown to have disruptions in sleep patterns and circadian rhythms, two things that occur in conjunction with SAD. This highly suggests that the disturbance of the circadian system may be, in part, related to why these patients developed drug dependence.
One study, “Circadian rhythms and addiction: Mechanistic insights and future directions,” spoke of this correlation, asserting that “disruptions to the normal sleep/wake cycle increase the vulnerability for addiction. Conversely, self-medication through drug or alcohol abuse is considered to be an attempt to ameliorate sleep and mood-related problems found with general circadian rhythm disruption.”
The study continues to speak of the impact that this disruption may have on dopamine, a neurotransmitter responsible for reward and pleasure that is heavily implicated within drug use and abuse. It states that “disruptions to the circadian system change the reward value and motivation for addictive substances through direct effects on reward circuits.”
Lastly, a second study speaks of the impact of SAD and cocaine addiction, outlining that “Since disturbances in circadian rhythms and pineal melatonin functions may in part underlie the pathophysiology of SAD and the psychomimetic effects of cocaine are mediated in part through the pineal gland, we propose that dysfunction of circadian rhythms and pineal melatonin functions may partly mediate the association of SAD with cocaine abuse.” Essentially this means that in normal circumstances, a person experiences cocaine’s effects partly due to this gland, and when this gland’s functioning is adversely altered by SAD, the disposition to abuse cocaine may become more pronounced.
Treating These Dual Concerns
Like any co-occurring disorder, it is extremely important that treatment entails approaches that focus on both SAD and addiction. This is because, if left untreated, SAD could again aggravate a person in a way that causes them to relapse.
Even if you feel hopeless during the fall and winter months, there are some things you can implement to keep yourself more stable during these periods. Try to:
- Bundle up and try to get outside, in natural sunlight as often as you can, preferably within two hours of waking.
- Open your blinds or drapes at home to let more light in
- Get up and move—don’t sit still for more than an hour, exercise can be very helpful
- Allow yourself to reach out for support from family, friends, or a support group
- Research about mood-boosting omega-3 fats
- Find out more about relaxation techniques and do the ones you enjoy
In terms of treating SAD, experts recommend the following four treatments, as outlined by NIMH:
- Light therapy
- Vitamin D
MedlinePlus reports that some people may respond positively to light therapy alone, noting, however, that half may need antidepressants, talk therapy, or a combination of both. Mayo Clinic suggests that an extended-release version of the antidepressant bupropion (Wellbutrin XL, Aplenzin) may work well in those who have experienced SAD before. They also note that it may be advantageous to be preemptive, and start an individual on medication before the onset of symptoms. This may be especially beneficial in terms of reducing substance abuse risk, as it may help to avoid the intense symptoms that a person may attempt to self-medicate with by drugs or alcohol.
Various forms of psychotherapy are also used to treat addiction, typically in the context of a treatment center. Beyond this, and depending on the severity of use, a person should seek outpatient or inpatient drug rehab that offers an individualized treatment plan. The good news is, many rehabs are actually offered in sunny locations, with nice weather even throughout the winter. Within treatment, a person may experience a medical detox, counseling, art therapy and other recreational therapies, relapse prevention, and any necessary medication-supported treatment they might need. Treatment will also teach a person critical coping skills to help them combat the stress and negative feelings from SAD and other aspects of their life that may trigger thoughts of drug use.
Don’t Be Overcome By SAD Or An Addiction
If you or a loved one is suffering from SAD and an addiction, contact us today for help. Getting the information and treatment you need will bring greater stability to your life, and help you to live healthier each day. Let DrugRehab.org get you started on this path.
National Institute of Mental Health — Seasonal Affective Disorder
Mayo Clinic — Seasonal affective disorder (SAD)
MedlinePlus — Seasonal Affective Disorder
American Family Physician — Seasonal Affective Disorder
U.S. National Library of Medicine — Circadian rhythms and addiction: Mechanistic insights and future directions