Do you or someone you know find yourself extremely sad or down this time of year? Now that winter is upon us, and the sun has gone away for most of the day, this is completely normal. There’s actually a name for this condition, seasonal depression or seasonal affective disorder, also known by its apt acronym, SAD.
I’ve suffered from this disorder for most of my life without really knowing why or putting a name to it, until this year. As soon as the time goes back an hour, the earlier it becomes darker, inevitably the vault of despondency opens.
So, who is the most susceptible to seasonal depression? Though anyone can get it, it happens most to adults between the ages of 18 and 30. Also, women are affected by SAD at four times the rate of men. People who have relatives with a mental health condition, such as depression, as well as people living anywhere where daylight hours are cut short are both vulnerable, as well.
The lack of sunlight and vitamin D is a major factor when it comes to SAD. The colder months are gloomy; people stay inside more; there are fewer activities to do, which means less interacting with people; and, let’s face it—being cold just isn’t cool at all. If you’re like me, staying bundled up at home in the winter sounds more appealing than putting on layers of clothes to go out.
The pandemic has also thrown an extra wrench into an already SAD epidemic. So, not only are you depressed about the deficit of sunlight that provides vitamin D, which in turn offers serotonin, you now have to combat the extra stress, fear, and depression of possibly catching COVID-19.
Signs and Symptoms of SAD
You may also be questioning whether you actually have seasonal depression (which is temporary) or major depression. Though similar, you will find that SAD has distinguishing characteristics. Board-certified adult psychiatrist Anjani Amladi, M.D., told TheBody in an interview, “Symptoms of depression are different than just feeling a little down, as the symptoms begin to affect social and occupational functioning, i.e., job performance, interpersonal relationships, task completion, organization, etc. Common symptoms include irritability, loss of interest in activities previously enjoyed, poor concentration, fatigue, lack of energy, appetite changes, poor sleep, weight changes, etc.”
As someone who personally struggles with a mental illness, dealing with SAD seems like a natural adaptation, being that it’s pertaining to the mental state. However, life strategist and empowerment coach Adriana Keefe addresses an aspect I never considered. “I am more prone to [SAD] because I have childhood trauma of sexual abuse,” she said. “So, with things like that, [doctors] say you tend to have more depression and anxiety. So it’s a possibility that I might not have it to the extent that I do, had I not experienced that trauma.”
Coping Tools and Options for SAD
Engage in social activities: It’s important to stay connected to friends and family, even if it’s only possible to see them virtually. Humans are wired for interaction and generally do not do well in isolation.
Stay active: Maintaining a routine—including waking up at a decent time, eating regularly, and getting exercise—helps to create a sense of purpose and normalcy in what may be another very trying year.
Try talk therapy: Talking to someone who is an objective party can help with the creation of coping skills, provide extra support, and also assist with identification of negative thought patterns that may be adversely affecting you. With the expansion of telemedicine, it’s possible to find a therapist online if you don’t feel comfortable going to an office. And you can see them in the comfort of your own home.
Consider medication: If symptoms are burdensome and begin to affect your interpersonal relationships and social or occupational functioning, medicine like an antidepressant could potentially be helpful.
Let some light in: Seasonal affective disorder is connected to changes in light during the fall and winter months, specifically shorter days, which means a decrease in sunlight. Opening blinds and curtains to let natural light in helps to get the most out of sunlight during the day.
Try light therapy: Also known as “phototherapy,” this mimics sunlight and can be used to help replace a decrease in sunlight during the fall and winter months. Not just any light will do—you will need a lightbox that is 10,000 lux to be effective. The idea is to sit near the lightbox in the morning to mimic exposure to sunlight. You want to be able to sit near the light (if you have a 10,000 lux lightbox, you will ideally want to be about 2 feet away from it) and be in a position to see it from an angle. It is not necessary or recommended to stare directly at the light. The way lightboxes work is that the light passes through the eye, stimulating retinal cells in the process, which connects to the hypothalamus in the brain, which helps to regulate melatonin and serotonin levels in the body that are helpful for sleep and mood. Be sure to consult with your doctor before using a lightbox if you are on medications that are photosensitive or have other health conditions or mental health conditions that are affected by light exposure.
Take vitamin D: Vitamin D deficiency is very common, especially during the fall and winter. A low vitamin D level is linked to an increase in morbidity and mortality. Over-the-counter supplements are relatively inexpensive and can provide significant benefit with regard to mood and overall physical health. As with all medications and possible interventions, talk to your doctor to determine what strategies are right for you.
Some people may feel as though you’re sad for no apparent reason. They may think you were being a grinch for the holidays or distancing yourself for minute reasons. Pay these people no mind. Any form of depression is serious, and it shouldn’t be overlooked, joked about, or dismissed. When you feel as though you have no support, or things are becoming too dark and overwhelming, don’t get discouraged. Depression can lead to thoughts of suicide. If you are experiencing either, please use the following information. You aren’t SAD for no apparent reason; seek help and be well.
Are People With HIV at Increased Risk for SAD?
It’s important to realize that people living with HIV are at an increased risk for depression in general, which means that, yes, they are at increased risk for developing seasonal depression during the winter months. And this is certainly a winter unlike any other. Winter 2021 is complicated by the ongoing COVID pandemic. According to Nathaniel Currie, D.S.W., M.S.W., LCSW, a clinical social worker and educator with over 14 years of experience in behavioral health and HIV, many of his clients have been triggered by the pandemic and fear of acquisition of the coronavirus.
“The diagnosis of a chronic illness or a stigmatized disease has significant mental and emotional health effects,” Currie said. “In fact, some clients have stated that they have kept their COVID-19 diagnosis secret for fear of judgement or being ostracized; reminiscent of the treatment and handling of one’s own HIV-related experience. These instances, in short, are all factors contribut[ing] to increases in depression among people living with HIV.”
Seasonal depression can affect a person’s sleep, appetite, attention, motivation, energy, and overall outlook, so it’s important for people with HIV to speak about these symptoms with their health care team, including their physician and mental health professionals.
And, finally, Currie added, “A good defense is a strong offense.” Currie said that he himself is prone to seasonal depression, and he becomes proactive about it.
“I get proactive,” he said. “I increase my cardio; vitamins B, C, and D; decrease alcohol and increase water and tea; and I talk to anyone that will listen—my therapist, my family, friends, my dogs. ... There is healing power in talk.”