The Impact of Seasonal Affective Disorder
Depression is a serious mental health disorder that affects millions of people worldwide. There are several forms of depression, each with its own unique symptoms and diagnostic criteria. One of these is seasonal affective disorder.
Seasonal affective disorder (SAD), also known as seasonal depression, is a major depressive disorder whose symptoms change with the seasons. Research findings reported by the American Psychiatric Association (APA) indicate that sunlight causes a chemical reaction in the brain that regulates mood.
Decreased amounts of sunlight in late fall and throughout the winter months can cause low mood and other associated symptoms of depression. As the amount of sunlight increases in the spring and summer, these symptoms decrease, often disappearing completely. Sufferers may feel like different people, depending on the season.
According to the Mayo Clinic, SAD affects approximately 1-2% of people, while 10-20% of the population suffers from a milder form, often referred to as the “winter blues”. It is more prevalent in women and typically has its onset during early adulthood. It can occur in children and adolescents, and is less likely to affect older adults.
Causes of Seasonal Affective Disorder
The exact cause is unknown, but research findings indicate that there are many possible factors, each related to a lack of sunlight. These may include changes in an individual’s circadian rhythm, a drop in serotonin levels (a neurotransmitter in the brain that affects mood), and an imbalance in melatonin levels, which also impacts mood and other depression symptoms.
A less common form of seasonal affective disorder is summer SAD. It is caused by longer days and increased amounts of daylight, higher levels of heat and humidity, and possibly even seasonal allergies.
Symptoms of seasonal affective disorder are the same as those for depression. With SAD, the severity of symptoms is impacted by the amount of sunlight, resulting in a worsening in the winter, and remission in the spring and summer.
Typical symptoms include a depressed mood, loss of interest in activities previously enjoyed, anger, irritability, anxiety, loneliness, difficulty concentrating, fatigue, low energy and changes in appetite, weight or sleep patterns.
Suicidal thoughts are common among those experiencing SAD, and friends and family members should watch carefully for indicators of suicidal behaviour. Any mention of suicide should be taken very seriously, before it is too late.
Because the symptoms lessen or disappear at certain times of the year, sufferers frequently dismiss their condition as not requiring intervention. That puts them at risk.
A treatment plan that includes counselling, light therapy, and/or medication is essential for anyone suffering with seasonal affective disorder. Quality of life can be greatly improved for those suffering from this manageable illness.
SAD and Substance Use Disorder
The National Institute of Mental Health (NIMH) reports that there is a strong correlation between drug and alcohol abuse and mental illness. This link is well-established and supported by extensive research. When an individual is suffering from both, this is known as co-morbidity, or dual-diagnosis.
The relationship between addiction and mental health issues is both complex and bidirectional. Individuals who are more likely to abuse substances are more susceptible to develop seasonal depression, and the reverse is also true.
As with other mental illnesses, individuals with seasonal affective disorder frequently self-medicate with drugs and alcohol, particularly if they do not seek professional help. SAD often causes painful symptoms like feelings of hopelessness, overwhelming sadness, and suicidal behaviour. If medications are not prescribed, or if they are not used properly, sufferers are at increased risk of substance abuse.
Drugs and alcohol do not provide long term relief, so SAD symptoms return as soon as the effects subside. This leads to repeated substance abuse, and more is required to achieve intoxication each time. This creates a cycle of recurring symptoms, and ongoing consumption of drugs and alcohol in response to those symptoms.
Eventually, a physical and psychological dependence on the substance is formed, and the individual becomes addicted. Sadly, the depression symptoms remain untreated. In fact, drug and alcohol use exacerbates them.
The Impact of Substance Abuse on Seasonal Affective Disorder
Alcohol is the most common substance abused by individuals with SAD. Less sunlight, colder temperatures, and the stress of the holiday season all combine to make the effects of any mood disorder unbearable. Having a few drinks almost seems natural with the ready availability at work and home functions, but relief is not provided for long.
Marijuana, a depressive itself, is another drug frequently used by people with a mental illness to manage their condition. As with alcohol abuse, this is terribly ineffective as the depressed mood returns, intensified, as soon as intoxication subsides.
Using stimulants such as nicotine, cocaine or methamphetamines, has an equally detrimental effect. Individuals often use these to relieve feelings of lethargy and fatigue. As with other substances, as stimulants dissipate, an even greater feeling of depression sets in. They are also highly addictive.
Treatment of Co-occurring Disorders
Winter can be a challenging time for everyone, emotionally and physically. For those suffering from a mood disorder and addiction, it can be unbearable. The best hope for recovery is a treatment plan that addresses both conditions with an integrated approach.
Only treating the substance use disorder leaves the seasonal depression unmanaged. This can trigger a relapse, and continued consumption of drugs and alcohol. An untreated addiction may worsen depression symptoms, also resulting in substance abuse. A plan that addresses both conditions simultaneously is crucial for recovery.
Psychotherapy allows the individual to work with a counsellor to identify and analyze thought patterns and behaviours that worsen SAD, and to develop new tools and strategies for managing stressors and symptoms. A form of this type of therapy that has been found to be extremely affective is Cognitive Behaviour Therapy (CBT).
Phototherapy, or light therapy, may be used by a medical professional to simulate the effects of sunlight on serotonin and melatonin levels. In addition, activities that involve getting natural light are strongly advised.
Medications, particularly specific types of anti-depressants that increase serotonin and melatonin levels in the body, as well as vitamin D supplements, can be an invaluable part of treating both the substance use disorder and SAD, these very manageable but debilitating conditions.
The first step to achieving lasting relief is seeking help.
Seasonal Affective Disorder (SAD) Mayo Clinic, Copyright 2020
Seasonal Affective Disorder (SAD) The Centre for Addiction and Mental Health (CAMH), Copyright 2020
Seasonal Affective Disorder (SAD) Health Links BC, Current as of: September 11, 2018
Seasonal Affective Disorder (SAD) American Psychiatric Association (APA), Physician Review: January 2017
NIMH » Seasonal Affective Disorder National Institute of Mental Health (NIMH), Last Reviewed: March, 2016