While some of us look forward to sweater weather and leaf-peeping, not everyone delights in the arrival of autumn. Leaving summer behind can be especially difficult for people with seasonal affective disorder (SAD), who experience significant shifts in mood and energy when the days get short. This year, some SAD experts worry that the winter blues will be worse than usual.
“People are already experiencing heightened symptoms of anxiety and depression due to months of adjusting to the new realities of COVID-19,” says therapist Nancy MacGregor, clinical director of Harmony Bay Wellness. “Many people have a sense of lack of control with what is happening and a general sense of unease, so it would be reasonable to expect an increase in the occurrence of SAD this year.”
That said, there are ways to prepare yourself to support your mental health going into winter, whether or not you’ve been diagnosed with depression.
Darker days, darker moods
We know how to identify SAD. We also know the condition is disproportionately common among certain groups of people. Women, for instance, are four times more likely than men to receive a SAD diagnosis. But we’re still figuring out what causes SAD. There may be a genetic component, as well as personality factors at play, says Dr. Raymond W. Lam, professor of psychiatry at the University of British Columbia.
What is clear is that seasonality is a dimension. “People with SAD only have depressive episodes, with symptoms of decreased energy, oversleeping and overeating, during the winter,” Lam explains. “We know there is a biological clock in the brain that controls the daily and seasonal rhythms of our entire bodies. We depend on bright outdoor light, or the day length, to synchronize that clock with the changing seasons. When the winter days get shorter, for people with SAD, they are not able to adapt compared to others.”
In turn, geographic location (latitude, specifically) appears to play a role in the chances of developing SAD. In a given year, about 5 percent of all Americans experience symptoms of SAD for almost five months of the year. But that figure varies significantly by state. Among Floridians, SAD prevalence is only about 1 percent, compared to 9 percent of Alaskans.
Additionally, some people experience “subsyndromal” SAD. “If you ask people if they have changes in their sleep, energy, weight, mood and outlook during the winter, many people will say yes,” says Dr. Paul Desan, assistant professor of psychiatry at Yale University. “Maybe as many as 15 to 20 percent of people living in mid-Atlantic latitudes will report changes that bother them and that they’d like help with. Many individuals have significant seasonal symptoms and would benefit from light treatment, even if they do not have the whole syndrome of SAD.”
How COVID factors in
Since the pandemic began, many of us have been spending more time indoors than usual. “The urge to seek out daylight is totally natural, and hard for us to resist. “Human beings are intrinsically seasonal animals,” says Desan. “We like an adequate level of illumination, and an awful lot of people are working in dark little areas of their home.” It’s a perfect storm for anyone vulnerable to SAD symptoms.
But decreased sunlight isn’t the only concern. Stress can also precipitate depression. “If the quarantine bought darkness, financial troubles and social isolation, your mood and energy will likely be worse this winter,” Desan says. On top of that, many people have been less able to do things that are helpful for psychological health, particularly exercise. “We also know that when people stop doing pleasurable activities, it’s harder to restart them,” Lam says.
It all adds up, according to experts. “I’m worried that people aren’t going to have exposure to light, and they’re not being physically active, and when you’re physically active, you get more light. Everything coming up this winter is a threat to our well-being,” Desan says.
That’s all the more reason to be proactive about protecting your mental health, experts say. If you’re vulnerable to seasonal mood changes, consider taking action before it’s time to break out the down puffer. Winter is coming, but it’s not here yet.
“Even when it seems dull and gray in the winter, the light outside is much brighter than indoor light.”
First of all, if you have SAD, it’s good to invest in a light box and use it for 30 to 60 minutes first thing in the morning, before 8 am. Early-morning exposure to bright light can help reset your body clock, which can make a dramatic difference in how people feel, Desan says. Not all light boxes are created equal, though. When Desan and two coauthors tested 24 light boxes on the market, only seven were research-grade. For instance, some that claim to be “10,000‐lux” devices only produce that intensity when the user sits very close.
“If you sit in front of a light box for half an hour, six months out of the year, a bigger device where you can move around is more practical,” Desan says. (Check out this list of the devices he recommends that are supported by research.)
Whether you have SAD or not, it’s still smart to make an effort to get adequate light every day. Sitting inside near a window won’t do the trick. “If you are three feet from a window, you’re not getting any benefit,” Lam says. “What you’re getting is purely indoor light.” He recommends getting outside, the earlier the better. “Even when it seems dull and gray in the winter, the light outside is much brighter than indoor light,” he explains. “Outdoor light at noon with clouds is 10 times brighter than indoor light.”
On top of the exposure to the sun, getting outside means you’re moving, which has added benefits. “Exercise increases new brain cell growth and can alter some neurotransmitters,” Lam says. “We always recommend exercise for people who are depressed as a way to help regulate mood. It’s no different in people with SAD.”
Try to stick to a regular waking, sleeping and eating schedule to help synchronize your biological clock. Also, even if you don’t feel like it, make plans to see friends while keeping social distancing recommendations in mind. “Most people with depression stop doing things they enjoy because they don’t have the interest and motivation to engage,” Lam says. “That can create a vicious circle: You stop, so you’re not getting the enjoyment, and then you’re less motivated to do those things again.”
Lastly, cognitive behavioral therapy (CBT) can help with SAD. “People with SAD tend to catastrophize. They think that winter makes them feel bad, then they stop doing things they like and that makes them feel worse,” Lam explains. CBT teaches you how to identify and change negative thoughts and behaviors. CBT also lends itself to telehealth, which makes it accessible even if your mental healthcare provider is staying socially distant.
While the outlook for SAD this year might seem bleak, taking steps as early as possible can help everyone prepare to cope. “SAD is seasonal. With the right action and support plan, it will be spring again before you know it,” MacGregor says.
This story has been updated.