Managing Seasonal Affective Disorder & Eating Disorder Recovery

 

Written by Emily Costa

As winter's shorter days and longer nights set in, an increase in reported cases of fatigue and depression is commonly observed. This is often a routine reaction to the diminished sunlight but for some, it escalates into a medical condition known as seasonal affective disorder (SAD). The distinction between ordinary winter melancholy and SAD is crucial to understand.

For individuals already grappling with the challenges of an eating disorder, the added stress brought on by the season can feel overwhelming. Understanding this condition and how to manage seasonal depression can mitigate its detrimental impact on recovery. 

Read on to learn more about: 

  • What Season Affective Disorder is & common symptoms 

  • The difference between normal depression and SAD 

  • Causes of Seasonal Affective Disorder 

  • How SAD is diagnosed 

  • The connection between SAD and eating disorders

  • Treatment options for Seasonal Affective Disorder 

What is Seasonal Affective Disorder?

Seasonal Affective Disorder (SAD) is a type of depression that is tied to changes in seasons. It typically begins and ends at about the same times every year. Most people with SAD experience symptoms starting in the fall and continuing into the winter months, sapping energy and leading to feelings of moodiness. A much less common type of SAD, known as summer depression, begins in the late spring or early summer.

Despite its cyclical nature, SAD goes beyond simply "feeling down" about the weather. It is characterized by persistent feelings of sadness or anxiety, a change in appetite, sleep problems, and a lack of interest in activities that were once enjoyed. Like other forms of depression, it can lead to severe outcomes if left untreated. Its unique feature is its seasonal pattern, which can aid in diagnosis.

Here are the symptoms:

  • Persistent feelings of sadness or anxiety

  • Notable changes in appetite, often associated with weight gain or loss

  • Problems with sleep, including insomnia or oversleeping

  • Lack of interest in activities once enjoyed or apathy towards social activities

  • Fatigue or loss of energy

  • Difficulty focusing or making decisions

  • Feelings of worthlessness or guilt

  • Thoughts of death or suicide.

Differences Between Normal Depression and Seasonal Affective Disorder

While both normal depression and Seasonal Affective Disorder (SAD) share common symptoms such as feelings of sadness, loss of interest in previously enjoyed activities, and changes in appetite, there are distinct differences between the two. The primary distinction lies in their timing and persistence.

Normal depression, also known as Major Depressive Disorder (MDD), may occur at any time of the year and is not tied to seasonal changes. Its symptoms can persist across months or even years if not treated appropriately. Furthermore, MDD might have no discernible external trigger, and can arise even when things in the person's life are going generally well. SAD, on the other hand, is specifically correlated with the changing seasons.

Causes of Seasonal Affective Disorder

Although the precise causes of Seasonal Affective Disorder (SAD) are not fully understood, research suggests that several factors might play a role in its onset. One of the main theories is that the reduced level of sunlight in fall and winter may disrupt your body's internal clock, leading to feelings of depression. This is because decrease in sunlight might disrupt your circadian rhythms, which regulate sleep, hormones, and other bodily processes, causing you to feel off-balance.

Another potential cause is a drop in serotonin levels, a neurotransmitter that affects mood. Reduced sunlight can cause a decrease in serotonin, potentially leading to depression. The change in season can also disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood.

SAD is more prevalent in people who live far north or south of the equator, suggesting a strong link to light exposure. If you live in a place that has long winter nights, less sunlight during the day, and more cloudy days, you might have a higher risk of SAD.

Additionally, personal factors can also contribute to SAD. For instance, it's diagnosed more often in women than in men, and while SAD can occur at any age, it more commonly appears when people are in their 20s to 40s. People with a family history of SAD or other types of depression are more likely to develop the disorder, suggesting a genetic component.

Lastly, individuals with certain mental health disorders, such as bipolar disorder or major depression, are more likely to have episodes of SAD. It's important to note that while these factors can contribute to the onset of SAD, many people with the disorder do not have any known risk factors. This makes understanding and treating SAD complex, and often requires a multi-faceted approach.

Diagnosing Seasonal Affective Disorder (SAD)

The diagnosis of Seasonal Affective Disorder (SAD) begins with a comprehensive evaluation of the individual's mental health and medical history. This may involve a thorough physical exam and, in some cases, blood tests to rule out other potential causes of the symptoms, such as thyroid issues or hormonal contributions. The diagnostic process typically involves detailed discussions about the person’s mood, appetite, sleep pattern, and daily behavior.

To be diagnosed with SAD, an individual must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. The essential feature of this disorder is a regular temporal relationship between the onset of major depressive episodes and a particular time of the year. Furthermore, full remissions also occur at a characteristic time of the year.

For a diagnosis of SAD, these depressive episodes must have occurred during the last two consecutive years with no non-seasonal depressive episodes occurring during that same period. The seasonal depressive episodes must also outnumber other depressive episodes throughout the patient's lifetime.

Eating Disorders and Seasonal Affective Disorder (SAD)

Research has suggested a potential link between Seasonal Affective Disorder (SAD) and the occurrence of eating disorders. Although the correlation is not completely understood, the connection may be rooted in the shared influence of seasonal changes on mood and behavior.

People with eating disorders are found to have a higher incidence of Seasonal Affective Disorder (SAD), and research indicates that symptoms of eating disorders tend to exacerbate during the colder months.

The emotional disturbances may lead individuals to adopt or return to harmful coping mechanisms, such as restricting food intake, binging, or purging. The cycle of disordered behaviors as a way to manage the emotional turmoil caused by SAD can become a vicious circle. A decrease in socialization in winter months is also common, and this can exacerbate feelings of loneliness and isolation. This can not only trigger the use of behaviors, but also create an opportunity for behavior use in secret, a dangerous characteristic seen in most eating disorders. 

For those already in treatment for their eating disorder, addressing these symptoms and feelings in therapy or with your doctor as soon as possible is an important step to managing SAD. If you are currently struggling with an eating disorder, seeking out support from a therapist that specializes in eating disorders can be a great first step to both addressing disordered eating concerns and any impact SAD may be having on your day to day functioning. The good news is that managing SAD and full recovery from an eating disorder is possible with the right care. 

Related: The Role of Therapists & Dietitians in Eating Disorder Recovery

Treatment Options for Seasonal Affective Disorder (SAD)

There are several treatment options available for Seasonal Affective Disorder (SAD), and the choice often depends on the severity of the symptoms, the individual's preference, as well as their overall health. Here are a few of the usual treatment options:

Light Therapy (Phototherapy)

Light therapy is considered a first-line treatment for SAD. It involves exposure to a specific type of light that mimics natural outdoor light, with the intent of altering the brain chemicals linked to mood and sleep. The individual sits a few feet away from a special light therapy box so that they're exposed to bright light within the first hour of waking up each day.

Psychotherapy (Cognitive Behavioral Therapy)

Cognitive Behavioral Therapy (CBT) can be particularly effective in treating SAD. This type of therapy helps individuals identify and change negative thought patterns and behaviors that may be making them feel worse, and also teaches effective coping strategies.

Medication

Certain medications, such as Selective Serotonin Reuptake Inhibitors (SSRIs), are used to treat SAD. These medications can help balance serotonin levels in the brain, which in turn improves mood. It's important to note that it might take several weeks to notice the full benefits from an antidepressant. A psychiatrist or primary care doctor may prescribe these. 

Vitamin D

Although the link between vitamin D deficiency and SAD is not fully understood, some studies suggest that taking vitamin D supplements might be as effective as light therapy. This should be discussed with your healthcare provider before beginning any supplements. 

Mind-body techniques:

These include relaxation techniques such as yoga, tai chi, meditation, music or art therapy. These techniques can help individuals manage stress and cope with SAD.

It's important to remember that while these treatments can help manage the symptoms of SAD, they do not cure the disorder. As such, symptoms might recur in future seasons. For this reason, an ongoing treatment plan might be necessary.

It is crucial to not let Seasonal Affective Disorder (SAD) interfere with your recovery from an eating disorder. Recognizing the impact a season change might have on your mood and eating patterns is the first step. Professionals can provide appropriate therapies and medications to manage SAD symptoms. Remember, it's not a sign of weakness to seek help but rather a step toward gaining control over your well-being. 

If you are ready to take the next step to getting support for your eating disorder and Seasonal Affective Disorder, please learn more about our treatment programs at Central Coast Treatment Center or reach out to us today to learn more about how we can support you or your loved ones recovery journey. 

Emily Costa

Having struggled with an eating disorder herself, Emily is passionate about spreading awareness, education and the possibility of recovery with others. Emily previously volunteered as a Crisis Text Line counselor and with the eating disorder non-profit Project HEAL where she served as their blog manager, their NYC Chapter Leader & a recovery mentor in their Communities of HEALing pilot program completing training by the Carolyn Costin Institute. Emily now enjoys working with various treatment centers, clinicians and non-profits in the eating disorder community providing marketing and design services. In her free time she enjoys spending time with friends, hanging with her dogs, and reading a book at the beach. 

 
 
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