UNC Health Talk

Dealing with Seasonal Affective Disorder During a Pandemic

The coronavirus disease 2019 (COVID-19) pandemic has led to an increase in the number of people who are feeling depressed. Now that the days are getting shorter and temperatures are falling, is seasonal affective disorder, or SAD, going to strike especially hard this year?

The answer is: It’s very possible. But there also might be unique opportunities to feel better.

We talked to UNC Health psychiatrist Rachel Frische, MD, to learn more.

What is seasonal affective disorder?

Also called major depressive disorder with a seasonal pattern, SAD is a form of depression that occurs in the same season every year. Although it is most common in the winter, SAD can affect people in any season.

Symptoms include sleeping or eating too much, not being able to sleep, lack of appetite or craving carbohydrates, especially sweets.

“It’s a recurrent depression that tends to happen for folks in the winter months, and it correlates with the way that our body experiences changes in our circadian rhythm related to changes in exposure to daylight,” Dr. Frische says.

Circadian rhythms are the 24-hour cycles that serve as our internal clocks, regulating several biological processes including the sleep-wake cycle. The decrease in sunlight that occurs in winter may disrupt the body’s internal clock and lead to feelings of depression.

“Reduced exposure to sunlight during the winter months may be correlated with reduced hormones and chemicals, such as vitamin D, serotonin and melatonin, that directly impact our mood and sleep. These fluctuating levels contribute to the development of depression or worsening of pre-existing depressive symptoms,” Dr. Frische says.

Direct exposure to sunlight causes your body to produce vitamin D, which in turn can help to regulate serotonin, a chemical substance in your brain that is associated with boosting mood and helping you feel calmer and more focused. Melatonin, a hormone that impacts the sleep-wake cycle, is released when the sun sets to help you feel relaxed, calm and ready for bed. Changes in daylight hours contribute to changes in sleep and mood.

How do you protect yourself from seasonal affective disorder?

The good news, Dr. Frische says, is that you can lower your risk of experiencing SAD.

The most important step is to maintain a routine. It is especially helpful to go to sleep and wake up around the same time every day.

Before bed, “have a process to wind down and allow yourself to get restorative sleep so that the daytime hours can be better used,” Dr. Frische says.

Make sure you’re eating healthy meals, getting enough exercise and spending more time outdoors, if possible.

“Getting exposure to sunlight and fresh air is important,” Dr. Frische says.

If it’s not possible to go outdoors, a solution that’s easy and not too costly is a therapeutic light. Dr. Frische recommends a 10,000-lux light box.

“Have the light set up next to you and turn it on around 30 minutes a day, or even twice a day,” Dr. Frische says.

Note: Typically, you will place the light about 16 to 24 inches from your face with your eyes open but not looking directly at the light.

You also can take a vitamin D supplement if you aren’t getting sufficient sunlight. “Having good amounts of vitamin D in our blood system is very protective,” Dr. Frische says. A melatonin supplement also can be used at night to help regulate your sleep cycle.

How will the pandemic affect seasonal affective disorder?

The COVID-19 pandemic has had a profound effect on people’s mood and anxiety issues.

“For those with a history of depression or anxiety, the isolation of a global pandemic can trigger more intense or more severe symptoms,” Dr. Frische says. “Also, people who have never struggled with mental health issues may find themselves experiencing mood symptoms now that they’re finding themselves confined and with really erratic work-life and sleep schedules.”

Yet there is a silver lining to experiencing SAD in the midst of a pandemic.

“The benefit of all of the changes with COVID is many folks are working from home and have more opportunities throughout their day to have access to sunshine,” Dr. Frische says.

Whether you’re working inside or outside your home, try to go outdoors between meetings or during online school breaks. If your feelings persist, talk to your doctor or look for a mental health therapist. A more flexible schedule might make it easier for you to see someone for talk therapy, and many therapists are working virtually now.

“While I anticipate we may see more (SAD) in terms of number of cases, I anticipate they will be cases that actually can be treated a bit easier, as long as we are focusing on taking the steps in the right direction to prevent those symptoms from getting worse—or better yet, actually prevent them from happening,” Dr. Frische says. “I think we have more space to do that with the flexibility of our life now, despite that it’s feeling somewhat more chaotic than normal.”

If you think you are depressed, talk to your doctor. Need a doctor? Find one near you or set up a virtual appointment.