Feeling down in December: The “Holiday Blues” vs Seasonal Affective Disorder
The holiday season, while marketed as a time of rest and celebration, can also be a time of loneliness, sadness, and worry. There are many reasons for this seemingly paradoxical experience: high expectations met with disappointment, disruptions in routine, travel stress, and the recollection of painful memories brought on by revisiting home and family. Given that there are so many valid reasons to not be feeling your best during this season, it’s easy to overlook a common cause of sadness during this time of year: your circadian rhythm.
The Circadian Rhythm
Your circadian rhythm is your body’s internal clock, primarily regulated by your exposure to sunlight. Your circadian rhythm tells your body to be awake in the day and sleepy at night. It’s disrupted when you travel to a different time zone, resulting in “jet lag”. And your circadian rhythm is impacted by the changes in sunlight intensity and duration that occur with the changing of the seasons.
As the days grow shorter and sunlight exposure decreases in fall and winter (the shortest day of the year is the first day of winter), our circadian rhythm is disrupted. This disruption can directly impact mood. People with pre-existing mental health conditions such as Major Depressive Disorder or Bipolar Disorder might find that their symptoms worsen during this time, and many people without these conditions might find themselves feeling more tired, unmotivated, and just not like themselves.
Seasonal Affective Disorder (SAD)
Some people may even fall into a full depressive episode due to these changes in sunlight and the impact on their circadian rhythm. This is referred to as Seasonal Affective Disorder (SAD) or major depressive disorder with seasonal pattern.
Symptoms of Seasonal Affective Disorder (SAD):
increased feelings of sadness
loss of interest in usual activities
changes in appetite (usually increased carbohydrate cravings)
feeling fatigued even with enough—or even too much—sleep
People at higher risk of SAD are those living further away from the equator (and therefore experience greater changes in sunlight with the changing seasons), but it can affect anyone who experiences changes in sunlight exposure throughout the year.
Treatment of Seasonal Affective Disorder (SAD)
While symptoms tend to improve as spring approaches and summer arrives, there are treatment options to make the fall and winter months more bearable, or even enjoyable. Medications and therapy–the mainstays of psychiatric treatment–are effective in SAD. Many lifestyle interventions can also be effective: going outside during the limited sunlight hours, exercising, and spending time with loved ones.
Another treatment option is light therapy, which simulates the morning sun exposure that regulates your circadian rhythm. This involves sitting in front of a light therapy box for a set period of time (usually 30 minutes) every morning.
The most effective treatment plan for Seasonal Affective Disorder (and for other mental health conditions that worsen with the changing seasons) is a personalized, comprehensive approach that takes your full history, current symptoms, and individual values into account.
