Seasonal Affective Disorder & Addiction: Managing Risk Through the Autumn Season

From the rocky shores of Maine to the heart of Los Angeles, many have noticed the change in the air, signaling the arrival of the autumn season.

With fall comes the rustle the leaves, the scent of pumpkin spice, and, at least for some, the emotional challenges of a seasonal transition. For these individuals, being forced to trade sun-soaked days for longer nights has a similar effect to a plant deprived of sunlight.

Now that autumn is upon us, here are some tips and strategies for maintaining your sobriety in spite of seasonal affective disorder.

What is Seasonal Affective Disorder (SAD)?

In spite of the unfortunate acronym, SAD is a specific type of depression that affects approximately 5 percent of adults and manifests at particular times of the year. Seasonal depression happens most frequently in the fall as daylight becomes scarce, continues through the winter months, and then dissipates by spring or early summer. Symptoms associated with seasonal depression include persistent low moods, increased fatigue, appetite changes, and a heightened desire for solitude.

Like other forms of depression, SAD can have profound implications on one’s daily life. Those afflicted struggle to fulfill work or school obligations, arriving late if at all. Concentration and productivity suffer; suddenly, tasks that had been routine become daunting or perhaps overwhelming.

Beyond professional and educational environments, the emotional weight of SAD extends to personal relationships. Seasonal depression tends to make people to withdraw from social gatherings, preferring isolation over companionship. This strains friendships and familial ties, compounding feelings of loneliness and exacerbating the depressive state.

Further, maintaining healthy habits — e.g. adhering to a regular sleep schedule, working out, eating as healthy diet — becomes challenging without the motivation to perform any of these tasks, potentially contributing to increased adult obesity. The culmination of these effects can lead individuals to seek relief, sometimes turning to substance use as a temporary escape, further emphasizing the need for understanding and support during this challenging season.

Common Treatments for Seasonal Affective Disorder

Seasonal affective disorder is unique among mental and emotional disorders in that it leverages treatment techniques that aren’t otherwise relevant in a healthcare environment. Let’s look at the four main therapies and care for SAD.

Light Therapy

Introduced in the 1980s, light therapy provides patients with a supplemental light source in order to offset seasonal depression brought on by the reduced sunlight during darker months.

In a light therapy session, the patient sits facing a specialized light box emitting 10,000 lux — or about 20x the intensity of standard indoor lighting — for up to 45 minutes every morning from autumn to spring. These light boxes filter out harmful UV rays, ensuring safety for most users although certain eye conditions and medications can limit the efficacy of light therapy.

Psychotherapy

Although cognitive behavioral therapy (CBT) is a staple modality used to treat almost every mental and emotion disorder — including substance use disorder — there’s actually a separate version tailed to treating seasonal depression, appropriately dubbed CBT-SAD. Conducted in two weekly group sessions over six weeks, CBT-SAD attempts to overwrite negative winter-associated thoughts with positive ones. To achieve this, CBT-SAD leverages behavioral activation, which teaches individuals to plan enjoyable activities to counteract winter’s typical interest loss.

Comparing CBT-SAD and light therapy, both effectively alleviate SAD symptoms. While light therapy tends to show faster results, CBT-SAD’s benefits appeared have shown to be more enduring in long-term studies.

Antidepressants

Like many other forms of depression, SAD is linked to serotonin disturbances, which is why antidepressant medications such as selective serotonin re-uptake inhibitors (SSRIs) are commonly prescribed. These include fluoxetine (“Prozac”), citalopram (“Celexa”), sertraline (“Zoloft”), and escitalopram (“Lexapro”), which are some of the most common antidepressants prescribed to help elevate patients’ moods. The FDA has also approved an extended-release form of bupropion (“Wellbutrin”) as a preventative treatment for seasonal depressive episodes from the fall to early spring.

Medications can have side effects, so it’s essential to discuss potential risks with your doctor. Sometimes, it may be necessary to experiment with different drugs to find the one that works best without causing significant side effects. For more on SSRIs, bupropion, and other mental health medications, refer to the NIMH Mental Health Medications page and the FDA website for the latest on side effects and warnings.

Vitamin D

It’s also worth mentioning that many individuals with SAD have a vitamin D deficiency. If correlated, then it stands to reason that vitamin D supplements could be helpful. However, for every study purporting no correlation, there’s another suggesting that vitamin D is as effective a treatment for SAD as light therapy. Until there’s a consensus, perhaps we should stick a pin in this one.

SAD & Substance Use Disorder (SUD)

Individuals with SAD tend to be motivated to alleviate their seasonal depression. Unfortunately, some have inadvertently developed comorbid, or co-occurring, addictions after attempting to use drugs or alcohol as a coping tool. This is particularly concerning, as substance use can further exacerbate feelings of depression, leading to a dangerous cycle of increased use and deepening depressive symptoms.

The Risk of Self-Medication

Someone experiencing seasonal depression has higher chances of becoming addicted due to so many turning to self-medication as a means to manage their depressive symptoms. Self-medication often involves the use of alcohol, drugs, or other substances to alleviate the feelings of sadness, fatigue, or hopelessness that come with seasonal depression.

However, self-medicating poses numerous risks. Instead of offering genuine relief, alcohol and drugs can exacerbate depressive symptoms, leading to a more profound sense of hopelessness or even triggering additional mental health issues. The temporary relief they provide often leads to increased dependence, escalating the potential for substance abuse or addiction.

Moreover, substances like alcohol can interfere with sleep patterns, further worsening the fatigue often associated with SAD. They can also hinder the effectiveness of prescribed medications or therapies for depression, delaying potential recovery.

It’s vital for individuals to recognize the dangers of self-medicating and seek professional help for their seasonal depression. Proper treatment, whether it be light therapy, prescribed medication, or counseling, can provide long-term relief without the accompanying risks of substance abuse. Embracing professional guidance and treatment paves the way for a healthier coping mechanism and a brighter winter season.

Managing Risk of Relapse Through Seasonal Depression

When shortened days and reduced sunlight trigger feelings of sadness, fatigue, and hopelessness, individuals with a history of substance abuse, these feelings can tempt a return to old habits as a means of coping. However, maintaining sobriety is crucial, not just for one’s physical health but for mental and emotional well-being. Here are strategies to help stay sober through bouts of seasonal depression:

• Awareness is Key: Recognize the signs of SAD. By identifying the symptoms early, you can seek help or implement coping strategies before the condition intensifies.
• Seek Professional Help: If you’re in recovery and battling SAD, consider speaking to a therapist. They can provide tools to help manage depression without resorting to substances.
• Stay Active: Physical activity can release endorphins, which are natural mood boosters. Whether it’s a brisk walk, yoga, or hitting the gym, keep moving.
• Light Therapy: One of the main treatments for SAD, light therapy involves sitting in front of a bright light for a set amount of time each day, mimicking natural sunlight.
• Connect with Your Support System: Stay close to your support group, whether it’s AA, NA, or another recovery group. Sharing your feelings and challenges can alleviate the sense of isolation that often comes with depression.
• Healthy Diet: Consuming a balanced diet with foods rich in vitamin D, omega-3 fatty acids, and other nutrients can help counteract some of the symptoms of SAD.
• Avoid Triggers: Whether it’s a certain group of friends, a specific location, or even certain holiday festivities, steer clear of scenarios that might tempt you to use.
• Establish a Routine: A set routine can provide structure and purpose, reducing feelings of aimlessness that can come with SAD.
• Practice Mindfulness and Meditation: Grounding exercises, deep breathing techniques, and meditation can help center your mind, alleviating anxiety and depressive thoughts.
• Stay Informed: Know the potential interactions between any antidepressants or treatments for SAD and substances to avoid complications.