Seasonal Affective Disorder (SAD) and Addiction

Winter’s gloom has long been linked to the “winter blues.” However, if this seasonal shift severely impacts your daily life, you might be dealing with Seasonal Affective Disorder (SAD). Learn how this condition increases your vulnerability to addiction and why understanding this connection is crucial for effective treatment.

As the seasons change, many people experience more than just a temporary drop in mood. Seasonal Affective Disorder (SAD) is a serious mental health condition that goes beyond the occasional blues. Often dismissed as merely “feeling down”, the reality is much more profound and requires professional treatment. The situation becomes even more complicated when self-medication comes into play.  This coping mechanism can quickly lead to substance abuse and addiction, exacerbating the effects of SAD and creating a dangerous cycle that is difficult to break.

What is SAD?

Classified by the American Psychiatric Association’s Diagnostic Manual of Mental Disorders (DSM-5) DSM-5 as a “major depressive disorder with seasonal pattern”, SAD is a form of depression that varies with the seasons. Women and younger individuals are particularly susceptible, with the condition often emerging between the ages of 18 and 30, though it can also affect teens and children.

Common SAD symptoms include:

• Persistent depression or feelings of helplessness and hopelessness
• Increased stress and irritability
• Lethargy and sluggishness
• Fatigue and difficulty concentrating
• Social withdrawal and loss of interest in usual activities
• Frequent sadness and tearfulness
• Increased appetite and weight gain
• Changes in sleep patterns, either too much or too little

To be diagnosed with SAD, a person must have experienced seasonal depression during the winter months for at least two consecutive years, with symptoms fully remitting during the longer days of summer. This cyclical pattern is key to distinguishing SAD from other forms of depression.

Causes of SAD

The exact causes of SAD are still under investigation, but research points to several key factors linked to reduced sunlight. When daylight diminishes for long periods of time, it can disrupt the body’s internal clock, leading to biochemical changes in the brain. Typically, the following three chemical imbalances are identified as fundamental in the development of SAD:

• Reduced serotonin levels: People with SAD often have lower levels of serotonin, a neurotransmitter that contributes to feelings of happiness and well-being, than people who don’t report changes in mood.
• Decreased Vitamin D: Lower sunlight exposure means less vitamin D, which may be associated with a drop in serotonin levels.
• Increased melatonin production: Longer nights lead to higher melatonin levels, a hormone that regulates sleep. Excess melatonin can result in increased sleepiness and contribute to the lethargy experienced during winter months.

These changes collectively affect circadian rhythms and can lead to the onset of SAD, causing significant disruptions in mood and energy levels as the seasons change. Furthermore,

• genetic predisposition: individuals with a history of depression or family members with SAD are at a higher risk of developing the disorder, as well as
• existing mental health conditions: those with bipolar disorder or depression may experience worsening symptoms during the winter months

have been proposed to explain its development.

SAD and Addiction: What’s the Connection?

SAD and addiction often occur together, a phenomenon known as co-occurring disorders: It is common for individuals with substance use disorders to also have other mental health conditions, which typically results in more severe clinical and psychosocial challenges. To be more precise, the link between SAD and substance use disorders is a “correlation”, meaning that while they are connected, one does not necessarily cause the other. For instance, substance use might lead to the development of SAD, or vice versa. However, a significant factor in this relationship is self-medication. People struggling with SAD might turn to alcohol or other substances to manage their symptoms. Some may use -highly addictive!- stimulants like cocaine to boost their energy levels during the winter months, while others might rely on depressants such as alcohol or opioids to numb their feelings of depression.

The risk of relapse and how to avoid it

Relapse rates rise during fall and winter, particularly around the festive season, due to numerous substance abuse triggers such as holiday drinks like mulled wine at Christmas markets, champagne on New Year’s, and social gatherings that often involve alcohol. Not surprisingly, statistics show an uptick in visits following these seasons. The cold, dark months can lead to isolation and a wandering mind, making it difficult for those in recovery to resist cravings.

To cope with SAD and reduce relapse risk, consider these lifestyle changes:

• Stay Social: Counteract self-isolation by spending time with others. Reach out to family and friends before winter, explain your situation, and seek their support.
• Exercise regularly: Boost your mood and relieve stress through regular physical activity such as indoor workouts.
• Get outdoors: Enjoy brisk walks outside, even in cold weather, to soak up whatever natural sunlight is available.
• Eat healthily: Focus on a diet rich in fruits, vegetables, omega fats, and complex carbohydrates.
• Maximize light: Open your blinds to let natural light fill your room. Also, the use of a light box – a so called “SAD lamp” – can offer relief.

Integrated treatment for SAD and addiction

When SAD and substance use disorder co-occur, addressing both conditions simultaneously is essential for effective recovery. Focusing solely on mental health without treating the addiction often leads to continued substance abuse and worsening symptoms. Conversely, treating only the addiction without equipping individuals with coping skills for SAD can result in relapse.

At NEOVIVA, a comprehensive clinical interview is the first step, allowing our mental health and addiction professionals to accurately identify, manage, and refer patients to the suitable treatment programme in our clinic. If you or someone you know is struggling with SAD and addiction, please reach out to our team confidentially.