As much as we associate the holidays with happiness and warmth, not everybody can get into the holiday spirit. Some people may be dealing with difficult family members or grieving a loss — while others may be suffering from a form of depression known as Seasonal Affective Disorder (SAD).

Estimates suggest as many as 10 million Americans suffer from SAD. This subtype of depression affects four times as many women as men, and results from changes in the season or weather — hence the name ‘Seasonal Affective Disorder.’

Many people suffer from the winter blues, but those with SAD experience full-blown depressive episodes thanks to the chilly weather and lack of light associated with the cold winter months. Unsurprisingly, a diagnosis of SAD can complicate the holidays, making them a less-than-joyous occasion for someone suffering from this form of depression.

Here’s everything you need to know about how to help someone with SAD during the holiday season, from recognizing SAD to understanding its causes, to practicing compassion and self-care at home.

What is Seasonal Affective Disorder (SAD)?

While the public and many providers know Seasonal Affective Disorder as well, that, the DSM-V handbook (used by therapists and psychiatrists to diagnose psychological disorders) lists SAD as a sub-disorder beneath Major Depressive Disorder: Depressive Disorder with Seasonal Pattern.

Here’s what it means to experience Major Depressive Disorder, as well as to have Depressive Disorder with Seasonal Pattern. 

Defining Major Depression

We all experience sadness and even despair from time-to-time. Many times, this sadness occurs following an event, such as a death in the family or the loss of a job, that explains the source of our sadness. Other times, however, we may feel a deep and profound sense of sadness for no apparent reason — which can signify a Major Depressive episode.

Major Depressive Disorder, also known as ‘Major Depression’ or simply ‘depression,’ is a psychological disorder that occurs episodically, meaning the disorder waxes and wanes over time. To be diagnosed with Major Depression, the individual must experience periods of at least two weeks during which they feel sad more often than not. However, emotional symptoms are not the only indicator of a Major Depressive episode — the disorder can also express itself physically, which we will explain in further detail below.

Symptoms of Depression

In addition to persistent low mood, the hallmark feature of depression, Major Depression also affects many systems throughout the body and brain. According to the DSM-V, five or more symptoms must be present to qualify for a diagnosis of Major Depressive Disorder, with one of those symptoms being depressed mood or lack of interest or pleasure in activities one usually enjoys.

Here are some of the other symptoms, both physical and emotional, that may be experienced by a person with Major Depressive Disorder:

• Significant
  and unintentional weight loss or weight gain (i.e. a change of more than 5% of
  body weight in a month)
• Decrease
  or increase in appetite nearly every day
• Insomnia
  (sleeping too little) or hypersomnia (sleeping too much) nearly every day
• Psychomotor
  agitation (appearing jittery or restless) or retardation (moving or speaking so
  slowly that others may have noticed)
• Diminished
  focus or concentration; inability to make decisions
• Recurrent
  thoughts of death (beyond fear of dying); recurrent suicidal ideation without a
  specific plan; a plan to commit suicide or suicide attempt

Major Depression vs. Seasonal Affective Disorder

If a person has suffered from one or more Major Depressive episodes, now or in the past, they qualify for a diagnosis of Major Depressive Disorder. But what makes Seasonal Affective Disorder different from Major Depression?

Unlike a Major Depressive episode, which can strike at anytime, a Seasonal Affective Disorder Depressive episode typically occurs (and re-occurs) at the same time each year. Most people who suffer from SAD experience a winter pattern, with an onset in early fall and remission in late winter. Still, patients can also experience a spring-summer pattern, triggered by the heat and humidity of the hot summer months.

How winter affects your mood

The winter holidays can feel bleak when someone is affected by SAD. A person with SAD may wonder, “Why now?” — as in, why feel depressed when all they want to do is enjoy the holidays?

As you will see, Seasonal Affective Disorder often strikes in winter for concrete reasons to do with the typical characteristics of this season. In fact, many of us experience the ‘winter blues’ — a milder, subclinical form of seasonal depression — due to these very same conditions! 

Here’s how the cold winter months affect your mood, sometimes leading to Seasonal Affective Disorder and other times, to the winter blues:

Lack of light

All living creatures require sunlight to function optimally: plants depend on sunlight for photosynthesis, and animals like us consume plants to reap the energy produced in this process! Hence why wintertime is a prime season for SAD to strike…. From October to April, daylight becomes scarce, leading our bodies to produce more melatonin (the hormone that makes us sleepy) and less serotonin (the ‘happy hormone’ associated with positive mood). When this reaction becomes extreme, it can lead to decreased mood, changes in appetite, low sexual desire and changes in sleep — all symptoms of a depressive disorder.

Cold temperatures

We all know how difficult it is to get out of bed in the morning — especially in the wintertime, when all we want to do is snuggle up in our blankets and go back to sleep. In fact, the cold weather may be responsible! When temperatures drop, our bodies compensate by reducing energy expenditure to conserve heat. Because of decreased energy expenditure, our hearts also need to work harder to pump blood throughout the body. As a result, we experience feelings of lethargy and fatigue — a key symptom of seasonal depression.

SAD during the holidays

For many of us, the holidays are the time of year we least expect to feel depressed. But what may seem to us like a celebration with family and friends can be a SAD patient’s worst nightmare. Here’s why some of us are prone to experiencing depression during the holidays — and what we can do about it:

Why the holidays can trigger depression

While there is no singular cause of depression, researchers have identified a number of factors that explain why some of us get depressed (and some of us don’t). Likewise, there are also many explanations why some people experience depression during the holiday season. Below, we detail some of the complex reasons why the holidays can be a stressful, saddening time for so many patients with SAD:

Cold, Wet Weather

As we explained previously, the dark, damp weather of winter can trigger symptoms of depression in individuals with SAD, such as sadness, lethargy, sleepiness and changes in appetite. It just so happens that holidays like Christmas and Hanukkah — a joyful time for so many of us — fall during this less-than-cheerful season for patients suffering from SAD.

Sociocultural Pressure

American culture loves the holidays. From peppermint mochas and red cups at Starbucks to the endless Christmas carols playing in stores during sales, the holidays have completely infiltrated our society, becoming almost inescapable from November to December. If you’re someone who doesn’t love the glitz and glamour of the holidays, you may experience an awful lot of pressure to keep up with the Joneses as you pretend to enjoy the endless parties and exchanges of gifts.

Family Difficulties

In addition to being a stressful time of year, the holiday season is also a time during which many of us reunite with family members we haven’t seen for awhile. Many of us view this as a reason to celebrate, but others may have complicated or challenging relationships with the family members they’re due to visit this December. For someone who does not have a positive relationship with their family (or certain members of their family), the holidays become less festive — and much more trying.

Reliving Trauma

Sadly, many of us have gone through traumatic events in our lives. If this event happened recently or shaped who you are, you may experience flashbacks or symptoms of depression at the anniversary of a traumatic event. Trauma does not discriminate against the holidays, either. When a person goes through something traumatic during the holiday season, they may not think of wintertime as a time of celebration, but rather as a time of deep pain and sorrow.

How to practice self-care during the holidays

Regardless of the psychopathology behind SAD, many of us experience this disorder during the holidays. Since we can’t escape the holidays themselves, instead we’re left with the challenge of discovering new ways to cope with the difficulty that accompanies this time of year.

Practicing self-care during the holidays, and being compassionate with ourselves, is one way to combat symptoms of seasonal depression. Self-care includes both treating our SAD (as medical care is an important component of self-care for mental illness) and engaging in helpful coping strategies on our own, to help us decompress and wind down from the stress of the holiday season.

Here are some ways you can combat SAD, both with the help of a skilled professional and independently at home:

Treatments for SAD

If a medical professional has diagnosed you with SAD, you may be wondering where to turn next. These options can help you and your doctor decide which treatment may be best for you and your Seasonal Affective Disorder.

Light Therapy

What’s the opposite of the dark, dreary winter months? Warm, cheerful sunlight, of course! While you cannot change the weather, you can simulate the positive effects of sunlight at home, with the aid of a therapeutic lamp designed especially for patients with Seasonal Affective Disorder. Under the guidance of a doctor or therapist, you can buy a therapy lamp (such as the Verilux Happylight) designed to mimic the effects of natural sunlight. Talk to your regular doctor before beginning a course of treatment, but know that most sessions begin at 30-60 minutes of light exposure per day.

Cognitive-Behavioral Therapy (CBT)

Other patients may wish to skip light box treatment and go straight to working with the help of a qualified professional — and that’s okay! Light therapy can be time-consuming, and doesn’t work for every patient. Another option is to pursue cognitive-behavioral therapy, or CBT. This mode of therapy focuses on assessing the validity of negative thoughts, and replacing those negative thoughts with more realistic ones. Therapists who practice CBT believe that changing our thoughts changes our behaviors, which in turn changes our emotions. Thus, by correcting your negative thought patterns, you can become happier by engaging in more positive behaviors — and experiencing more positive emotions.

Medication

Still others may want to try medication as a therapeutic remedy for Seasonal Affective Disorder. Patients who do not respond to light therapy or CBT alone may want to talk to their doctor about trying an antidepressant medication. There are many types of antidepressants that may work, but most people take a type of medication known as a Selective-Serotonin Reuptake Inhibitor, or SSRI. SSRIs block the reuptake of serotonin by your brain’s receptors, making more serotonin available for your body to use to generate happy hormones and positive emotions.

Self-Care at Home

Medical treatment is not the only way to cope with Seasonal Affective Disorder during the holidays. Self-care, or the time you take to tend to yourself physically, mentally and emotionally, matters almost as much as formal treatment by a licensed professional. Here are some of the ways you can engage in healthy coping strategies at home to help you fight SAD during the holiday season:

Take a Break

During the hustle and bustle of the holiday season, lengthy to-do lists can quickly take top priority. That’s why it’s important to take a step back and reassess your priorities. Finding a gift for your aunt’s cousin’s wife probably isn’t as important as taking care of your mental health! So, when you notice yourself becoming stressed or depressed as a result of all the things you need to do this holiday season, take a break to do something you love. Whether it’s adult coloring, soaking in the bathtub or curling up with your favorite Christmas movie, your mind and body will thank you for the reprieve from the holiday stress.

Navigate Family Dynamics

Finally, as we mentioned before, the holidays can force us to interact with family members with whom our relationships might be fraught. Practicing patience, rather than giving into tension and animosity, will serve you (and your Seasonal Affective Disorder) well during the holiday season. Whenever possible, make a plan on how you will cope with difficult family members prior to seeing them. Negative people can unfortunately rub off on us, but going in with a gameplan to avoid or make pleasantries with that person will lessen the temptation to give in to toxic behaviors.

Most importantly, however, if you’re struggling with family challenges this holiday season, remember the importance of your chosen family. Our family is anyone who loves us unconditionally. Sometimes, our own flesh and blood may fail us in this regard — but we all have people in our lives who we can’t imagine living a day without. Those people are the most important family you have — so, make the holidays a time to celebrate them, rather than a time to grieve the family members who have failed you.

Are you struggling with Seasonal Affective Disorder as the holiday season rapidly approaches? You don’t have to struggle alone. If you’re affected by this debilitating disorder that makes the worst of the fall and winter seasons, you can reach out to us in order to learn more about how the Meadowglade can help you make strides in managing your disorder. Contact us today to learn more!