Whether it’s a result of the cold, the long hours of darkness or the poor weather, people have bemoaned the winter blues for a long time — and for some, the winter brings with it depression and vulnerability to substance abuse. In fact, addiction and Seasonal Affective Disorder, known as SAD, are closely tied to each other. A 2018 study from the University of Pittsburgh Medical Center showed that alcohol consumption increases as hours of sunlight decrease and temperatures drop. Let’s take a look at the relationship between SAD and addiction.
What is SAD?
SAD is a depressive disorder that affects some people between late fall and spring. Triggered by the diminished daylight hours, SAD affects about 5% of U.S. adults, occurring more often in northern locations that experience less sunlight during the winter.
SAD is considered a major depressive disorder, formally known as major depressive disorder with seasonal pattern. People are not diagnosed with SAD unless they have experienced seasonal depression during the winter months for at least two years, with full remission of depressive symptoms during the longer days of summer.
Women and younger people are more likely to experience SAD than are men and older adults. The disorder is most often first noticed between the ages of 18 and 30, though teens and children can also diagnose it. Those with a personal history of mental illness and/or a family history of depression, especially of SAD, are also more likely to develop the disorder. Those who already have bipolar disorder or depression may see the symptoms related to those disorders get worse during the winter months.
The Symptoms of SAD
SAD can sometimes come on slowly as the days shorten in late fall and early winter. People with SAD typically feel fatigued, unmotivated and unable to concentrate as their depression begins. Other symptoms of SAD include:
- Decreased energy
- Insomnia, sleeping too much and other sleep problems
- Mood swings
- Increased isolation and social withdrawal
- Loss of interest and motivation in most activities
- Weight gain, often accompanied by a craving for carbohydrates
- A feeling of hopelessness or guilt
- Falling behind in work, school and personal responsibilities
- Changes in appetite
- Depression and unexplained sadness
- Suicidal thoughts
In addition, people with SAD become more prone to substance abuse during the winter period.
The Causes of SAD
When sunlight decreases, some people experience biochemical brain changes involving their circadian rhythms. These changes typical involve three factors. First, those who develop SAD typically produce less serotonin, a neurotransmitter that helps create feelings of happiness and well-being. They also produce less vitamin D, which is triggered in the skin by sunlight. Lack of adequate vitamin D may also be linked to that drop in serotonin.
Finally, people with SAD also increase their production of melotonin. Production of this hormone, which helps to regular sleep, is enhanced by darkness, so the longer nights of winter result in greater melotonin levels, which, in turn, can result in greater sleepiness.
The Relationship Between SAD and Addiction
People who develop SAD are twice as likely to develop an addiction problem as the rest of the population. This is right in line with the numbers of people with other mood disorders who develop substance use disorders. In fact, the National Institute of Mental Health points out that over 20% of people who’ve been diagnosed with a mental health disorder also struggle with substance abuse.
It’s not clear, though, whether substance abuse and addiction trigger the development of SAD or whether SAD causes people to develop an addiction. It’s very possible that self-medication plays a significant role here, since people may turn to alcohol or other addictive substances to try to treat themselves for their depression, including SAD and other mental health conditions.
Those with SAD may turn to different substances to deal with their changing circadian rhythms and moods. Some may seek stimulants, such as cocaine, to provide the energy they need during the winter. Others may try to numb the depression they’re feeling by ingesting depressants such as alcohol or opioids. Unfortunately, these attempts to self-medication are generally unsuccessful. In fact, using drugs and alcohol often makes the symptoms of SAD even worse.
The Effect of Addiction on SAD Symptoms
Addiction may correlate with SAD in different ways depending on the substance someone uses. Most people who fall into a substance use disorder related to SAD turn to alcohol, perhaps in part because of the craving for carbohydrates brought on by the SAD. The fact that alcohol is served at many winter holiday festivities may also encourage its overuse. People may drink alcohol to push back against feelings of depression, but because alcohol is actually a depressant, their symptoms are instead likely to increase. These feelings of lethargy and sadness may be exacerbated by SAD.
Some people turn to marijuana in hopes of relieving their depressive symptoms. After their high fades, however, they’re likely to become even more depressed and experience deeper SAD symptoms. Those who turn to stimulants to combat SAD often want to fight the feelings of fatigue brought on by the disorder. However, once the effects of the stimulant have worn off, their depression is likely to worsen — and those who didn’t already have a substance use disorder may develop one through the use of addictive stimulants.
Treatment for Co-occurring Substance Abuse and SAD
Treatment for SAD that co-occurs with substance use disorder is typically individualized with a dual diagnosis treatment plan designed around the addiction. The person fighting both disorders can thus get treatment for them concurrently, which offers the best chance for recovery. This treatment can include medically supervised detox, as needed. It is also likely to include group therapy and individual therapy, medications as appropriate, education, and aftercare.
Anyone with a dual diagnosis of SAD and addiction should seek professional help. Their disorders are treatable. However, without treatment, they can feed on each other, with dark days leading to substance abuse, which then leads to further depression. While people may feel they can self-medicate against SAD with drugs or alcohol, in reality, this self-medication is dangerous. Integrated treatment that addresses both issues at the same time produces the best results.
Treatment for co-occurring SAD and addiction is likely to employ phototherapy, or increased exposure to light. During this therapy, which has been tested and developed extensively in far northern countries such as Sweden and Norway, the person with SAD sits in front of a light therapy box for about 20 minutes a day. This box puts forth bright light in the daylight spectrum while eliminating harmful UV rays.
In addition, treatment is likely to include cognitive behavioral therapy (CBT), which helps people address the thoughts and behaviors that are causing them harm. CBT is often used to treat substance abuse disorders and depression, and specific types have been developed for SAD as well. Some therapists may also prescribe selective serotonin reuptake inhibitors, or SSRIs, for their patients with SAD. These antidepressants help increase the amount of serotonin in the brain.
Lifestyle Changes to Cope With SAD
People who have been diagnosed with SAD can also make some lifestyle changes to help them cope with this disorder. Because SAD often causes people to self-isolate during the cold months, it’s important to make a point of spending time with others. Those with SAD can reach out to family and friends before the winter arrives, telling them what to expect and asking for their help in avoiding isolation.
Exercise is also helpful to boost mood, and it can also help by releasing stress and negative feelings. Inclement weather can make it difficult to exercise regularly outdoors during the winter, so it’s important to plan ahead. Working out at a gym or bringing some exercise equipment into the home can make a big difference, and taking a brisk walk even when it’s cold can also lift one’s mood.
Regardless of the weather, just going outside and getting whatever natural sunlight is available goes a long way to alleviating the symptoms of SAD. In addition, opening up all the blinds and curtains at home and work can provide maximum exposure to light during the day.
Are You Ready to Seek Help for SAD and Addiction?
Do you feel yourself becoming lethargic and depressed every winter? Do you find yourself turning to drugs or alcohol because you just don’t have enough energy to get through the day or to try to lift your mood? We’re ready to help you deal with both your addiction and your seasonal affective disorder. Don’t wait to get help. Contact us today when you’re ready for help, and we’ll be there for you.