Illustration by Chris Gash
Illustration of a girl in a snow-globe
When pediatric psychologist Sara Gonzalez moved to Minnesota from slightly warmer Texas, she braced herself for a deluge of clients experiencing affective disorder (SAD). People who live far from the equator face a higher risk of this type of depression—as well its milder, more common cousin, the wintertime blues.
This year, as daylight wanes and COVID-19 rages, psychologists and therapists are bracing for a doubly harsh SAD season. Early studies and surveys reveal high rates of anxiety, depression, PTSD, and stress in younger adults, older adults, and students during the pandemic worldwide. And that’s during the summer. Come winter, some people living in northern climates will add SAD to the already onerous list.
Minnesotans who typically experience SAD, which is officially classified as a type of major depression with a seasonal pattern, often start experiencing symptoms in November when the hours of darkness overtake the hours of daylight. With the additional layer of COVID, “we’re maybe starting off at a point of greater vulnerability,” says Craig Sawchuk, a professor of psychology and co-chair of the Division of Integrated Behavioral Health at Mayo Clinic.
In other words, just about anyone living near the 45th parallel this winter likely faces a higher-than-usual risk of mental health issues. Whether the symptoms people are experiencing are caused by SAD or the social isolation and anxiety of the pandemic may be hard to tease apart, but the bottom line is that more people may need psychological help.
“It’s very hard to say if COVID will impact SAD,” says Gonzalez, who works at Children’s Minnesota. “But research is showing that families in confinement have high levels of stress, irritability, and trouble sleeping. So our team is coming from the assumption that people are overloaded mentally and emotionally, and so things that have been successful in the past to improve mood may not work during the current health crisis.”
Is it SAD or something else?
An official SAD diagnosis means meeting the full criteria of the disorder for two years, Gonzalez says. People often start experiencing it as young adults, but it can occur at any age—including in children. SAD patients experience symptoms such as irritability, lethargy, sadness, decreased energy, food cravings, and withdrawal from social situations seasonally.
“It tends to be a hibernation-type syndrome,” Sawchuk says. “There’s a lot of fatigue setting in. People may describe their mood as ‘blah.’ Their motivation is less, they may sleep more, there may be carb cravings or carb loading and gaining weight. It’s like the animal nature of us wanting to hibernate.”
Situational depression related to the pandemic can look similar. Fortunately, since similar treatments and practices can help with both, it may not be critical to pinpoint what’s causing the depression or low mood.
“Depression of any kind can be really serious,” Gonzalez says. “It doesn’t matter where it’s stemming from.”
If someone is experiencing a low mood—for any reason—talking about it with family and mental health professionals is critical.
What can everyone do?
Engaging in healthy practices before SAD or other types of depression set in may help prevent symptoms, experts say. Since most of the treatments for SAD are non-invasive, most of us who aren’t head over heels for winter can benefit from these healthy practices. Here’s how to tweak them during COVID:
Get outside: Simply going outside on a daily basis to take a long walk or sit on a bench soaking up the sun can make a difference, says Jean Larson, assistant professor in the Earl E. Bakken Center for Spirituality & Healing at the University of Minnesota and manager of Nature-Based Therapeutics Services at the Minnesota Landscape Arboretum. “Even on cold or cloudy days, outdoor light can help—especially if you spend some time outside within two hours of getting up in the morning.” Our body clocks need that morning light to recognize what time it is, she explains. And, Sawchuk says, our brains crave novelty, so changing up the environment by leaving your house is important—even if that means 10-minute increments when it’s really cold.
Find more light: If you can’t go outside safely, Larson recommends spending time close to a window, looking into the daylight. Open your drapes, trim tree branches, or even add more windows to create a brighter indoor environment, she suggests. And if you’re working from home, consider moving your “office” to the backyard or a park during warm weather if possible, Sawchuk says. In winter, change up what room you’re in, or go for a drive.
Exercise: If you’re not into cross-country skiing or snowshoeing, no problem. One positive side effect of the pandemic is the amount of free exercise apps and videos it inspired, Sawchuk points out. Whether you’re into yoga or weightlifting, chances are you can find a great program online.
Establish sleep and diet routines: Try to maintain a normal routine and schedule. Yes, that means showering and getting dressed, Sawchuk says. “Even in pandemic times, try to change into more wakeful types of things; it’s a signal to the brain that it’s time to get up and get going,” he says.
Photo by Shutterstock.com
Woman reading with seasonal light
Socialize: Spending time with others is a natural antidepressant, Sawchuk says. This may look different during the pandemic, but it’s just as important as ever. Set daily or weekly goals for the number of social contacts you’d like to initiate, he suggests. For example, strive to FaceTime or phone at least one person outside of your work circle each day. For people prone to SAD, ask friends to call you if they don’t hear from you for a couple of days, Sawchuk suggests, “so you don’t get caught up in that withdrawn hibernation mode.” And choose your contacts carefully: “There are people in our lives who are healthy, positive, supportive, and nonjudgmental—and sometimes other people are well-intended but maybe negative or ruminative,” he says. “Prioritize the ones that will lift us up rather than drag us down.”
Learn more: Educate yourself and your family about SAD and winter blues. And encourage everyone to verbalize their emotions, Gonzalez says. That may give you some insight into when to seek professional help.
What if you have a history of SAD?
Start light therapy early: About two weeks before your SAD usually sets in, begin turning on your light box (pictured left) within the first hour of waking up each day. Look for a box that offers at least 10,000 lux of intensity, Sawchuk says. And while you don’t need to stare at it, it should be within about three feet of you for 30–45 minutes, he says.
Establish your routine: This may look different during COVID, so get this set in place early as well. Get your healthy sleep, exercise, and diet patterns in place before the season hits. For families, that includes discussions about staying active and getting outside during winter, Gonzalez says.
When should you reach out?
If you can’t motivate yourself to do the things you usually love for a series of days, seek professional help, Larson says, especially when this symptom is paired with sleep disruptions, appetite changes, or self-destructive behavior.
For parents, in addition to looking for mood changes, watch for changes in behaviors, Gonzalez says: sleeping more or less, changes in eating patterns, not reaching out to friends, or wanting to be alone. Parents are the experts on their kids, she says, but you sometimes have to look for subtler clues than obvious stress signs or your child telling you they’re sad.
If you’re not sure if a behavior is crossing the line, opt toward seeking support, she advises. “With the added stressors of this season, it’s important to understand it’s OK to reach out,” she says, pointing out that Children’s established a free parenting line to help families during the pandemic. “At Children’s, we’re wanting people to reach out, whether it’s SAD or depression or having a difficult time managing what’s going on. We want to be able to provide a treatment plan customized for your family.”
And remember—by the end of February, daylight nearly surpasses darkness in Minnesota. Only, like, 100 days left!
