Last winter, A.S.—a 26-year-old from Minnesota who asked to go by her initials to protect her privacy while job searching—was terrified of seasonal affective disorder (SAD). No stranger to seasonal depression during Minnesota’s cold, dark, snowy winters, A.S. worried that pandemic isolation would only make the problem worse. She planned a regimen of prescribed antidepressants, light therapy and exercise, then hunkered down and tried to relax through the winter. To her pleasant surprise, it mostly worked.
This year, however, she hasn’t been so lucky. Since daylight saving time hit, “it has been so awful,” she says. “None of my tools have been working the way that they used to.”
Like the virus itself, pandemic-related stress and trauma haven’t gone anywhere—but now it feels like the world is moving on and everything is supposed to be “normal” when it’s not, she says. Between that and her usual predisposition to SAD, her mental health is going through the ringer.
Luana Marques, an associate professor of psychiatry at Harvard Medical School, says she’s seeing similar trends among her patients. If last year’s primary challenge was isolation, this year’s is uncertainty, Marques says. As the pandemic drags on and new variants emerge, many people are afraid of what that could mean for the winter ahead—especially when, post-vaccine rollout, they’d envisioned spending the season around friends and family. That’s colliding in an unfortunate way with SAD, which is defined as depression that follows a seasonal pattern for at least two consecutive years.
“There’s a lot of anticipatory anxiety,” Marques says. “What is [this winter] going to look like?”
Rates of depression and anxiety have been elevated in the U.S. since the pandemic began. As of April 2021, about 33% of U.S. adults reported symptoms of depression, according to a study recently published in the Lancet Regional Health. In a 2019 study, about 19% of U.S. adults said they’d felt depression symptoms over the prior two weeks.
There’s not much data about how the pandemic has affected SAD specifically, but experts say it has likely exacerbated the condition for some people. During an average year, an estimated 10 million people in the U.S. experience SAD—typically, but not always, during winter. It’s not exactly clear why that happens, but many experts believe it’s linked to shorter days with less sunlight, which may throw off the body’s natural rhythms.
It’s logical to think the pandemic would worsen that situation, given that many people are spending more time at home and socializing less than ever—effectively doing the opposite of what experts typically recommend for avoiding SAD. Some experts have even theorized that infection by COVID-19 could be a risk factor for psychological distress, given its ability to affect the brain, explains Dr. Teodor Postolache, a professor of psychiatry at the University of Maryland School of Medicine and a SAD expert.
Since SAD is only diagnosed among those who have experienced symptoms for at least two years in a row, it’s difficult to say whether the pandemic has caused an uptick in prevalence—but for some people who regularly have the condition, Marques says it hit harder than usual during the last pandemic winter. Dr. Norman Rosenthal, a psychiatrist and pioneering SAD researcher, agrees. “It’s still winter,” he says. “And there are added fears, there are added challenges.”
Widespread vaccination will hopefully make socializing easier and safer for many people this winter compared to last, possibly easing some of that burden. But the Omicron variant—which, compared to other strains, appears highly contagious and more likely to cause breakthrough infections—may change that equation. Marques warns that people who are predisposed to seasonal depression should mentally prepare for “COVID roadblocks”—like breakthrough infections or changes in COVID-related restrictions—that could force temporary isolation and become psychologically difficult.
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“You think you’ve got a handle on the whole thing, and then you get something new, like the new variants,” Rosenthal says. “You’re piling it all one on top of the other.”
For that reason, Marques says it’s crucial to think ahead. You may not like the current reality, but you can at least accept it by making contingency plans. That way, you won’t be blindsided if the unfortunate does happen. “If I don’t see my family, what’s my backup plan?” Marques offers as an example. “You create a little bit of certainty within that uncertainty.”
It’s also helpful to remember we’re not powerless to the virus anymore, Rosenthal says. “There are things we can do,” he says. “We can get vaccinated. We can wear masks when we have to. We can minimize risky situations like big crowds of people and maximize safe situations like walking with friends.” One study of U.S. adolescents even found that following public-health guidance about COVID-19 could lessen some of the pandemic’s mental health consequences.
Indeed, that’s one benefit of entering our second pandemic winter: by now, researchers know a lot more about the virus, its psychological effects and how to combat some of its consequences. One study, for example, found that physical activity and time spent outdoors were associated with lower rates of depression and anxiety during lockdown. Another paper found that dog ownership was linked to higher feelings of social support and lessened symptoms of depression (though, of course, getting a dog is a long-term commitment and not a quick fix for SAD). Peer support, such as that found in self-help groups, is also a valuable tool during the pandemic, another study found.
Pre-pandemic tools for fighting SAD still apply as well. There is some evidence that exposure to light therapy lamps can help, and some people have luck with vitamin D supplements. Mental health professionals can also provide extra support.
Aside from that, Marques recommends tried-and-true habits like getting enough sleep, eating well, exercising, spending time outdoors and socializing to the extent possible. Do “anything that keeps you engaged and gives you energy,” she says.
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Contributor: Jamie Ducharme