Does the idea of leaving your house in the morning when it’s still dark outside, and coming back at five p.m., in total darkness, feel devastating to you? While some people relish the idea of turning back the clocks and getting an hour of sleep, others feel like it seals their fate until March. It’s not an uncommon phenomenon—almost twenty percent of the U.S. adult population feel this way.
It’s also well known that depression and eating disorders often occur together. Are seasonal depression and eating disorders co-occurring as well? Do the seasons affect the severity of eating disorder symptoms? Read on to find out what causes seasonal depression, how it affects eating disorder symptoms and severity, and what can be done to cope with seasonal changes.
What is seasonal depression?
Seasonal depression is the occurence of overwhelming feelings of sadness, fatigue, sluggishness, hopelessness—essentially, symptoms relating to depression—that occur due to the changing of the seasons. People who suffer from seasonal depression usually find themselves starting to feel down as the sun sets earlier in the day, and then bounce back in March or April, when the sun is up for longer periods of time.
Depression disturbs someone on physical and emotional levels. Seasonal depression does the same and may cause you to:
- Feel less energetic
- Need more sleep than usual (otherwise known as hypersomnia)
- Crave sweet foods and carbohydrates more than usual (as these foods provide a rapid dose of serotonin, a mood-regulating hormone)
- Become less productive at work or school (otherwise known as experiencing cognitive impairment)
- Want to withdraw socially
Seasonal depression can happen to anyone, but more common risk factors for seasonal depression include:
- Living farther from the equator: It has been proven that the farther you live from the equator, the more vulnerable you are to seasonal depression. In fact, the incidence of seasonal depression in New Hampshire is nearly 10% of the population, compared to 1.4% of the population in Florida.
- Being a woman between the ages of 15 and 55. 60-90% of seasonal depression sufferers are in this demographic.
- Wishing you could hibernate all winter: People with seasonal depression often feel extremely tired during the winter months. Many wish to “hibernate” like bears until spring.
- Counting the days until we turn the clocks forward: If you feel as though a fog in your brain has lifted in March, you may be suffering from this disorder.
The Science Behind Seasonal Depression: Sunlight and Serotonin
The sun is the body’s natural alarm clock: before clocks and alarms, the sun basically controlled when we did anything, including waking up. Our retinas have special cells that detect sunlight and send a signal to the part of the brain that keeps track of our circadian rhythms. Circadian rhythms manage the body’s processes, especially our wake-sleep cycles.
In the winter, as light cues become weaker, the brain doesn’t get the wake up call, so it continues to release melatonin, the “sleep hormone”, into the body. The lack of proper sunlight is why people are so lethargic. Studies have also been conducted to determine the relationship between seasonal changes and serotonin, which is a hormone that contributes to mood regulation. Researchers focused particularly on SERT, which is a protein that transports serotonin from the brain to nerve cells in the body.
It has been found that SERT levels are higher in the fall and winter for those with seasonal depression. This means that during these times, more serotonin is being taken away from the brain and transported to the body. The less serotonin the brain has, the worse it will feel moodwise.
The Connection Between Seasonal Depression and Eating Disorders
Many people with an eating disorder have co-occurring disorders. Co-occurring disorders occur when someone is diagnosed with two or more mental health disorders. Common co-occurring disorders in eating disorder patients are depression and substance abuse disorders. The National Eating Disorder Association (NEDA) has found that in a study examining the co-occurring disorders and eating disorders in women, 94% of participants had been diagnosed with a co-occurring mood disorder, and 92% had been struggling with a depressive disorder.
Since depression plays a role in eating disorder severity and treatment, it makes sense that seasonal depression does the same. Studies have found that the severity of eating disorders, especially bulimia and binge eating disorder, increases with seasonal changes.
Reduced levels of serotonin, increased levels of melatonin, and intense cravings for carbohydrates during the winter months all contribute to episodes of binging. Increased levels of depression can affect anyone with an eating disorder, as the two disorders feed into each other. Those experiencing eating disorders and depression feel the effects of both, physically and emotionally.
Related: Want to know more about the relationship between eating disorders and co-occurring disorders? Read about it here.
Treating Co-Occurring Disorders Physically and Emotionally
The only good part about seasonal depression is that it can be anticipated. Clinicians and patients know that it’s coming, and can prepare to manage it. The big contributors to seasonal depression are the lack of sunlight and serotonin, so clinicians start with trying to increase both of these.
A doctor or psychiatrist may prescribe a selective serotonin uptake inhibitors (SSRIs), a type of antidepressant, increases the levels of serotonin in the brain. This helps to regulate moods, emotions and sleep, which will all help mitigate depression symptoms.
Seasonal depression has also been treated with light therapy, which increases the amount of “light” your body gets in the wintertime. Patients are instructed to sit in front of a “light box” for approximately 30 minutes per day. Researchers have found that this kind of therapy relieved symptoms of seasonal depression in about 70% of patients.
In more severe or resistant cases of seasonal depression, dawn simulation devices have been used to mimic the light patterns of spring and summer. These devices are used to realign the circadian rhythm. Combining these two therapies greatly reduces symptoms of seasonal depression when compared to doing only one or the other.
Behavioral interventions also help minimize the severity of seasonal depression. Practicing good sleep hygiene helps the body regulate the levels of melatonin in the body, which regulates energy levels. Going to bed and waking up at the same time every day, putting away technology at least one hour before bedtime, and establishing a “wind-down routine” really help to regulate sleep patterns. Spending time outdoors, for even a little while, and even on cloudy days, gives you a dose of natural sunlight and fresh air. Taking slow, mindful walks, if you are able to, helps regulate mood.
Talk therapy is an effective treatment for both depression and eating disorders. Being able to anticipate upcoming mood disturbances allows clinicians and patients to come up with strategies to cope ahead. And, of course, following a balanced meal plan and getting all the nutrients you need will decrease cravings, improve energy levels, and help regulate mood in the long run. Following a meal plan is an essential part of eating disorder recovery, as well as an essential part of treatment for depression.
Managing Co-Occurring Disorders: The Treatment Gap
Many treatment facilities lack the resources, or simply ignore, co-occurring disorders during eating disorder treatment. But we know that disorders interact with and feed into one another, so full recovery can’t happen until all of a patient’s disorders are addressed and treated. At ‘Ai Pono, we understand the need for a holistic approach to eating disorder treatment.
We begin with a thorough psychiatric assessment of those entering our treatment programs. Symptoms of co-occurring disorders are taken into account when developing a unique treatment approach for every patient. We then use a multi-modal approach to treatment, integrating talk therapy, pharmaceutical interventions, movement therapy and nature therapy to provide treatment for disorders on all fronts. Patients have time to go outside for fresh air and doses of sunlight in our safe, natural and beautiful treatment facility and the surrounding area.
Eating disorders and co-occurring seasonal depression can be treated.
Wintertime does not automatically mean that eating disorder recovery is put on hold. Seasonal depression can be anticipated and coped with using several treatment approaches. We here at ‘Ai Pono believe that full recovery is possible all year long.
If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or simply learn more about the holistic eating disorder recovery programs we offer.
