The Double Whammy of Seasonal Affective Disorder in a Season of Covid - Health, Medical and Fitness News Blog

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Tuesday, November 03, 2020

The Double Whammy of Seasonal Affective Disorder in a Season of Covid

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We hadn’t yet switched back to standard time, with its shortened hours of afternoon daylight, when I began to notice a lack of enthusiasm for activities that I usually enjoy during the darker, colder days of fall and winter. Indoor projects like knitting and crocheting and preparing enticing new recipes — even books and televised shows and movies friends recommended — failed to interest me.

It didn’t take long to link this ennui to the limitations and isolation associated with the Covid-19 pandemic. The arrival of fall in New York heralded an end to summer’s socially distant get-togethers on stoops and decks and outdoor meals with friends and family. Gone too was a satisfying structure of daily exercise, work and meals that provided a feeling of control over my life.

It’s challenging to maintain joie de vivre when there are limited opportunities to socialize with people who can lift one’s spirits or to attend cultural or sports events that break up the monotony of pandemic days and nights.

But while the pandemic, with its myriad economic, vocational, educational and social disruptions, is challenge enough for people who are not normally prone to the blues, the days of truncated daylight this November through March could be far gloomier than usual for millions of Americans who suffer annually from seasonal depression.

This winter the pandemic is expected to intensify the depression experienced by many people with the syndrome known as seasonal affective disorder, or SAD, which predictably kicks in each fall when the hours of daylight shorten in the Northern hemisphere and gradually remits in spring.

An estimated 5 percent of the population — one person in 20 — has the full-blown SAD syndrome, said Dr. Norman E. Rosenthal, the psychiatrist who first identified it in the 1980s and then devised an effective treatment. In an interview, he estimated that three times as many people have a milder version of SAD, commonly called “winter blues,” that saps their energy and enthusiasm for life.

Except for its seasonal pattern, the symptoms of SAD are similar to those of clinical depression: pervasive sadness, undue fatigue, difficulty concentrating, excessive sleep, lost interest in normally enjoyed activities, and cravings for starches and sweets and its attendant weight gain.

“I think we’re in for a particularly difficult winter for people with SAD, who seem to be especially susceptible to stressful life events,” Kelly Rohan, professor of psychological science at the University of Vermont, told me. “I saw evidence of this last March among the 26 people with SAD we were studying when the pandemic shut everything down. We were interviewing them weekly about their mood and everyone’s score shot up dramatically.”

Although the symptoms of SAD normally disappear completely every summer, Dr. Rohan said, “in the summer of 2020 we didn’t see a full remission in our patients. With such big stresses going on, they are overriding the seasonal pattern.”

Dr. Rohan fears that the anxiety and stress provoked by the pandemic will increase the risk and severity of winter depression for everyone. “It’s possible that those with subclinical SAD will become clinical,” she said. “People will be limited in what they can do to stay well even if they normally have good coping resources.”

However, Dr. Rosenthal said, “Just understanding the issues can give people a blueprint for handling them more effectively.” Most helpful for people with SAD, he said, is exposure to sunlight or its artificial equivalent for 20 to 30 minutes every morning. The standard amount of light needed is 10,000 lux. Sitting under a commercial light box at least one-foot square will do the job. Also helpful is using a dawn simulator in the bedroom or a light set on a timer to turn on 10 or 20 minutes before you get up.

LIGHT THERAPY Wirecutter, a New York Times company, reviews light boxes here.

My late husband was helped by walking the dog for half an hour or so every morning after sunrise.

“A 20-minute early morning walk in the sun is as good as commercial light therapy,” Dr. Rosenthal said, “but while morning is best, whenever you can do a walk is helpful. The combination of exercise and outdoor light is crucially important. It connects you with your environment — not just the light but also the birds, trees, animal life, neighborhood — all can act as an antidote to the cocoon of isolation.”

Our conversation reminded me of the spirit-lifting tactics I had adopted during the devastating early months of the pandemic, when my city was the epicenter of Covid-19 infections, hospitalizations and deaths. I made a point of finding something every day that brought joy: new growth on neighborhood trees, emerging blooms in people’s yards, watching my dog play with his canine pals, flirting with toddlers on the street, doing an evening shout-out for our essential workers who put their lives on the line for the rest of us.

“Don’t squeeze joy out of your life,” Dr. Rosenthal said emphatically. “There’s got to be joy every day. It’s an upfront investment that pays off handsomely.” He suggested taking classes online, perhaps learning to make jewelry or paint or play an instrument. Also very important is staying connected with people, perhaps by scheduling a socially distant lunch date or joining a friend for coffee or tea.

Dr. Rohan said, “It’s more important than ever to push yourself to stay engaged with activities you enjoy and stay connected with people as best as you can. To do otherwise is a recipe for disaster.”

If in-person connections won’t work, use the telephone to stay in touch with people you care about. I make a practice of calling a geographically distant family member or friend every week.

The isolation and quiet of the pandemic enabled Dr. Rosenthal to tackle a long-delayed book project: analyzing poetry. “Poetry,” he said, “has the power to heal,” and he’s chosen 50 poems to discuss how they can make a difference in one’s life.

Another valuable tip is to establish and maintain structure by doing things in a more-or-less set pattern every day. I recently realized that it was the loss of the satisfying routines of summer that helped precipitate my fall funk.

In a Times Op-Ed in March, Scott Kelly, a retired NASA astronaut who spent nearly a year on the International Space Station, described the tremendous psychological value of following a schedule and leading a structured life with a consistent bedtime.

“Smoothing out the structure of the day is important for maintaining circadian rhythms,” Dr. Rosenthal said. “Sleep becomes more consolidated and it’s good for psychological well-being.”



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