Seasonal Affective Disorder and substance misuse: What’s the link?

It’s freezing outside, the sky is grey and there are limited daylight hours. It can be difficult to stay cheerful at this time of year, but for some people the problem goes further than a dose of the “winter blues.”

Seasonal Affective Disorder (SAD) is a form of depression that occurs at the same time each year, usually in the autumn and winter months. SAD affects around 2 million people in the UK and can often co-occur with addiction. It is very common for people struggling with addiction to have additional mental health problems, but SAD is often a lesser-known condition.

What is Seasonal Affective Disorder?

Sometimes known as “winter depression”, SAD is a type of major depressive disorder occurring with a seasonal pattern. The symptoms correlate with a certain time of year, usually the winter, and dissipate during the rest of the year. Although rare, it is possible to experience SAD in the summer and to experience remission in winter.

Who it affects

As with addiction (and most mental health disorders), SAD doesn’t discriminate. It can affect anyone, of any age, gender or social class. However, it does tend to affect people in the Northern Hemisphere more often due to the greater seasonal changes.

A study from Glasgow University found that women are significantly more likely than men to experience symptoms of SAD.

SAD is less likely to affect people who live in places where there are long hours of daylight in the winter.

What the symptoms are

People with SAD generally suffer from a persistently low mood from around the time of year when the daylight hours begin to significantly reduce, up until Spring time when the daylight hours increase again. In the UK, this is from around mid-September to the end of March or early April.

Experiencing a loss of pleasure in activities that you usually enjoy is another common symptom. Normal daily activities may become a chore and difficult to complete. Many people also report feelings of irritability.

Sleeping for longer periods than usual and continuing to feel sleepy during the day, craving carbohydrates and gaining weight in the winter months are also symptoms of SAD.

In addition, the NHS describes the following as common symptoms of SAD:

  • feelings of despair, guilt and worthlessness
  • feeling lethargic
  • difficulty concentrating
  • decreased sex drive

Many of the symptoms overlap with general depression symptoms.

What causes SAD?

The seasonal variation in mood experienced by SAD sufferers is thought to be driven by reduced hours of daylight. (Walton et al, 2011)

Reduced day length and later sunrise in winter is thought to lead to a phase shift in sleep-wake circadian rhythms, associated with disruptions in mood, as well as sleep, immune function, metabolic function, cognition and many other health outcomes.

SAD and addiction

SAD can make recovering from addiction more difficult. As with any dual diagnosis, experiencing mental health difficulties and the symptoms of SAD can make you more vulnerable to relapse.

It may be tempting to turn to alcohol or substances to try to relieve the symptoms, but this often only makes things worse in the long term. For the best chance of recovery, it is advisable to receive professional treatment for both the seasonal affective disorder and the addiction behaviours.

In countries where daylight hours significantly reduce in the winter months, studies have shown that alcohol consumption increases with the darker days:

“Seasonal changes in mood and behavior (seasonality) may be closely related to alcoholism. Some patients with alcoholism have a seasonal pattern to their alcohol misuse. They may be self-medicating an underlying seasonal affective disorder (SAD) with alcohol or manifesting a seasonal pattern to alcohol-induced depression.”

– Alcoholism and seasonal affective disorder

Feeling lethargic, tired, and withdrawn from social activities are all risk-factors for substance misuse as well as symptoms of SAD.

Can SAD be cured and can I avoid it?

There is no “cure” for SAD, but it is treatable and symptoms can improve. This is achievable in similar ways to other types of depression. Some general tips for dealing with SAD include:

  • Get outside in daylight as much as possible – even on a cloudy day you will benefit from the light this provides. Vitamin D is produced by the body on contact with sunlight, and it has mood-boosting properties.
  • Eat a healthy diet – Avoiding alcohol and eating a balanced diet helps your brain to function and avoid fatigue.
  • Exercise regularly – especially outdoors! Exercise naturally releases endorphins into your body, helping to boost your mood and keep you healthy both physically and mentally.
  • Keep your surroundings bright – try to let as much natural light into your home or work environment as possible.

If you suspect you have SAD, you should see your GP as a first port of call. If you are struggling with substance misuse or alcohol misuse as a result of your seasonal depression, we recommend get in touch with your local drug and alcohol team. This can be done via your GP. See below for how Ara can support you with our recovery housing and gambling treatment.

Support and treatment for SAD

  • CBT – cognitive behavioural therapy can help you to reframe your thoughts and better cope with negative emotions. We provide free counselling for people struggling with gambling harms.
  • Medication – antidepressant therapy, particularly the use of SSRIs during the winter months can help some people
  • Support groups
  • Light therapy – light boxes are a relatively cheap and effective option for many people with SAD. An hour or so each day can help set your circadian rhythm.
  • Treatment for co-occurring substance misuse – this is important to address. Your GP can guide you to the appropriate services. If you live in Bristol and are homeless, we can help you with our substance misuse recovery housing.

How Ara can help you

Our Bristol housing service (sometimes known as dry houses) provides safe, secure accommodation for people at the beginning of their recovery journey. The substance misuse Pathway 4 housing, in partnership with Bristol City Council, allows people to recover at their own pace with the support of a dedicated housing support practitioner. Weekly 1:1 sessions help people to access drug and alcohol treatment services, mental health support, benefits, volunteering and training opportunities.

To access this service, you can ring us on 0330 1340 286 or attend a weekly housing drop-in. These are every Wednesday at 2pm at 11 Kings Court, King Street, Bristol BS1 4EF.

If you’re struggling with gambling-related harms, you can access our free gambling treatment service by ringing 0330 1340 286 or visit our Get Support referral page.

We also offer support to partners, family and friends of problem gamblers. This service is called the Six To Ten Project and can be accessed by visiting the Six To Ten website or by ringing 0330 124 1274