In the summer of 2017, Lindsey Smith, 31, found herself avoiding the outdoors whenever possible. “If it was sunny and nice outside, I would draw the blinds and just want to stay inside and lie down,” says Smith, who lives in Pittsburgh. “Everything seemed like a big chore: I didn’t want to eat, never wanted to go anywhere, and was barely sleeping. And, the worst part was, I always felt like I was missing out, which caused me to spiral even more.” Her primary care physician, who’d been treating her anxiety since she was 12, diagnosed her with summer-onset seasonal affective disorder (SAD) that June. Smith learned that she's among a small percentage of people who experience SAD, also known as major depressive disorder (MDD) with a seasonal pattern, in the summer.
Overall, SAD affects about 10 million Americans, according to Psychology Today, and it's most common in women. Although SAD is most frequently associated with winter, a whole 10 percent of Americans with SAD have it during the summer. Instead of being linked to a lack of sun, like winter-onset SAD, summer-onset SAD is thought to be caused by too much sun, as it turns off melatonin production. Since melatonin controls your sleep-wake cycle, it disrupts your circadian rhythm and lessens serotonin levels — and since serotonin is a brain chemical that affects your mood, low serotonin levels have been associated with depression.
“Staying up later during the summer can also throw off the internal body clock,” says Dr. Caroline Fenkel, a Pennsylvania-based social worker with Newport Academy, a nationwide mental health facility targeted toward teens and young adults. “For many people, summer means a less structured routine in general, which can increase vulnerability to depressive symptoms.”
The signs and symptoms differ for each type of SAD. While common symptoms of summer-onset SAD include agitation, insomnia, loss of appetite, and weight loss, indications of winter-onset SAD include low energy, oversleeping, appetite changes (and craving carbohydrates), and weight gain.
“In most cases, SAD is a specific type of depression,” Shari Harding, a professor of nursing at Regis College in Massachusetts, tells Mic. “Depression with a seasonal pattern is more common in areas further from the equator — where the days become shorter and there are longer periods of darkness — but it can occur anywhere.”
Although the symptoms of SAD are similar to the symptoms of depression — down or depressed mood, loss of interest or enjoyment in things that usually bring pleasure, decreased concentration and self-esteem, changes in energy, appetite, and sleep, and possibly suicidal thoughts — the key difference is that SAD symptoms come on with the change in season, says Harding.
“They then go away when that season is over,” she says. “For example, symptoms may start in fall or winter and go away in the spring, or some people will experience the opposite and notice that their depression occurs in the spring/summer each year.”
“I have been on anti-depressants for Bipolar Disorder II/depression for over a decade, and I was diagnosed with summer-onset SAD in 2009,” says Ali Kellog, a 28-year-old living in Los Angeles. She recalls having no motivation to do even remedial tasks, having no appetite, not sleeping, feeling very down, and having suicidal thoughts. At first, she wrote it off as just the hot weather affecting her, but her doctor eventually verified that what she was experiencing was actually summer-onset SAD.
Harding advises tracking your moods daily to help assess how you’re feeling. She notes that with a first depressive episode, it likely won't be clear if it’s SAD or not, unless a correlation is made that it starts and ends with the change of seasons. But if you realize that you've experience a depressed mood or loss of interest in activities for more than two weeks, seek professional help from your doctor or a therapist, particularly if you’re thinking about hurting yourself.
“Don’t brush off symptoms,” says Harding. “I often ask people to imagine their close friend is having the same problem and then to give their friend advice.”
Your doctor will likely discuss viable treatment options, from medication to non-pharmaceutical remedies such as light therapy and behavioral therapy. Dr. Fenkel adds it’s also important that the doctor rules out other potential issues that may be causing SAD symptoms, such as a thyroid problem.
“The first step for me was talking with my doctor and realizing that summer-onset SAD is a real and valid disorder that I should take seriously,” says Smith. “For a long time, I just always felt like I was a weirdo missing out on summer fun. But, instead, I realized that my body just enjoys colder temperatures and feels better in the fall and winter.”
Smith says that working with both a therapist and a naturopath (who focuses on alternative medicine) has helped her tremendously, and Kellog, too, has used a variety of treatment methods over the past decade. “I just finally started seeing a therapist last summer after being hospitalized following a suicide attempt and we’ve done some incredible work together,” she explains. She uses a hybrid of Western and Eastern medicine (Lamictal, seroquel, and birth control to help regulate her hormones, as well as various Chinese herbs like Longan and Ashwaganda), talk therapy, and exercises like meditation.
“The therapeutic/cognitive work has helped me make sense of my depression, which has given me a sense of power over it instead of being a slave to my chemical imbalances,” Kellog adds. “I use CBD nd marijuana, too, which has helped many of my symptoms, including issues with anxiety, sleep, and appetite."
Smith says she also makes sure to take extra care of herself in the summer months, making sure to drink plenty of water, running her air conditioner, and trying not to schedule too many work events. She says that if it’s a sunny day, but she wants the blinds drawn, she’s learned to give herself permission to stay inside. “Don’t be afraid to do that, because it’s good for your mental health,” she says.
Similarly, Kellog says she’s figured out what to do when her symptoms are flaring up. “Try and activate all five senses, and do something to stimulate your mind,” she says. “When symptoms or intrusive thoughts are taking over, I find sticking to this and treating it like a checklist works wonders.”
For example, for “senses,” she’ll look at something beautiful and hypnotizing, like the ocean, or smell something relaxing, like an essential oil. “Focusing on physical sensations can take your focus away from your intrusive thoughts, removes you from your head, and makes you focus on the environment around you,” Kellog says.
As far as activating her mind, she says this may vary from person-to-person, but she tries to read or play video games. “I work in virtual reality (VR) and it’s been extremely helpful in temporarily removing me from whatever thoughts are haunting me in that moment,” she explains.