It’s summer for a while now. The days are long, the sun shines intensely, everyone is posting fun pictures of holidays and moments on the beach. It is fantastic, it is supposed to be fun for everyone! Though, is it really..?
“Oh I am sick and tired of the summer this year! When will it be cold and rainy again?”, a friend of mine recently complained. Indeed this year summer has been surprisingly intense here in The Netherlands , and not only.
But actually, there IS such thing as summertime SADness. It is a very real condition, called reverse Seasonal Affective Disorder (reverse SAD). There are really people that feel much more vibrant and themselves during winter, than during the summer months.
I suppose most of you are familiar with the concept when it refers to winter, since it is much more prevalent, after all.
What is Seasonal Affective Disorder?
SAD is a type of recurring major depression with a seasonal pattern. According to DSM-5 (Diagnonstic and Statistical Manual of Mental Disorders) , criteria for depression with a seasonal pattern include experiencing a depressive episode that begins and ends during a specific season every year, for at least two years, with full recovery during the other seasons. This condition happens more often in the winter, but it is estimated that around 10% of SAD sufferers experience reverse-SAD; in the summer, where longer and warmer days trigger the onset of depression symptoms.
Women are more susceptible to SAD, since the prevalence in women is 4 times greater than in men. It also affects people more the further away they live from the equator. Therefore, while winter SAD is more prevalent in places with colder and longer winters, summer SAD is more common where the summers are longer, hotter and more humid.
Both winter and summer SAD people can experience the full range of depressive symptoms, such as low mood, worthlessness, hopelessness and lack of interest and motivation in activities previously enjoyable.
Yet other symptoms can be quite the opposite, like the two seasons themselves: While winter SAD people may experience a lack of energy and can feel more lazy , sleep more, eat more and gain weight in the winter, summer SAD people may experience the opposite of those things: they can be more agitated and on-edge, irritable, restless, sleep less, eat less and lose weight, while they overall feel more anxious and nervous. They may even exhibit more aggressive behaviours than normal for their standards. If you are amongst the summer SAD people, it is expected that you may feel even a bit manic, unsure of what to do with the excess energy, that can seem daunting and exhausting.
Reverse SAD is fairly uncommon, and it can often get misdiagnosed with other conditions such as major depression, dysthymia and anxiety. Another reason making reverse-SAD difficult to diagnose is its comorbidity with other disorders, such as other depressive disorders, bipolar disorder, ADHD, eating disorders and alcoholism. Moreover, people are hesitant to seek help, because of the social conventions associated with summer and good mood. Others may disregard their condition and just advise those people that “it’s all in your head; just enjoy the sun and be happy”!
Causes and Contributing Factors
While the exact reasons for the occurrence of reverse SAD still remain puzzling and unclear, there are several contributing factors that have been underlined. As with most mental illnesses, there is a definite genetic component, since 2/3 of SAD sufferers have someone in their family who suffered a major depression episode or another mood disorder.
Seasonal change causes depression
Seasonal change when referring to summer SAD means longer days, more sunlight, higher temperatures and changes in humidity.
The longer days and exposure to sunlight cause modulations in melatonin production. Melatonin is a hormone produced by the pineal gland that responds to darkness by causing us to feel sleepy and want to go to bed. Together with serotonin, they affect our circadian rhythms; our inner “biological clock” that dictates when we have to be alert and awake and when we desperately need to sleep.
Circadian rhythms are synchronized to respond to the rhythmic light–dark changes that occur daily and throughout each of the seasons.
As summer days become brighter and longer, melatonin production decreases. Melatonin is essential in preparing our body to get into deep and relaxing sleep. Therefore, those with summer SAD would understandably experience difficulty falling asleep, as well as an increase to their energy levels.
Moreover, there is a constant interplay between melatonin and serotonin, that is an immediate precursor of melatonin. Serotonin is a neurotransmitter that is essentially our own happiness drug. People with depression have lower levels of serotonin overall, yet the interplay of melatonin and serotonin can explain the hypomanic and agitated state that people with summer SADness find themselves at.
The combination of decreased serotonin and decreased melatonin impacts circadian rhythms. For people with SAD, the circadian signal that indicates a seasonal change in day length has been found to be timed differently, thus making it more difficult for their bodies to adjust.
Body Image
It is beach season and we are all constantly bombarded with news and pictures of the ideal “bikini body”. This can add pressure and increase anxiety and depressive symptoms to people that are predisposed to summer SAD.
Changes in Schedule and Routine
For many people, the somewhat strict schedule of winter provides them with structure and helps them feel more comfortable and better organized. In contrast, in the summer there are constant disruptions in our schedules; BBQ’s can be planned or hosted spontaneously, a trip to the beach can last much longer than you expected, and everything may be just a bit slower and more lazy… While this can feel great to most, it can be nerve-wrecking to others, who prefer to be able to plan their days according to their responsibilities and not based on how warm or sunny it is.
Your work schedule might be disrupted too; you have probably noticed that many people leave work earlier in the summer, lured by the high temperatures and preferring to relax at sunny roof terraces and bars instead. While this is admittedly something to look forward to for most of us, it can create challenges for our scheduled responsibilities and tasks, with many of those falling behind.
Also, because the days are longer and we tend to be more often outside than inside, we tend to go to sleep later as well. This combined with the change in our melatonin levels can greatly throw our circadian rhythms off balance.
For parents with children, in the absence of school, you may suddenly find yourself overwhelmed with organizing activities for your kids, who probably spend much more time at home now. If you are not on vacation mode yet, this can be an added responsibility for you that can cause increased anxiety and exhaustion.
Social Pressure
While winter SAD people can join forces with many others who feel similarly, if you are one of those who suffer from summertime sadness, you most probably feel like the “odd one out”. The social pressure is huge; after all, you’re supposed to be having a fabulous time, just like all of your friends. Not only that, but it might feel very lonely to be the grumpy one, while everyone else is having fun in the sun. This might increase feelings of being misunderstood and even isolated, as you probably prefer to stay in a cool air-conditioned closed space rather than indulge in endless “fun” summer outdoors activities.
Temperature and Humidity
Most people welcome the warm, hot days of summer. But for people with summer SAD, they can be exhausting and excruciating. What others find exciting may be a humid sweaty nightmare for you, especially if you need to carry on with your daily schedule, take public transport and squeeze yourself in limited spaces with dozens of others who puff and sweat every minute.
The drop in temperature that comes in autumn probably feels soothing to people with reverse SAD, for whom the summer heat may feel oppressive and intense, further contributing in creating agitation and hypomania that gets exhausting after a while. For those people, the promise of dark, cold and snowy winter days with cloudy skies and the possibility to hit the mountains and enjoy what the winter season has to offer is probably a much preferable alternative.
Finances
Summer means holidays, and this can be expensive. It requires reasonable saving during the rest of the year, and if you run a private business, this can mean not being paid for as long as you are on holidays. Financial pressure can be a substantial contributing factor to the maintenance of reverse SAD.
Holiday Plans
It is not only the financial aspect of holidays, but overall the organizing and planning of where to go, what your accommodation will be, what places to visit etc. that constitutes a significant source of anxiety. After all, holiday anxiety is also a very real concept (that we will discuss another time). Since holiday plans need to be made before the actual holiday begins, and possibly when you are still in a strict working schedule, this can feel overly pressuring and demanding. Something that will eventually bring you pleasure and relaxation starts off with stress and anxiety, and that’s quite a conflict.
Coping Tips for Summer SADness
Seek Help and Support
Depression symptoms are never to be taken lightly, no matter the season. If you feel off-balance, sad, moody, irritable, and experience changes in your energy levels, appetite, sleep patterns and habits, and this persists- don’t delay. Address the issue with a professional to help you get through it and rise again. Furthermore, it is important to seek support through your friends and loved ones. The ones who care will understand you are not making it up, and it is vital to remember you are not alone in this.
Sleep Well
We already established the role of circadian rhythms in the development of seasonal affective disorder and how your disrupted schedule may further contribute in your mood. Even if it feels challenging, what with all the outdoors activities and the longer days, make a conscious effort to get the sleep that you need. Sleeping masks, ear plugs, dark blinds and curtains may help in this process.
Plan Ahead
If you have repeatedly noticed that you get moody and feel low in the summer months, you have an important advantage: you know when it’s coming. Therefore you can better prepare for it. For instance, consider what helps prevent your mood from worsening and how can you counteract it well in advance. Plan activities that you find pleasurable and push yourself to follow through, while making sure you are getting enough rest. Think of your coping mechanisms and carefully evaluate what is the best time to take your holiday, based on your condition.
Exercise
Especially if you are feeling slightly manic, adhering to a consistent plan of physical exercise can greatly help with modulating your energy levels. By trying out sports and hitting the gym you will help regulate your appetite and your circadian rhythms overall, since it will bring about sleep more effortlessly. However balance is the key word here- don’t overdo it with fitness!
Diet and Eating Habits
You may feel inclined to eat less and lose weight, but better keep an eye on your eating habits and make sure you are eating healthy and light snacks that can keep you satiated and content. Even if the social pressure on the ideal beach body can be high, never mind. Don’t overexhaust yourself with dieting; it can be counterintuitive to your mood. A balanced diet can go a long way in regulating your emotions.
Explore Past Patterns
Despite the fact that SAD can have a strong physiological base, it can be worthwhile and useful to consider whether there are other events from the past that trigger depressive symptoms in you. Maybe something happened during summer in the past that originally made you feel depressed, and from then on you connected this feeling to the summer season. Our brain can create strong associations and patterns and it can be substantial to uncover and understand them.
Self-Care
With all the social pressure that goes around, you might agree to social gatherings and activities because you kind of feel obliged and pressured to do so, rather than because you really want it. Or maybe you are embarrassed to deny plans because your friends may assume you are crazy for not wanting to join in in their fun summer sailboat evening.
It is true that when you are depressed, it often helps to push yourself out of your comfort zone and join activities that will eventually improve your mood- but keep your boundaries in mind too. Try to be friends with yourself and listen to your deepest needs, especially when planning your vacation activities.
Make sure that whatever you plan will actually contribute in your pleasure and well-being, and that you are doing it for yourself first. This may be quite challenging if you have children and a family, but even in this case, take yourself and your needs into consideration and make yourself a priority. Ensure to schedule activities and relaxing moments that will fulfill you and enhance your summer experience, rather than wear you out. After all, “you can’t pour from an empty cup”. Take care of yourself first.
Get in Touch with Nature
Nature is a healer. Even in the darkest moods and moments, it always helps to get in touch with yourself when you go out to nature. Ground yourself by listening to the sound of the waves by the sea, empty your mind and meditate by the ocean; the good weather of the summer provides endless opportunities to get closer to nature and realize that you are one with it. Such experiences will help you relax and will definitely boost up your mood.
Bibliography
Melrose, S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression Research and Treatment, 2015, pp. 1-6.
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