Finding Holiday Cheer by Managing S.A.D. in Recovery

Finding holiday cheer isn’t always easy for those in recovery from substance use disorders (SUDs) who also suffer from a dual diagnosis known as seasonal affective disorder, also known as S.A.D. S.A.D. is a treatable mood disorder characterized by symptoms of recurrent and often major depression that surface seasonally. S.A.D. recurs predominantly during the fall and winter seasons when shorter days marked by less sunlight can disrupt sleep patterns, circadian rhythms and the production of serotonin and other good mood-regulating neurotransmitters. That reality can make S.A.D. an obstacle to enjoying the good cheer of the holidays while sober.

How common is S.A.D., and what are the risk factors for it? What’s the link between S.A.D. and substance abuse? How do you manage symptoms of S.A.D. when you’re in recovery? This article will answer these questions in an effort to spread more of the joy of the season to those in recovery from SUDs and dual diagnoses like S.A.D.

How Common Is S.A.D.?

S.A.D. is a very common condition in America. Just how common can depend on whom you ask. Researchers who study the syndrome have dubbed it a “prevalent mental health problem” that accounts for an estimated 10 to 20 percent of all recurrent depression cases. (Depression itself is one of the most common mental disorders in the United States, according to the National Institutes of Health.)

In a given year, roughly 5 percent of the U.S. population suffers from seasonal depression, according to a Mayo Clinic estimate. A report by the Cleveland Clinic pegs the number of Americans suffering from S.A.D. at half a million, but adds that as many as 10 or 20 percent of the U.S. population suffers from a milder version in the form of the very familiar “winter blues.”

The Link Between S.A.D. and Substance Abuse

More than 20 percent of people diagnosed with a mood disorder such as S.A.D. struggle with a substance abuse problem, the Cleveland Clinic has also said. There is thus a link between seasonal depression—and even its milder version, the winter blues—and substance abuse. One manifestation of this link may be the fact that alcohol-related traffic fatalities increase by a whopping 50 percent during the holiday season, according to statistics from the National Highway Traffic Safety Administration.

Risk Factors for S.A.D.

An obvious risk factor for S.A.D. is being a woman: anywhere from 60 to 90 percent of all people diagnosed with S.A.D. are women, according to information from the American Osteopathic Association. The same source says older teens and younger adults are also more likely to suffer from this condition. Other risk factors can include:

• A pre-existing diagnosis of depression or bipolar disorder, symptoms of which can worsen seasonally
• Living at a greater distance from the equator (with shorter days and less sunlight during the winter months being a likely cause)
• A family history of S.A.D.

Symptoms of S.A.D.

Because S.A.D. is a subtype of major depression, the symptoms can also be similar:

• Feelings of sluggishness and fatigue
• Disruptions in sleep
• Feeling down or worthless
• Suicidal thoughts

The Mayo Clinic lists the following symptoms as other potential signs of winter-specific S.A.D.:

• Irritability
• Fatigue or low energy
• Hypersensitivity or relational troubles with others
• A heavy “leaden” feeling in the arms or legs
• Oversleeping
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain

Managing S.A.D. in Recovery

If you are in recovery with a dual diagnosis of S.A.D., coping with and managing your symptoms is feasible and can help you experience more of the holiday cheer of the season while staying sober. The following tips can help:

• Get as much sunlight as possible. Exposure to natural light is ideal, but if that’s not possible where you live, talk to your doctor about the prospect of light therapy and whether it’s right for you. Light therapy boxes, sometimes inexpensive, can be as effective as an antidepressant for some people with S.A.D., according to a Harvard Health blog.
• Talk to your doctor about medication options. An antidepressant may be one component of a comprehensive treatment approach to address the depressive symptoms you’re experiencing and to help you break out of a perennial holiday rut.
• Exercise regularly. Both seasonal depression and sobriety can benefit greatly from a minimum of 30 minutes of cardiovascular exercise on most days of the week. Serotonin and other feel-good neurotransmitters go up—and with them, so can your mood and even your self-esteem.
• Eat a balanced and nutritious diet. While the holidays are replete with temptations to splurge on sweets and other high-carb treats, these foods can have a direct, negative impact on your mood. Do your best to limit your intake of sugary fare and stick to a diet that is high in fresh fruits and vegetables and good omega-3 fats like those found in fish, walnuts and flaxseed.
• Reach out to others for support and in service. If you’re already in a 12-step group, stay connected and don’t be afraid to reach out to other peers to share what you’re going through. Service is another proven way to boost spirits, and over the holidays can help you tap into the genuine joy of the season: the spirit of giving. Serving Christmas dinner at a soup shelter, caroling in the neighborhood or sending cards of encouragement to others in recovery are just some ways you might engage in service at this time of the year.