Winter Could Be ‘Double-Whammy’ for Mood Disorders

As the weather cools in Pittsburgh and beyond, people may find themselves indoors more often. With that however, comes an unwelcome presence that could be exacerbated by the COVID-19 pandemic.

Seasonal affective disorder (SAD) is a mood disorder that occurs in climates where there is less sunlight during certain times of the year. People who experience SAD may have feelings of hopelessness and become socially withdrawn.

The onset of SAD typically occurs between 20 and 30 years of age, and is diagnosed four times more often in women than men. It’s also seen more in northern U.S. states than southern due, to differences in time between dawn and dusk.

“There’s often lower interest in activities, and also changes in appetite and sleep,” said Kathryn Roecklein, associate professor of psychology at the University of Pittsburgh. “Then when spring arrives, people either have remission and return to ‘normal’ moods, or experience mania in some cases.”

Standard treatments include light therapy, talk therapy and medications. But Roecklein has been studying another treatment, cognitive-behavioral therapy for SAD (CBT-SAD), which targets negative thought and behavior patterns to improve depressive symptoms. In addition, patients are encouraged to identify behaviors that might be help them better cope.

This type of therapy was developed by Roecklein’s collaborator Kelly Rohan, a professor of psychological science at the University of Vermont and director of its Department of Psychological Sciences’ clinical training program.

Roecklein, along with Rohan and Pitt researchers, is now leading a study to confirm the effectiveness of this type of therapy.

“We found that cognitive-behavioral therapy is equally effective as other gold-standard treatments like bright light therapy, but there is one difference. If you do CBT-SAD this winter, then even if you do nothing next winter, you have a lower chance of experiencing depression,” she said.

Roecklein points to CBT-SAD’s method of changing typical thoughts about winter and winter-time behaviors as effective treatment components.

“These changes are things that stick with you for more than one year,” she said.

Pitt researchers working on this project include Peter Franzen and Greg Siegle, associate professors of psychiatry. Franzen and Siegle are also working with Roecklein and Rohan to identify the biological risk factors for SAD that make individuals vulnerability to the environmental changes in winter.

COVID-19 and SAD

The COVID-19 pandemic has caused many people to explore alternative options for physical activity and socialization with friends and family. For people with SAD, physical activity and socialization are the two most important activities that lessen the effects of depression.

“It’s a double-whammy this year,” Roecklein said. “People don’t go out as much during winter and socialize with people, and the pandemic makes social and physical activities harder.”

Roecklein says people who experience SAD could prepare by identifying winter social and physical activity options that work for them. She also recommends finding friends and treatment through virtual communication.

“We’ve started hosting CBT-SAD groups over Zoom, similar to telehealth,” Roecklein said. “Finding ways to be physically active and see friends and family will take some creativity. You may not be comfortable playing sports inside, but outdoor activities like skiing and snowshoeing could be options. It depends on the persons’ interests.” Other ideas include outdoor fire pits and physically distanced hikes in local parks.

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