Several different types of depression are set to collide this winter

by Chia-Yi Hou | Nov. 6, 2020 | Nov. 06, 2020

Story at a glance

Surveys from early in the pandemic found depression symptoms were three times pre-pandemic numbers.
With the seasons changing all across the country, people may begin to feel symptoms of seasonal depression.
Control what you can, says a psychologist.

This year has been full of uncertainty and unknowns, and the current election may have increased anxiety levels for many people. For people who experience depression, they may be feeling added pressure from the COVID-19 pandemic, while for others depression may be new to them. And as fall slides into winter, people may also start experiencing seasonal depression or seasonal affective disorder (SAD). As the country waits for a decision on the presidential election, experts warn that this could be a tough season for many people and to make a plan.

Depression is a clinically diagnosed condition defined as a serious mood disorder in which symptoms like “persistent sad, anxious, or ‘empty’ mood” are experienced regularly over an extended period of time. According to the National Institute of Mental Health, symptoms need to be present for at least two weeks.

As the pandemic took hold of the country, people lost their jobs and millions were infected with the coronavirus. Changes to life circumstances like jobs and health can cause stress and lead to anxiety and depression. Being in quarantine or being isolated from others can also take its toll. “With that many people going through it at the same time, what you’re experiencing is heightened stress,” Andrew Schwehm, an expert in post traumatic stress disorder, told Changing America.

“This is a challenging time for the entire nation for many reasons: chief among them is uncertainty,” writes Ravi Shah, who is a professor of psychiatry at Columbia University Irving Medical Center, in an email to Changing America. “There is uncertainty about the election, coronavirus, the economy, school, and our futures.”

A survey conducted in March to April found that the prevalence of depression symptoms in Americans increased by three times compared to the pre-pandemic period. The Centers for Disease Control and Prevention (CDC) reported that, from a survey taken June 24-30 of more than 5,000 adults, “younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation.”

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Seasonal depression can occur because of changes in daylight hours, increased darkness and colder weather, that may lead to more time spent inside and potentially less time in nature.

“It may be the people who are at risk of seasonal affective disorder may be the same people for whom covid has already triggered depression,” says Lisa Carlson, who is president of the American Public Health Association, to The Washington Post. “So, we may have a lot of overlap in those people.”

“I do think that there’s potential for increased depression, specifically as it relates to seasonal affective disorder,” says Vaile Wright, who is Senior Director of Health Care Innovation at the American Psychological Association. This is particularly because being outdoors has been so critical as a respite for most people during the pandemic, she adds. As the weather gets colder, it may not be as feasible for some people to spend time outside.

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Mind and body

Recent cultural shifts have made it more common to openly talk about depression, as well as anxiety that may accompany it. Mental health is not only about your state of mind; mental health is intertwined with physical health.

“Throughout human history, we have relied on others for survival, and proximity to others, particularly trusted others, signals safety. So when we lack proximity to trusted others, our brain and body may respond with a state of heightened alert,” says Julianne Holt-Lunstad, who is a psychology professor at Brigham Young University. “This can result in increased blood pressure, stress hormones, and inflammatory responses, which if experienced on a chronic basis, can put us at increased risk for a variety of chronic illnesses.”

It can be harder for some people to realize that physical symptoms they are experiencing are related to mental health. Racial and ethnic minorities may not realize the need for mental health services until physical symptoms occur at high rates. Research also shows that loneliness is a risk factor that could lead to lost years of life in older adults.

Make a plan

Just like you may make a health and safety plan for the rising COVID-19 cases in your area, you can make a mental health plan. Find out what your therapy options are and whether you have access to low-cost services. You can also prepare by identifying what triggers your symptoms.

The real goal is to focus on what’s in your control, says Wright. For example, if you know how the weather is going to change, you can adjust your schedule to try to maximize sunlight. “In all the situations, the depression and anxiety likely manifests in the same way, but the solutions might look different based on what’s in your control and each one,” says Wright.

Experts who spoke to Changing America previously said that SAD may not be officially diagnosed until it occurs during multiple years. In addition, it may be hard to distinguish it from regular depression. But, there are some suggestions on how to deal with seasonal depression if symptoms arise. For example, studies show that light therapy can make a difference for lifting mood and cognitive performance. Light therapy lamps are commercially available, and psychiatrist Philip Gehrman at the University of Pennsylvania recommends lamps with brightness of 10,000 lux or higher. Screen time and blue light at night can also affect sleep quality.

Whatever your current mental health state, talk to an expert if you think you need help. “Get help if you need it,” says Shah. “This is a time of self-compassion and self care.”

There may be affordable therapy services available in your state, and many therapists have been offering virtual sessions during the pandemic.

Shah also suggests taking on a project. “We can’t keep waiting for a silver bullet or magic solution,” he writes. “Do something that you can look back on and say ‘During 2020 the world was crazy, but I did this one positive thing.'”

“The anxiety people are feeling is normal, but I think it’s also important to look towards the future,” says Wright. For example, with election anxiety, there will be a decision about the president. We can look to plan for a point in the future when things will be different, with the weather or with the election status. Wright adds, “It isn’t going to feel like this forever.”

More resources:

Mental Health Awareness month resources from American Hospital Association and Mental Health America

National Suicide Prevention Lifeline (Hotline is 800-273-8255)

BIPOC mental health resources

Affordable therapy options at Open Path Collective with BIPOC therapists

Therapy for Black Girls on Instagram

Therapy for Black Men

Melanin & Mental Health

Ethel’s Club

Asian Mental Health Project

More resources for BIPOC listed by Teen Vogue

Native American focused One Sky Center