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At this time of year, as the seasons change, people start to talk about the seasonal affective disorder (SAD) and its links to addictive behaviour, particularly substance abuse. The two conditions can be treated concurrently. Symptoms of SAD should never be ignored.
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What Is Seasonal Affective Disorder and Addiction?
SAD is a mental health disorder and recognised as such in the DSM V (Diagnostic Manual of Mental Disorders of the American Psychiatric Association). It is a form of depression where people are affected negatively by the loss of natural light due to seasonal changes that make their days shorter (and their nights longer). The nearer in the world you live to the poles, the more extreme the change, and correspondingly more people are affected.
Symptoms of SAD
SAD is an acronym for Seasonal Affective Disorder, but sadness is also a characteristic of the condition. Many symptoms of this disorder are the same as those of depression:
- Fatigue and lethargy
- Irregular sleeping habits
- Anhedonia (inability to feel pleasure)
- Changes in eating habits
- Feelings of hopelessness
- Stress and irritability
- Lack of interest in usual activities.
Misconceptions and Stigma
Like any form of mental health disorder, there are bound to be misconceptions about SAD. It is important to understand that it is a clinical condition, not a sign of weakness or poor self-control. It is not a case of ‘feeling a bit low’ although feeling misunderstood can make things worse, so it is important to seek help and support without delay. There are a number of charitable organisations such as Mind or Samaritans with helplines always available. At Smarmore Castle we are always ready to talk and we see addiction and disorders such as SAD as co-occurring conditions that can be successfully treated at the same time.
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Sad and Substance Abuse
SAD is not directly linked to substance abuse but it certainly makes some people more vulnerable to it. Mental health disorders should never be ignored or hidden because of some false sense of shame. Approximately 50% of all people who struggle with mental health will also experience a substance use disorder at some point.
Statistics on SAD and substance abuse in the UK
- Around 6 percent of the population experiences seasonal affective disorder at some stage
- Men are twice as likely to have been diagnosed with SAD as women.
- Younger people are more likely to have been diagnosed with SAD.
Research in the USA found that as with other mood disorders, people struggling with SAD are twice as likely to have a co-occurring substance use disorder as the general population. Alcohol, cocaine, and nicotine are the most popular substances.
How People React to Sad
Some people may react to the feelings SAD produces with self-medication of some kind – prescription drugs, other drugs, or alcohol. Some may try to shake themselves out of their malaise and lethargy by using stimulants, while others may turn to sedatives such as opioids to deal with depressive feelings.
Self-Medication Can Worsen Symptoms
This kind of self-medication may lead to addiction. Contrary to what is intended, the use of alcohol and drugs may worsen the symptoms of SAD – self-medication may seem like a quick fix but overall it may actually worsen symptoms and lead a person into a substance use disorder.
Adverse Effects of Addiction
The converse is also true – people who abuse substances, especially alcohol discover that the after-effects commonly produce feelings of depression and anxiety that simply lead the user to repeat the addictive cycle.
Response to Addiction
Substance abuse is not the only response that vulnerable people may have to SAD. The general unhappiness, sadness, and depression it engenders put those suffering from any type of addiction – gambling or smoking for example –at increased risk of relapse.
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Treatment and Rehab
If you feel you are affected by SAD, it’s a good idea to act sooner rather than later. A visit to your GP is the best way to start. The National Institute for Health and Care Excellence (NICE) guidelines say you should be offered the same types of treatments for SAD as for other types of depression.
The full guidelines, including recommendations on treating SAD are available on the NICE website.
Your GP may recommend medication or counselling (as they would probably do for any type of depressive disorder) or they might suggest a more targeted approach in the form of light therapy.
- Medication often takes the form of antidepressants which might start a few weeks before the seasons start to change. These medications can be helpful but are not recommended for long-term use and should be used with care. They can react adversely with other drugs and alcohol.
- Herbal remedies, especially St John’s Wort are often recommended. It is widely used in many countries, Germany for example, as a treatment for depression although medical opinion is divided as to its efficacy, and it would be unwise to use it without prior discussion with healthcare professionals.
- Counselling is another way of addressing the symptoms of SAD. Simply being able to share one’s fears and anxieties can be helpful. Techniques such as Cognitive Behavioural Therapy (CBT) or simple Person-centred counselling are often used. Feelings of depression may appear for a wide variety of reasons and exploring these with professional guidance is often the best way of finding peace of mind. There should be no thought of shame and stigma in seeking this kind of help, thousands of people regularly do this as a sensible way of keeping themselves an emotional balance.
- Light therapy is a technique specifically used to address symptoms of SAD. A light box – a device that gives off a strong white or blue light is simply employed in a kitchen or living room, for example, to bring more light into a person’s day. The NHS does not normally provide such devices because their helpfulness is not proven, but many people find them useful during the winter months.
At Smarmore Castle and CATCH Recovery, we often see people with addictions of all kinds who at this time of year speak of being affected by seasonal change. While there is no proven link between SAD and addiction of any kind, they are both often seen in the history of people seeking treatment either as part of the cause or part of the effect. Either way, we are well able to treat addictive disorders and mood disorders at the same time, as co-occurring elements of a common problem. The kind of focused treatment in peaceful surroundings that a residential stay provides, is an option that should be considered if at all possible.
Our treatment plans are always tailored to meet an individual’s needs and can include daycare and continuing care after a spell of residential treatment.
If you or someone close to you is affected by SAD or substance use, don’t hesitate to call us – we are always ready to discuss and advise on the best way forward.