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How Do You Know It's Seasonal Affective Disorder?

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You may be suffering with Seasonal Affective Disorder without realizing that you’re suffering from something else. In this week’s post I want to talk about the fuzzy grey area between Seasonal Affective Disorder as a unique kind of depression and, well, depression.

Last week I wrote about Seasonal Affective Disorder (S.A.D.), which occurs for some people mostly in fall and winter, and is considered to be related to Major Depressive Disorder. I offered nine suggestions for managing symptoms of S.A.D., but I also briefly mentioned how confidence varies among researchers about the nature of S.A.D.

The biological theories behind S.A.D. have given it enough street cred that most of us take it seriously, and many people diagnosed with S.A.D. keep their full-spectrum light boxes handy during this time of year. But while we know that lower light levels affect our biology, light therapy doesn’t work for everyone with S.A.D., and we don’t know why for certain.

Some researchers argue that the symptoms associated with S.A.D. may overlap with other forms of depression, making it challenging to know if it’s S.A.D. or something else. As well, the underlying biological mechanisms proposed for S.A.D., such as serotonin and melatonin dysregulation, lack consistent empirical support. The biology underlying depression is more complex than simply “low serotonin.”

So is there really a “standalone” S.A.D. that has nothing do with anything, other than the biological effects of more darkness in winter? And if not, then what might be going on for people who feel depressed at this time of year?

Is it winter, or your relationship to winter?

We often treat depression as the affliction itself, the same way we speak of disease. I believe that’s in part because medical science keeps showing up as the ultimate authority on the human condition in so much public discourse. And it’s in the nature of medical science to pathologize adverse bodily circumstances and make an object of those circumstances.

That’s understandable when it comes to cancer or a compound fracture of the left femur. But it becomes controversial when medicine’s extension into mental health – psychiatry – pathologizes relatively normal aspects of human adaptive behaviour.

Researchers are still debating theories about what the neurobiological mechanisms are that create the experience of feeling depressed. For example, on rare occasions, depression can have a purely biological cause, such as certain types of disruptions to the gut’s microbiome.

It’s not that I want to push you away from understanding the biological components possibly contributing to your seasonal depression. Rather, I want to highlight the possibility of depression as the outcome of how you are experiencing yourself in the world right now, in winter. You already know that the long winter nights disrupt your circadian rhythms. But does that amplify an old depression that’s always lurking underneath the surface? Or, do the long winter nights and grey days unconsciously provoke an old and familiar sense of despair?

I once had a boss in my previous career who was a high-energy, high-achieving manager, and a force to be reckoned with. They almost always got their way, and to be their employee was to be in boot camp. One winter morning, I asked what the strange glowing box was on their desk, and they explained it was their full-spectrum light box for their winter depression. I had only vaguely heard of Seasonal Affective Disorder back then but, of course, I learned more about it from my boss. So I saw it as a reality that they had to live with. But after a couple of years of working for them, I wasn’t so so sure. My doubt began when I realized my boss was a genuine workaholic.

For example, in addition to being into the office at 6 AM and out at 8 PM, they usually came in on statutory holidays. They didn’t need to. And they were especially distressed about how they would spend their alone time whenever their spouse (a higher-ranking executive in the same organization) was out of town during a long weekend. They would attempt to arrange private parties and implore us to attend. If they couldn’t do that, they’d come into the office.

Knowing what I know now, I can see how their strenuous workaholic efforts probably kept them distracted from a painful, core emotion at the heart of their sense of self. And if I had to guess, I would wager they were trying to prove themselves good enough, once and for all, to a parenting environment that rarely, if ever, left them feeling validated and worthy. So, a painful core sense of self like that would be activated whenever they had nothing to do, nowhere to be, and nobody around.

I could see that for my boss, it wasn’t really so much about the low winter light, although I’m certain the full-spectrum lamp helped. During winter, they got up in the dark to go to work. They left work in the dark and arrived home in the dark. And there was a good chance that such an environment would amplify the low-level hum of sadness and grief tamped down deep within.

For other people dealing with seasonal depression, the reason might be different. It might be a reason similar to mine. As a young adolesent in junior high school, I had an unstable and emotionally unsafe home life, very low self-esteem, raging acne, was frequently picked on at school because I was an easy target, and achieved mostly mediocre grades because it was so hard to concentrate on schoolwork.

I was chronically depressed, and frequently felt an existiential despair that came from the sense that there was nothing truly for me, and nothing ever ahead to look forward to – except Christmas and summer vacations. I often had to go into school early for “extra help” in math (which was useless). So, of course, in winter I also got up in the dark, went to school in the dark and came home in the dark.

The memory we don’t recognize as memory

For me, the darkness of winter and its early mornings were deeply evocative of those young experiences for decades after. I didn’t fully realize or understand that until I had processed it all with my psychotherapist. I now understand that the environment around you can trigger implicit memory, moreso than it might affect circadian rhythms.

When I use the term implicit memory I mean memory without words. That’s one of two major kinds of memory we have: implicit and explicit. Explicit memory is of events and things we “see” in our mind’s eye. Implicit memory is unconscious, usually non-verbal, and often not recognized as memory. As children and adolescents, implicit memory is often the emotional or somatic impression that strong experiences leave in us. Sensory elements, without words. We don’t necessarily remember the details, but we remember how we felt.

Psychologist Dr. Janina Fisher, who helped develop Sensorimotor Psychotherapy, has said that Seasonal Affective Disorder might sometimes be a misdiagnosis of what is otherwise a trigger for implicit memory. And indeed I’ve had more than one client speak about how they fear certain times of year or certain kinds of weather because of how it makes them feel. They are being reminded of the past in a way that doesn’t feel like memory, but is.

And my gut sense tells me that this is a far more common reality for so many people than we realize. Perhaps to the extent that there will be a great many of you out there thinking you have Seasonal Affective Disorder when you are instead being implicity triggered by your environment. Your depression is real, of course. But does it arise from winter, or from something else within you? For many, the adverse experience of winter itself, or the personal experience of this time of year, may be evoking an underlying, implicit sadness and bringing it into focus.

To be sure, when my clients come to me asking for help with persistent depression, I ask them in the first session to have a full medical evaluation (that annual medical checkup so many of us skip). I do want to make sure we’re ruling out a purely biological cause. Otherwise, if I were to conceptualize the depression most of my clients describe to me, I would use my own therapist’s description: depression is an infection of aliveness.

This kind of depression arises when you are weary from carrying the unconscious burden of a story about yourself. The story may be that no matter how hard you try, nothing you do will ever be good enough. Or that nothing you do will ever qualify you to be fully lovable. Or that happiness is not possible without certain core conditions being met which you somehow cannot meet. Or by a loneliness that persists from never feeling truly seen or cared for. These stories are carried by people from all socioeconomic contexts. And although these stories are readily apparent to some, they are also often unrecognized by most others. But they show up as implicit memory through their emotion.

People adapt to these burdens. Whether or not you recognize your burden, it will have compelled you to find ways of adjusting the load on your shoulders while simultaneously seeking a remedy. The adaptive combination of shifting the burden from shoulder to shoulder, while trying to find a way to have the burden removed, creates those sorts of patterns and behaviours that medical science wants to pathologize.

But to simply put down those burdens and walk away from them, with the sort of pragmatism advocated by positive-thinking gurus, is rarely possible. To do so puts you face-to-face with the reality of trying to be a person you know nothing about. That is, you don’t know how to be the person without the burden. As teacher Byron Katie has often asked, who would you be without your story? Perhaps the intended answer is, “anybody I want!”

But the most common response I hear is, I have no idea. It’s a terrifying prospect. It’s easier to keep shouldering the burden of a story that’s familiar, then to “start over” (spoiler alert: you don’t have to actually “start over”). And so the burden remains. And that’s when despair sets in. That’s the depression I most often see. And there’s nothing quite like winter in Nordic countries to bring out this despair so easily. It’s an evocative season either because it underscores that despair -- or it's reminding you of a certain thing, or things, which happened to you around this time of year.

So what can you do? I want to get to that in a moment, but first, I want to acknowledge that your depression may also come from something which people generally don’t want to talk about.

“You don’t hate Mondays, you hate your job.”

Coincidentally, at the same former job with my workaholic my boss, I would occasionally cross paths with an administrative assistant from another branch. One Monday morning I stepped into the elevator with her and asked how her she was doing.

“Well...” she said mournfully, “it’s Monday...”

Of course, this was shorthand for, “I wish I had a career where returning to work from the weekend didn’t feel so unhappy for me.”

To be honest, I didn’t like my job either, so I wasn’t about to disagree with her. Moreover, I was in a tight spot financially, with a very short resume, and so I wasn’t about to smugly tell her to “just get a better job.” That was over 25 years ago. In 2024, the situation for countless people is much more dire.

Tightly interwoven power relationships between state and enterprise, combined with the concentration of wealth among large corporations and the top 10 per cent of the population, is resulting in untenable biopsychosocial-economic situations for much of the other 90 per cent. Those situations include poverty, precarious employment, labour exploitation, and stagnant or shrinking wages. To that, I could add a long litany of very serious problems which will affect all of us sooner or later, the greatest being our exponentially warming planet and its myriad near-future consequences.

Continued participation in our traditional democratic institutions is having little to no effect. It should not be a mystery to anyone why we have a mental health crisis across North America. This is not a pandemic of unhelpful thinking patterns or people with a “scarcity mentality.” So the dark winter months do not lend any support for the millions of people in this situation.

That’s why when it comes to depression, psychotherapists will likely be increasingly called upon by clients to help with how to become resilient enough to survive what’s coming. That’s in addition to dealing with what we normally assume causes depression. Both are important, but psychotherapy must be alert to taking a systemic approach to assessment that goes beyond the domains we’ve been trained to evaluate.

And that includes thousands of psychotherapists first learning about what resilience will need to look like for themselves.

What To Do Next

If you came here looking for help in managing your Seasonal Affective Disorder’s symptoms, you’ll already know I linked to last week’s post on nine suggestions for S.A.D. self-care at the start of this post. If you’re still with me, you may be seeking help for what you thought was Seasonal Affective Disorder, but might be something else. I invite you to reach out to a mental health helping professional who can help you understand what might be causing your depression. Knowing that will help determine how to respond.

For many of my clients, that response looks like cultivating the ability to mindfully and non-judgmentally notice when and how implicit memory affects mood. And then to gently intervene with kindness and compassion for the self, in order to shift how they relate to the self. When that happens, winter doesn’t feel so dark and burdensome anymore.

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