For a long time, Equip Peer Mentor Kelsey Gilchriest didn't understand why her mood would dip so low around the winter holidays. At times, the seasonal shift made it difficult to spend time with family and find joy in her usual hobbies. The sadness also made her relationship with eating even more challenging — a feeling known far too-well for many people with eating disorders.
“This only worsened after treatment, when I felt isolated because of my eating disorder diagnosis and lonely in a new city,” Gilchriest says. “When my doctor finally diagnosed me with seasonal affective disorder (SAD), some things finally made a lot more sense.”
What is SAD and how can it affect individuals with eating disorders?
Gilchriest’s diagnosis, commonly referred to as SAD, or seasonal affective disorder, is a form of depression associated with seasonal changes. For many, SAD often starts and ends at approximately the same times each year, usually with symptoms beginning in the fall and continuing through winter. While some people experience the signature symptoms of SAD (depressed mood, low energy, trouble sleeping, etc.) in the spring and early summer, most people feel its effects in the latter half of the year.
According to the National Institute of Mental Health, millions of adults suffer from SAD, although many may not know they have it. The condition is much more common in women than in men, and for those who live farther north (like in Alaska or New England), where winter days are shorter and there are fewer daylight hours, anyone can develop SAD. Experts still don’t fully understand what causes it, but research suggests SAD may be related to reduced activity of serotonin, a neurotransmitter that helps regulate mood. Other research indicates that people with the condition produce an excess of melatonin, an important hormone involved in maintaining the sleep-wake cycle.
While anyone can develop SAD — or any form of depression — there is some evidence that individuals with eating disorders may be more likely to experience symptoms of SADA 2000 study found that eating disorders and mood disorders both include serotonin disruptions, and that bulimia in particular seems to share certain symptoms with SAD. A 2014 study found that the symptoms of SAD also overlap with many of the symptoms of binge eating disorder (BED), which are associated with atypical depression symptoms.
Gilchriest says that while an official diagnosis was helpful, the label itself wasn’t enough to alleviate the pain she felt. “It didn't change the fact that in the winter months, I could suddenly change into someone I didn't recognize,” she explains. “Even following moments of joy, like opening Christmas presents with my family.”
“The holiday season can be difficult for so many due to the various activities we encounter,” says Equip therapist Sara Quint. “From food-centric family gatherings that we may not necessarily enjoy to financial crises and fears, the season of joy can turn dark quickly. Loneliness, disappointment, past traumas, and grief and loss are all sore spots that may flare up for folks during this time.”
Gilchriest says that one of her biggest challenges each year was knowing that she would have to navigate an entire season of internal turmoil that could affect her desire to eat, be in community with others, or participate in joyful movement — activities she struggled to participate in despite recognizing their potential to boost her mood.
Finding a solution for SAD and other forms of depression
Experts use a variety of treatments to reduce the symptoms of SAD, including light therapy, which involves sitting in front of a very bright light box for about 30 to 45 minutes a day to help boost vitamin D, a nutrient believed to promote serotonin activity. For some people, talk therapy and medication may also be helpful in addressing the full scope of symptoms.
“The ways I've learned to overcome these challenges is by creating a plan, both with myself and with my partner, for those moments when my depression overwhelms my ability to stay recovery-focused,” Gilchriest says. “I use a light box starting around Labor Day, which has greatly improved my symptoms overall. I go for regular walks even when I'm feeling willful, and I always keep Boost [a nutritional supplement] in the house during the holiday season. It's these things that I plan ahead for that keep my head above water and remind me that the depression won't last forever.”
Quint agrees that some of the most important tools to cultivate during bouts of seasonal (or longer-term) depression are kindness to oneself and a commitment to planning. “I would encourage practicing self-compassion, giving yourself a break (or several) when needed, and finding ways to have support on tougher days,” she says. “Creating a ‘Cope Ahead’ plan (taken from DBT) with your family, therapist, or peer mentor may be just what is needed to find a way to enjoy your holiday; if we have a plan, sometimes we can walk in to the festivities feeling more confident and capable, which leads to lower anxiety and less stress, knowing someone has your back (or, knowing that you’ve got your own back in setting up self-care for after the party is over!).”
All forms of depression — seasonal, acute, chronic, etc. — are serious and should be addressed as soon as possible. For those with eating disorders, treating the ED is often an indispensable part of long-term mood treatment as well. A 2019 study found that those who had recovered from an eating disorder were significantly less likely to be diagnosed with depression. According to the researchers, these findings provide evidence that long-term recovery from EDs is associated with recovery from or absence of these common major comorbidities.”
“This season can certainly be stressful,” Quint says. “But walking in with a plan of attack can help protect you and your family from the ED and lead to a more pleasant, enjoyable, and bright time!”
Gilchriest agrees, adding that her biggest piece of advice to others struggling during the holidays is to “create a plan when you're feeling well to use when you're not,” which can prevent bigger blowouts in times of crisis.
“Let loved ones or friends you trust know that you tend to struggle during this time, and create a plan together of ways that they can support you and ways you can support yourself,” she suggests. “Most importantly, be gentle with yourself. The holiday season is tough, and you are still enough and deserving of love and life, even when you're feeling depressed or lonely.”
1. Lyall, Laura M et al. “Seasonality of depressive symptoms in women but not in men: A cross-sectional study in the UK Biobank cohort.” Journal of affective disorders vol. 229 (2018): 296-305. doi:10.1016/j.jad.2017.12.106
5. Keshishian, Ani C et al. “Eating disorder recovery is associated with absence of major depressive disorder and substance use disorders at 22-year longitudinal follow-up.” Comprehensive psychiatry vol. 90 (2019): 49-51. doi:10.1016/j.comppsych.2019.01.002