Summertime sadness: Seasonal affective disorder isn’t just a winter thing

Summer: full of sunshine and laughter. For some, at least. But for those who struggle with seasonal affective disorder, summer can be a time of irritability, anger and depression.

“You can see somebody getting very agitated in summer and you can say, ‘Oh gosh, it’s so hot outside. It’s getting to you,’” said Sid Khurana, the medical director of Nevada Mental Health.

Seasonal affective disorder, or its apt acronym SAD, is a type of major depressive disorder in which a person’s depressive episodes are related to a specific time of year, according to Khurana. The more well-known and common version of the disorder occurs during the winter and is characterized by low energy, depression and hunger. When it occurs in the summer, the symptoms are the opposite: People with the disorder are restless, lose their appetite and are more prone to aggression.

But a lack of knowledge about summer seasonal affective disorder leaves many people suffering in silence, which can result in more anger, and even violence, across society, according to Khurana.

“This depression has more anxiety, irritability, even aggression, or sometimes even violence associated with it,” Khurana said.

Data shows that by some metrics, summer can be an especially violent season. The Centers for Disease Control and Prevention shows the highest rates of suicide occurring from May through August. A study by Patrick Behrer, a researcher at the World Bank, found a correlation between heat and violent crime.

As for the science behind the disorder, questions remain. Khurana said that scientists do not understand the exact physiology of the disorder, but essentially it seems that affected people produce more melatonin and less serotonin during darker winter days, and less melatonin in the summer.

Khurana also acknowledged the sociological factors, especially in a place as hot as Las Vegas, where spending time outdoors in the summer is difficult. People can find themselves trapped inside with limits to the types of activities that they can do and less exposure to fresh air, Khurana said.

Marriage and family therapist Sheldon Jacobs said that during his first few summers in Las Vegas he was miserable. As an active individual, he found less energy to do activities.

Importance of routine

While the winter disorder can be treated by special light lamps and vitamin D supplements, there is no clear treatment for the summer disorder.

“I hate when people call up and ask about summer seasonal affective disorder, because when they talk about winter seasonal affective disorder, I can tell people exactly what to do, and we have terrific research and understanding, but summer seasonal affective disorder, it’s much harder to find patients,” said Paul Desan, a psychiatrist who leads the Winter Depression Research Clinic at Yale University.

Jacobs tells his clients about the importance of routine. For instance, people may need to wake up earlier in the summer to exercise in order to tolerate the heat.

Khurana treats the summer version like he would any other form of depression. He takes a proactive approach and begins to look ahead in winter and early spring to plan for patients who can expect seasonal affective disorder in the summer, often by prescribing more medication in the spring and reducing it again in the fall.

“Why do I need to have your brain go through another depression and then crawl back up?” Khurana said.

Disorder not well-known

But it is likely that many people who experience the disorder go untreated. Compared with the 9 percent of people who live with the disorder in the winter in Alaska, for example, only 1 percent of people in Florida experience the disorder in the summer, according to Khurana. But those numbers could be related to people not knowing about the disorder or not getting diagnosed, Khurana said.

“I think if you just randomly audit 10 therapists in this time they might not even know that there is a summer onset seasonal affective disorder,” Khurana said.

Jacobs worried about the effects of a lack of diagnosis.

“If you don’t know that you’re struggling with something, you’re more likely to have an increase in symptoms,” he said.

If you’re thinking about suicide, or are worried about a loved one or friend, help is available 24/7 by calling or texting the Lifeline network at 988. Live chat is available at 988lifeline.org.

Contact Katie Futterman at kfutterman@reviewjournal.com.