Can the shortening daylight of winter make you hurt more? Is there a connection between light and chronic pain? How do you tell the difference between symptoms of chronic pain, depression and Seasonal Affective Disorder (SAD)?

Researchers are still exploring some of these questions, though we’re already sure that shorter winter days can trigger feelings that can drag people down and worsen their chronic pain. These negative feelings go beyond a case of “winter blues,” when many of us feel naturally unhappy about less daylight, colder temperatures and possibly having to scrape ice off our cars and driveways. Instead, SAD is a depressive condition that shows up around the same time every year (summer can bring on a version of SAD, too, by the way). SAD can disrupt your usual routine and make chronic pain feel even worse. 

Symptoms of Seasonal Affective Disorder

First, check to see if you might, indeed, be dealing with SAD. A doctor will help you understand which of your symptoms may be attributable to chronic pain, to depression or a related mood disorder or specifically to SAD, but SAD might be affecting you if you feel:

• More exhausted, fatigued, tired or worn out than usual
• That it’s especially tough to get started in the morning. The thought of staying in bed longer or not having to do anything is very appealing
• That you don’t have much energy. Things just feel hard to do, and it’s difficult to concentrate or “push through”
• You can’t sleep well. You notice choppier sleep, disrupted sleep patterns in general, insomnia, or lower quality sleep (i.e., you don’t often feel rested)
• That your weight is changing, your appetite is shifting or you’re craving carbs
• That things don’t interest or excite you as much. You’d rather be left alone; you don’t know why you’re not interested in things you normally care about
• That you can’t concentrate; you feel “sludgy,” unfocused and slow
• That you might be depressed
• That you’re spending a lot of time thinking about dying or suicide

Many of these indicators are signs of non-seasonal depression or chronic pain as well, and it can be tough to untangle what’s going on. What’s clear is that if you’re feeling worse than usual, and those kinds of feelings keep going on longer than two weeks, you may want to investigate what’s happening. 

Causes of Seasonal Affective Disorder

SAD tends to affect people who live away from the equator or in cloudy regions, and can have genetic aspects. You may be more susceptible to it if you’ve struggled with depression or depressive thoughts before. About 5% of Americans report symptoms of SAD; the majority of them are women who say SAD showed up in their 20s. 

SAD happens, experts think, because seasonal changes in natural light exposure can cause changes in melatonin and serotonin levels, both of which affect mood and sleep. (Unsurprisingly, perhaps, serotonin pathways are also involved with chronic pain pathways.) Winter is not always the most cheerful time for people, and it’s not uncommon for sufferers of SAD to report also feeling anxious and worried as winter approaches, even if they’re not sure exactly why.

Treatments for Seasonal Affective Disorder

Though depressive conditions, including SAD, can feel both insidious and overwhelming, people who want to treat their SAD do have options, including:

1. More light! (also called phototherapy): Since SAD is so frequently associated with fewer hours of daylight per day, adding more light often helps. Sunlight is often best, so, if possible, go outside for at least 10 minutes a day. A short walk can really help, even if it seems like a drag to get out. An extra plus from sunlight is more vitamin D, which can help both mood and your immune system (so much so that it’s worth checking with your medical team to see if taking vitamin D supplements might help).
   
   If sunlight isn’t so possible, a light therapy lamp might help. Talk to your doctor first, and see if a lamp or light box could be a fit for you. Typically you use a therapy lamp in the mornings for about 15 to 30 minutes a day, positioning it a bit above eye level if possible. Phototherapy may not be appropriate for you if you have retina issues, bipolar disorder or are using antibiotics that can make you more sensitive to light. 
   
2. Therapy: A therapist could help you sort through what’s going on and could help you learn reframing techniques or cognitive behavioral therapy (CBT) strategies to both help control chronic pain and to cope with any depressive symptoms. CBT has proven particularly effective for treating SAD.
   
   Some therapists also have expertise supporting clients in learning how to sleep better or use mindfulness, and these kinds of therapies may be particularly good choices if you believe you might be affected by SAD. If your chronic pain is particularly challenging, consider a therapist who offers services online, via telehealth technology.
   
   Don’t forget: talk therapy isn’t the only kind of therapy you can access. Physical therapy can help with your pain, and lessening pain through exercises and physical training can also combat depression. Massage therapy is an option too, since therapeutic massage can boost your oxytocin, help you heal quicker and lower your pain levels. 
   
3. Medication: antidepressants (SSRIs) that affect serotonin levels may help raise or stabilize your mood if SAD is a factor for you. Doctors may prescribe medication by itself or along with phototherapy. Regular exercise and healthy eating help, too, and support your medication’s effectiveness. Some of these medications are also used with chronic pain, so you may notice improvements in multiple aspects of life, though you should consult your doctor before starting or stopping any medications.
   
   SAD, it turns out, can respond quite well to treatment. Again, exercise, healthy eating, and making connections with people who care about you give you an excellent foundation for preventing and managing SAD, depressive conditions in general and chronic pain. 
   
   What about next year though? Doesn’t winter come around again? It does, of course, and knowing that it’s approaching can help you be more prepared. SAD sufferers don’t necessarily struggle with depressive feelings every single year, and those who manage their pain and susceptibilities to SAD are often able to avoid the worst of SAD, even as the days darken. 

A Few Final Tips

• Hygge it up: the Scandinavians often make their surroundings intentionally cozy and use winter as a time of connection. Saunas, hot water baths, welcoming candles and particularly warm bedding can turn a bleak setting into something more home-like. Snuggling with pets can help, as can scheduling more simple hang-out times with laid-back friends, or cooking more pots of stew, chili or other comforting, healthy foods. Don’t be afraid to sprinkle your days with small treats and bright moments.
• Support yourself: don’t be hard on yourself, particularly when winter is already giving you a tough time. Treat yourself as you would your best friend. Look for supportive things to say to yourself, and encourage yourself as best you can. It may sound cheesy, but practicing positive self-talk can teach you to be kinder and easier on yourself, which often lessens your stress and eases your pain.
• Try creative ways to get out: maybe winter is a good time to take up swimming? Or cross-country skiing, if you have snow, since it’s such a good workout, and the time outside can give you a boost in your mood while also being relatively easy on your joints. Maybe you really are stuck inside, but you can get a birdfeeder, a poinsettia, an evergreen wreath or other touches of nature to lift your spirits while reminding you of the world outside. Some people find it soothing to play videos of outdoor hikes or snow falling peacefully. Others prefer gaming, good books, sitting near a space heater or becoming immersed in a new hobby. Discover what works for you.

Whatever season is your favorite or your most challenging, we wish you bright times, and we’re here if you’d like a hand.