The Connection Between Seasonal Affective Disorder and Fibromyalgia

With winter on everyone's doorstep and the snow that comes with it, there are some people who cannot enjoy the winter as much as other people around them.

For those who have seasonal affective disorder, they usually do not feel as comfortable as others once the weather changes. Leaves fall, and lands become barren, covered with a thick layer of powder. While this can create a scenery that may be appealing to some, to others, it’s a source of dismay, anxiety, and depression, which can negatively affect them and trigger certain conditions, or exacerbate the symptoms of already existing ones, which can include fibromyalgia.

Seasonal affective disorder is a mood disorder characterized by the presence of symptoms such as depression during a specific time of year — usually winter. Frequently, the symptoms manifest as autumn reaches its end and when winter begins to take place, but they disappear when spring and summer rolls by. However, there is also an uncommon variant during the summer; starting near the end of spring and disappearing in the winter.

The DSM-V, a manual used in the diagnostic and statistical analysis of mental disorders, defines seasonal affective disorder as a viable seasonal pattern for the diagnosis of a recurrent major depressive disorder that occurs in a specific time of the year. The prevalence of the disease is higher in regions where there are longer winter nights, and it is believed to be caused by the brain’s natural (yet defective) response to less natural light, which lowers the person’s serotonin and melatonin levels that are charged while a person is asleep.

When it comes to seasonal affective disorder, the most common symptoms are appetite changes, weight gain, constant fatigue, and somnolence, as well as affective symptoms such as desperation, irritability, anxiety, and anhedonia. On the other hand, in the summer variation of seasonal affective disorder, the most frequent symptoms are diminished appetite, weight loss, insomnia, irritability, and anxiety. Luckily, it has been discovered that a constant exposure to artificial light, such as the one created by fluorescent lamps can positively affect the afflicted. Considering that the main cause of the disorder is the lack of light due to long winter nights, it is believed that said exposure can help regulate the chemical balance in the body.

Seasonal affective disorder, by itself, is rarely a serious condition. While its symptoms are frequently related to those of a major depressive disorder, it is, by nature, transitory, and can be usually overcome through medication or with assistance from a mental health professional. However, due to its symptoms affecting mostly mood and causing excessive fatigue, its effects can be magnified in certain individuals, such as those with an underlying fibromyalgia diagnosis. In these cases, special care is necessary since the symptoms of the seasonal affective disorder can exacerbate those of fibromyalgia, and vice versa, greatly increasing the intensity of both conditions.

Fibromyalgia is a chronic condition characterized by widespread pain and hypersensitivity in specific parts of the body, often referred to as tender points. The pain often comes accompanied by other symptoms such as irritability, depression, and chronic fatigue that cannot be reduced, no matter how much rest the person gets. In the past, fibromyalgia was classified as a purely-somatic disorder, given the complete lack of any physical evidence to explain the symptoms. However, recent discoveries suggest that said fibromyalgia symptoms, similar to seasonal affective disorder, may be caused by a chemical imbalance in the subject’s nervous system.

Due to their similar origins, as well as common symptoms, seasonal affective disorder and fibromyalgia are a very intense combination. The symptoms of one exacerbate those of the other. Luckily, they are both still fairly uncommon. In Nordic countries, where it is most common, winter depression is a very common occurrence. In fact, the term was first described in the 6th century when Goth scholar Jordanes described the inhabitants of Scandinavia. Interestingly enough, the disease is very rare in Iceland due to what is believed to be a genetic factor in the populace of the country. On the other hand, in the United States, the term was formally described in 1984 by Norman Rosenthal, MD, as he pondered why he would feel sluggish and depressed every time winter came around, only to feel better after moving to New York, where winters are usually cold, but are frequently sunny, compared to where he previously lived (South Africa).

Similarly, fibromyalgia is also quite uncommon, though it is slowly becoming widespread as time goes by. Currently, the disease affects around 2 to 5 percent of several countries, the highest of which being Portugal with 3.6 percent, and the lowest being the United States with 2 percent. The disease affects mostly women at a ratio of 10 to 1 and is observed in individuals in the 20-50 age range. However, though vastly uncommon in relation, fibromyalgia can be observed in children, as well as in senior citizens. An important factor to consider with fibromyalgia is that around 10 to 20 percent of its cases manifest alongside an underlying rheumatoid disorder such as rheumatoid arthritis. Furthermore, due to its similarity with other conditions, and lack of physical evidence, the disease is very difficult to diagnose. It is estimated that around 90 percent of fibromyalgia cases go unnoticed.

Coping with fibromyalgia and seasonal affective disorder

Due to the oppressive and crippling combination of symptoms, those who suffer from both fibromyalgia and seasonal affective disorder must often take radical measures in order to cope with these conditions. Sadness and depression are one of the biggest issues in times of winter, since fibromyalgia may cause them, and seasonal affective disorder can increase their intensity when winter comes by. It is very important for the person to remain active when possible, and to follow a low-impact workout routine to complement the treatment plan.

Exercise can strengthen the heart and lungs, keep blood flowing through the entire body, and improve overall health. Furthermore, it can help produce dopamine, the body’s natural feel-good drug, which in turn may help to reduce depression symptoms.

Since the seasonal affective disorder is a condition caused by lack of sunlight during winter time, it is important to keep the blinds curtains always open in order to let the most amount of natural light in, which can help improve the symptoms. It also helps to complement vitamin supplements to complement the treatment. Common supplements include vitamin D, omega 3 fatty acids, 5-HTP, and melatonin.

If natural light is not easily accessible (such as for those who work in a cubicle), light therapy is the next best thing. It consists of using sources of artificial such as LED or fluorescent bulbs to shine them directly at the person, similar to a hydroponic plant. The increased sunlight can slowly but surely stave off the symptoms of a seasonal affective disorder.