The brutal struggles of seasonal affective disorder

“Fancy a smoke?” Adrian Curwen asks through the computer screen. The 58-year-old is surprisingly relaxed despite the topic of conversation.

“I remember being about nine or ten, standing on a railway bridge and wanting to jump off,” he says as he takes a drag and leans back on the sofa. “That’s not normal for a nine, ten-year-old.”

He’s right. Despite looking like any other middle-aged bloke, Curwen hasn’t had an ordinary life. He’s been fighting bipolar and depression for decades and had to wait until his thirties for a diagnosis.

The battle encroaches on every element of his life. “It’s like you have your own black storm cloud that’s over your head […] that follows you around, and you can’t lose it.”

It gets worse around this time of year as, along with millions of others, Curwen suffers from Seasonal Affective Disorder (SAD), sometimes referred to as seasonal depression or just the ‘winter blues'.

Psychology Today describes SAD as a recurrent depressive disorder whereby episodes of depression arise annually, usually during the winter months. It’s more than just feeling a bit sad. Similar to depression, SAD can cause a marked lack of energy, difficulty concentrating, deliberate social isolation, sleeping problems, changes in appetite and even increased susceptibility to colds and viruses.

Adrian has been fighting bipolar and depression for decades, and had to wait until his thirties for a diagnosis
Adrian Curwen

One of the most unpleasant symptoms, however, is invasive and inexplicable feelings of hopelessness and uselessness. “You’re feeling these dark thoughts – this paranoia that everyone is looking at you on the street, and they know that you’re worthless,” Adrian explains.

He takes a drag before describing the toxic pattern of “spiralling downwards – all this negative thought. Feeling really sad and low, and really tearful. Guilty and kind of hopeless as well. […] You don’t really want to see people.”

Around three in every hundred people in the UK are affected by seasonal depression at some point in their lives, with most sufferers first experiencing symptoms between 18 and 30 years of age. Women are four times more likely to be affected than men.

There is not a confirmed reason behind SAD, but some evidence suggests higher levels of the hormone melatonin in the body, caused by more time spent in the dark, which increases lethargy and sleepiness. Less vitamin D from direct sunlight causes a reduction in serotonin – the happy hormone – which can aggravate depressive symptoms. Disruption to the circadian rhythm – the body’s natural sleeping pattern – due to daylight-saving is also said to have an impact.

For most people, the disorder is mild to moderate, but can quickly become severe. It has affected Curwen greatly, partly due to his existing mental health conditions.

His bipolar, which causes extreme mood swings from deep depression to manic episodes, has shaped his life. “I say I am bipolar. […] My experience is that that’s how I see the world. It’s like I’ve got my own internal weather system [and] the sounds and the colours are turned up a thousand-fold.”

While he says these symptoms can be life-enhancing and make him who he is, they also exacerbate depressive thoughts, meaning he experiences SAD “times a hundred”. This has led him down some dark paths in the past.

Leaning forward, he shares how one time, “for about three weeks, I was writing my will out, and I was getting together all my passwords, so people would know how to log in to stuff. […] I [was] telling [my psychologist] this matter-of-factly, and I remember her getting a psychiatrist and walking me down to the hospital.”

He was hospitalised with suicidal ideation a few times a number of years ago, and a common theme emerged. “All my hospital admissions, I just realised, were around September or October, or January or February, so that says something, I think,

“[I was] having these intense depressive feelings anyway, and then [I had] SAD to intensify them even more to the point where it almost pushed me to the edge," he says as he takes another drag.

Despite lessening in severity, the disorder is still a painful fact of Curwen’s life, and his nonchalance while chatting about such shocking experiences must be a coping mechanism. That being said, he’s not trying to play down how severe SAD can be.

“Even though it’s so terrible, I wouldn’t wish it on my worst enemy. Even the ex-wife.”

To someone who has never experienced SAD or depression, it can be difficult to comprehend how someone can’t just snap out of it, or even how it exists in the first place. Curwen is concerned that this stigma is leading thousands into potentially dangerous self-denial.

“A lot of people [think] ‘I’m really sad, really depressed, pull myself out of it’, rather than thinking ‘hold on, this is actually something clinical’. I often say to people that it’s just as physical an illness as breaking your leg.”

He is critical of the idea that you can convince yourself out of depression through so-called ‘manifesting’ or the ‘law of attraction'. “There’s an element of truth in ‘be positive because misery loves company’, as they say, but that puts so much onus on people whereby they think, ‘manifesting sadness is my own fault’. That adds to the guilt.”

Having said this, mindfulness can sometimes be an effective form of self-treatment. You can practise it by taking a walk, establishing an exercise routine or simply writing down little things you’re grateful for.

Alternatively, resources like Headspace and Calm offer a range of guided meditation sessions that can offer respite both in tough moments and as part of a consistent mindfulness routine.

This self-intervention won’t be enough for many people, which is totally normal. In that case, various forms of therapy can be helpful, such as one-on-one talking therapy, compassion-focused therapy (CFT) or cognitive behavioural therapy (CBT).

Curwen is a particular advocate for CBT, which hones in on changing self-sabotaging thought patterns through reflection on your behaviours. “Every few days I feel the need to stop for a bit, use some of those CBT techniques,” he says.

Another emerging treatment option for SAD is light therapy, during which special lamps, called light boxes, imitate sunlight to make the daylight seem to last longer. It might sound odd, but it’s thought using the lamp for around 30 minutes daily could reduce the production of melatonin and boost serotonin levels.

The form of treatment people tend to find most difficult to accept is prescribed medication. Contrary to popular belief, anti-depressants can be used for short periods of time without developing a dependency, so if you only suffer from depressive episodes in the winter months, medication can be really helpful.

Curwen is adamant that whatever form of treatment works for you, the first step is the most important. “I always come back to the same thing, but asking for help isn’t a sign of weakness, it’s a sign of strength.”

One trip to the GP can be enough to start the process of getting help. “Don’t wait for it to get serious. Even if it’s a small thing that might get you thinking this, like if a comedy show doesn’t make you laugh quite like it normally does,

“Reach out. Ask for help. Don’t wait until you’re thinking about jumping out of the window.”

Curwen, despite still living with both bipolar and depression, has found his way out of the darkest of places, and now volunteers with the East London NHS Foundation Trust (ELFT) to raise awareness of the realities of mental health.

He teaches medical students how to deal with mental health patients by breaking down common misconceptions, and offers advice in workplace disciplinary cases involving behaviours linked to mental health, changing perceptions and doing things that have “never been done in the NHS before”.

It wasn’t an easy road to get to where he is now, and managing his mental health is still a daily struggle, but his primary message for those with depression or SAD is one of hope.

“The sun will come out again.”

For more information on SAD, visit the NHS or MIND websites.

If you feel you or someone you know might need help, call your local NHS helpline or contact Samaritans 24/7 on 116 123.

If you require urgent assistance, don’t hesitate to call 999.