Many people experience a boost in their mood and energy levels when the sun comes out and it's finally warm enough to laze about in rooftop bars and let their legs see the light of day. But not everyone's experience of spring and summer is sunshine and roses.
Seasonal affective disorder (SAD), a type of depression related to changes in seasons, is most commonly associated with the cold, dark autumn and winter months, but many people instead experience "reverse SAD", whereby they feel particularly low during spring and summer.
It's unclear what proportion of people with SAD experience it in "reverse", but research has put it between 10 and 40%, says Laura Peters, head of advice and information at Rethink Mental Illness. The causes are also less clear compared with SAD associated with the winter months, which has been linked to changes in melatonin, serotonin and the body's circadian rhythm caused by lack of sunlight.
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While research into the triggers of reverse SAD is sparse, theories abound. "It could be due to people staying up later during summer, which can interrupt their sleep-wake patterns and change their mood," suggests Peters. "Or it could be down to increased melatonin production because of increased sunlight."
The signs of reverse SAD are often different from those of SAD experienced during the winter months, which often include low energy. Reverse SAD symptoms are most often agitation and irritability-related, which may be mild to begin with at the end of spring but become more severe as summer progresses, says Isabel Leming, senior technician at Smart TMS. These might include trouble sleeping (insomnia), poor appetite, weight loss, agitation or anxiety.
If the symptoms of reverse SAD sound familiar, rest assured that you're not the only one whose mental health is adversely affected by warm, sunny weather. Disorders like anxiety can also be triggered and worsened by the "good" weather and the pressure to be constantly happy and enjoying the sunshine.
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Seeing everyone having fun in the sun during summer has made my depression worse because I couldn't enjoy it.
Eleanor Segall
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"Mental health in summer can be hard," says Eleanor Segall, 29, a mental health blogger and freelance writer, who has been on lithium since she was 25 following a serious manic episode. "I struggle with the heat – my medication dehydrates my body anyway so I have to continually drink water and try to stay out the sun at midday. I burn like a tomato.
"In the past when I've been low, seeing everyone having fun in the sun during summer has made my depression worse because I couldn't enjoy it."
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Zoe Thomson, 22, an office administrator, was diagnosed with depression and generalised anxiety at 19 and says the heat and humidity make her feel claustrophobic and so trigger her anxiety. She says the worst thing about mental health struggles in summer is "feeling left out" and feeling the pressure to be happy and "joining in with everyone else's fun".
"I just prefer the colder seasons and my depression can’t go away for the summer. It doesn’t work like that. It makes me feel like an outsider because I’m the only one not praying for the season to never end."
It's a similar story for 19-year-old student Alice Wardman, who has had depression and anxiety for a few years. "The warm weather can sometimes help my mental health, but it's mostly short-lived. I don’t feel ‘better’ in the sun."
Most often, it means feeling pressured to be sociable when she doesn't always want to be. "The worst thing is having friends want to go out and take trips when all you want to do is stay in bed. I feel too guilty saying no, so go anyway as they're so keen and I don’t want to feel like I’m letting them down."
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Mental health issues don’t just stop because the weather is nice, they continue just as if it were a miserable day.
Olivia Callaghan, mental health advocate
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Olivia Callaghan, 25, a mental health advocate who works in retail, lives with bipolar disorder, anxiety and bulimia, and has self-harmed in the past. She also cites the "pressure to have a good time in the sun when all you want to do is to crawl back into bed and sleep" as a burden. "People can’t imagine you being depressed when the weather is lovely, but mental health issues don’t just stop because the weather is nice, they continue just as if it were a miserable day."
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It's also a difficult time of year for Callaghan because she has self-harm scars. "Wearing summer clothes is hard because I feel a tad scared to show my scars in case I’m met with stares or comments."
Ricky Thamman, 39, a graphic designer who hosts a mental health radio show called Mentally Sound, lives with anxiety and depression and says the heat is a "trigger", stopping him from being able to control his symptoms. "I feel faint and it brings on palpitations, leading to faster breathing and anxiety attacks. I regularly carry water and freeze gel, sometimes freeze spray used to treat sports injuries.
"The most difficult thing is not being able to enjoy summer like everyone else, not being productive, and the difficulty in getting from A to B, which affects day-to-day things like work. I don't socialise, travel, or go out in general in high temperatures." He still experiences anxiety during winter, but this isn't weather-related.
If you think you might be suffering with reverse SAD, show yourself the same compassion and care you would if you had any other mental health issues. "Like all depressive disorders, it's important to speak to your GP," says Peters. "They may prescribe medication or talking therapies. It also helps to eat well, do some exercise and make sure you get enough sleep."
Alternative treatments for depression, such as transcranial magnetic stimulation (TMS), which modulates brain activity and is approved by NICE, can also be used to treat SAD, says Leming. She also recommends blocking out as much natural light as possible when trying to sleep if you're suffering with insomnia as a result of reverse SAD.
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If you are experiencing depression and need support, please call Mind on 0300 123 3393.
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