Coping with Seasonal Affective Disorder When You Have Cancer

While many rejoice in the change of season, watching the leaves fall and feeling the air grow colder, some Americans instead begin to feel moody and fatigued. As summer changes to fall and continues to progress to winter, some individuals may get the sense that they are in a seasonal funk or have “the winter blues,” when they may actually suffer from seasonal affective disorder (SAD).

SAD is a subset of depression associated with the change of season, and is most commonly experienced from the fall through the winter season. The symptoms can start out mild and become more serious, making it difficult to diagnose in some instances. For cancer patients going through treatment, it may also be difficult to decipher SAD from other side effects of treatment, like cancer-related fatigue.

SAD and Cancer-Related Fatigue in Cancer Patients

Though it’s common for anyone to have some days where they feel a bit down and may not be in the mood to do anything, seasonal affective disorder follows many of the same symptoms as major depression and can last for months at a time. Some signs of SAD during these fall and winter months may include:

Though researchers have struggled to really understand why SAD occurs, there are several factors that may cause these changes. One big factor is the change in sunlight, which can lead to a disruption in the body’s internal clock and trigger feelings of depression. Along the same lines, experts believe serotonin levels may also be a cause. Serotonin is a chemical in the brain that impacts mood, which may also decrease with decreased sunlight, and thus lead to feelings of depression. The body’s melatonin levels may also decrease, which can disrupt normal sleeping patterns and also alter mood.

SAD can be difficult to diagnose specifically for many people because similar symptoms can be found with other types of depression or mental health disorders. For patients just learning of their cancer diagnosis or undergoing treatment, feelings of depression and anxiety are rather common, as well, so may not be linked specifically to seasonal affective disorder. In general, many researchers refer to any persistent and distressing emotional, physical, or cognitive tiredness as cancer-related fatigue, which can look a lot like types of depression. Much like SAD, cancer-related fatigue can result in extreme tiredness that persists for months or possibly even years, appetite changes, oversleeping, and feeling weak. Patients with cancer-related fatigue may also have trouble concentrating and remembering things, which may continue well after treatment.

Recent Research to Combat These Symptoms

The National Cancer Institute estimates at least 33% of cancer patients suffer from depression and related symptoms. In the last few years, researchers have honed in on SAD and cancer-related fatigue in a series of clinical trials in an effort to help mitigate some of the symptoms. Light therapy, in particular, has been increasingly explored in these studies as a means for improving these conditions, since depression and fatigue have been linked to lack of natural light.

The Icahn School of Medicine at Mount Sinai began a clinical trial last year that’s expected to continue through 2020 studying systematic light exposure in the treatment of cancer-related fatigue. The researchers involved noted that while there are pharmacological treatments for cancer-related fatigue, most show insufficient evidence of actually helping the patients. Instead, this study is looking at a low-cost, low-burden intervention for these symptoms with daily administration of light from a handheld device.

The study is investigating 200 cancer survivors with 30-minute intervals of self-administered light from these devices each morning to determine if light therapy will improve their various fatigue symptoms, both mentally and physically. Researchers will monitor sleep quality, fatigue, depression, and circadian rhythm among other factors to determine if light therapy benefits patients’ overall quality of life.

This clinical trial stems from a study also held at Mount Sinai in 2014 in the early phases of exploring light therapy for this type of fatigue. This study tested two groups of cancer survivors suffering from cancer-related fatigue by treating the symptoms with exposure to a bright light or a dim red light every day for a period of four weeks. Patients’ symptoms were monitored throughout.

The study found that bright white light applied daily helped survivors with their symptoms, while the group using the dim red light still reported chronic levels of fatigue. Overall, researchers are hopeful these bright light therapies can prove to be a continued cost-effective and viable treatment option for these symptoms.

Help for Patients with SAD

Though these studies show potential as future treatment of depression or other symptoms of cancer-related fatigue and SAD, there are other ways for patients and their caregivers to seek help in the meantime. Pay attention to any side effects you experience throughout your journey, both physical and mental. Caregivers should also keep an eye out for symptoms of depression or cancer-related fatigue that seem to go beyond normal fatigue from treatment or everyday activities.

Make sure to discuss any symptoms you’re experiencing with your medical team, as they will be able to recommend ways to help overcome or combat these side effects. Talk with a survivor or another cancer patient to learn about their own side effects and the actions they took to help overcome them.

While there is no specific cure for seasonal affective disorder or cancer-related fatigue, there are various options to at least ease the symptoms. Speaking with someone, whether a loved one, fellow patient or survivor, or your medical team, may be the first step to receiving the help you need.