Ask the Doctor: Why Do I Get Depressed Every Fall?

Many people react to changes in light with shifts in energy level and mood, and for some, the fall is a difficult time.

One of the characteristics of depression in bipolar disorder is the variable patterns of the course. “Patterns” and “course” generally refer to recurrent themes: something predictable over time. Experiencing depression at specific times of the year is referred to as having a “seasonal pattern,” while daily fluctuations are termed “diurnal variation.”

Why Do I feel Depressed in the Fall?

The change in seasons affects everyone. The intensity and duration of light are what determine patterns for all living entities: new green leaves appear in the spring, and bears hibernate in the winter. The privilege of being alive is dependent on sunlight.

Many people react to changes in light with shifts in energy level and mood, and for some, the fall is a difficult time. Days become shorter; we see the migrations of birds and reflect that the leaves fall, and winter is on its way. Joni Mitchell captures a doleful fall mood in the lyrics for her song “Urge for Going”: “And all that stays is dying and all that lives is getting out.”

For those experiencing depression at any time of the year, it is wise to keep a diary, even if you only write down a single word on your calendar that captures your mood on a given day. Over time, you can look back and, in discussion with healthcare providers, explore whether there is a seasonal pattern. This is important, as everyone is different. The seasonal behaviors of some mammals are highly predictable, but less so for humanity.

If a seasonal pattern is identified, you can anticipate and prepare more easily. For those who experience depression in the fall, it is wise to plan how you will mitigate the impact. Schedule an appointment with your care provider well in advance of the anticipated challenging time.

Recall what the symptoms were in previous depressions and put contingency plans in place. For example, if sleep is typically a problem, discuss this with your doctor or therapist. Cover all options, including light therapy, medications, and talk therapies. If time away — somewhere warm and sunny — is available to you, consider it.

Can You Explain ‘Diurnal Variation,’ as Opposed to ‘Seasonal Patterns’?

Many people experience daily patterns in which they wake up in a lousy mood with limited energy and the ability to engage with the world. As the morning passes, mood may gradually begin to pick up, and often things feel better by lunchtime or so. This is what clinicians refer to as diurnal variation.

While it is frequently incapacitating, it can be useful in monitoring mood changes. Individuals who are beginning to enter a depressed phase often note that mornings are getting increasingly worse; during the improvement phase, they may notice that the time to feeling better shortens.

The basis for diurnal variation is not known; it is likely related to your internal body clock, the driver of the sleep/wake cycle. While it is often a measure of depressed mood, many of my patients tell me they are just not “a morning person,” and they choose to start their day mid- or late morning. If your lifestyle aligns with this pattern, that’s totally fine.

However, obligations often require a fixed schedule, and therefore, adaptations are necessary. Again, work with your support team to develop a plan, which may involve a combination of medical and/or environmental strategies. Allocate weekend time to “sleep in” and catch up. Coordinate with your family around schedules. Keep a mood diary and share it with your care providers.

Unstable moods are a part of bipolar disorder and come in many variations. Learning your own mood patterns and developing a strategy with your healthcare team and family is an essential part of successful management.