Seasonal Affective Disorder, Changing Seasons, and Lupus
Systemic lupus erythematosus or SLE is an autoimmune disease that effects organs throughout the body, including the joints. Many people with lupus feel that their symptoms change not just with the seasons, but with the weather itself. Sudden changes in weather, as in the times where the seasons change.
Sudden changes in weather, including drops or increases in temperature, changes in humidity, barometric pressure, sunlight intensity, can cause headaches, fatigue, and pain as the body tries to adjust. You can read more about fatigue and the seasons here. These sudden changes have even been associated with migraines! You can read more about headaches and lupus here.
This is not the same as “Seasonal Depression” or “Seasonal Affective Disorder,” although people with lupus also have issues with this mental condition.
What is Seasonal Affective Disorder?
Seasonal affective disorder, also known as SAD, is a form of depression that is correlated to the seasons. It has similar symptoms to classical depression, including:
- “Down” or low mood
- low energy and sluggishness
- sleep issues
- food cravings
- weight gain
- fogginess and lack of concentrating
- and also feelings of hopelessness, sadness, and even suicidal ideation.
The most common form of seasonal depression occurs during the fall and winter months and appears to be related to lower ambient light. Light effects the body’s internal clock and mental state. Supporting this is the typical treatment for SAD, which is light therapy. Light therapy uses lamps that mimic sunlight, which can help the body re-calibrate its internal clocks properly. It is also treated with medications and psychotherapy, much like classical chronic depression.
More rarely, people experience SAD during the spring and summer months. This form has a few differences to winter-fall SAD, which resemble classical anxiety:
- low appetite
- weight loss
- increased irritability
- and anxiety
Seasonal affective disorder can exacerbate already existing depression, anxiety, and other mood disorders. It can also make conditions such as fatigue and brain fog worse. Because people with lupus sometimes have issues with sunlight and photosensitivity, they are especially vulnerable to seasonal light changes. You can read more about photosensitivity and lupus here.
With less sunlight exposure, people with lupus are also potentially vitamin d deficient, which can make the symptoms of lupus worse.
Light therapy can have a risk of causing flares for people with lupus if they are sensitive to light – however, if the seasonal depression is intense enough, their treatment team may decide that the light treatment is worth the side effects.
Circadian Rhythm and Lupus
The body’s internal clock, known as its circadian rhythm, is controlled by cells in the brain that detect light. half of these cells detect when darkness falls, and the other half detect the appearance of first light. This allows the body to synch itself up with the natural day and night cycle. Modern life throws off this clock, and is known to increase symptoms of depression, partially due to poor or disturbed sleep. Temperature and humidity are also linked to how the body tells time and when people wake or sleep.
Researchers didn’t find a significant difference in heart attack and stroke risk depending on the season, but different seasons have different levels of physical activity. Changes in the weather can interfere with exercise and outdoor time. Exercise issues can lead to poorer general health. You can read more about physical inactivity and lupus here.
Temperature Changes and Lupus
Heat stresses the body out as it works extra hard to keep itself cool. The body increases bloodflow to the skin by widening (or dilating) the blood vessels and thus releasing heat to the outside world. In order to make sure that blood flows to the skin, blood vessels in the gut constrict, which can cause a “leaky gut” syndrome. You can read more about leaky gut here. Toxins that leak into the bloodstream from the gut can cause an inflammatory response, which can lead to lupus flares that are then made worse by dehydration and other symptoms of heat stroke. You can read more about hydration and lupus here.
This makes keeping cool and hydrated important in hot weather, but sudden changes in temperature from cool weather to hot weather can make people with lupus more vulnerable to overheating since they are still acclimated to cold weather. Cold can make muscles, ligaments, and joints stiffer.
Basically, in hot weather, stay cool. In cool weather, keep warm. A paraffin bath can help warm the joints.
Weather and Lupus
The researchers found strong correlations between pain intensity and weather when the temperature, relative humidity, and cloudiness were all consistently high. Read more about the weather and lupus, here.
Weather changes can cause spikes in aches and pain. The exact reasons are unknown, but it is thought that changes in barometric pressure cause changes in the synovial fluid, the fluid that surrounds and cushions the joints. Rain often causes a sudden change in barometric pressure – yes, you can predict the weather with your joint pain!
Both increases and decreases in pressure can put additional strain on the joints and interfere with the lubrication of the joints, leading to pain. there is an association between air pressure and synovitis, when the cushioning layer of the joint, the synovium, is swollen, unable to lubricate the joint properly, and putting pressure on the joint, causing pain. This appears to be the case in rheumatoid arthritis, which supports the idea that it could be the same in lupus-related pain.
Overcoming Seasonal Changes with Lupus
Keeping track of the weather report can help people with lupus make plans and predict when they are going to have particularly bad days (due to the weather.) Staying indoors can help with temperature and wind and light changes, but barometric pressure won’t be affected. A healthy diet, proper hydration, regular exercise, and getting plenty of sleep can help to reduce symptoms of lupus, including the changes related to the changing of seasons.
Heating pads and cold packs can help change the temperature on the joints to something more comfortable.