People with autism seem to be more prone to Seasonal Affective Disorder, or SAD. Seasonal Affective Disorder is a form of depression that occurs in the fall and winter seasons when there is less daylight. It affects mood, energy levels, sleep patterns, and can lead to feelings of sadness, fatigue, and sometimes irritability.

“In those who experience SAD, what we tend to see as we move from summer to fall is a change in behavior,”  Marianne Simon, a psychologist at Wildwood, says. “Many people we support are not able to express that they feel ‘sad’ or ‘down,’ but we may see a lower frustration tolerance or a reluctance to participate in activities they once enjoyed.”

SAD presents some specific challenges when it occurs alongside autism. People with autism sometimes already have sensitivities to changes in the environment, particularly light and temperature. Disruptions to routine, which can be problematic for people with autism, occur as the weather gets colder, darkness increases, and holiday season preparations begin. When combined with difficulty expressing feelings and a propensity toward depression and anxiety, SAD and autism can be a challenging combination.

“Individuals on the spectrum thrive with consistency and routine, but as fall and winter approach, everyone is expected to shift routines due to reduced daylight,” Marianne says. “This can cause increased anxiety and distress for those with Autism Spectrum Disorder, who already experience anxiety at a higher level. Further, being hypo- or hypersensitive to various environmental factors, such as the weather, could cause even greater distress, leading to some of the behavioral changes that we see as the seasons change.”

There are some strategies designed to address SAD. Light boxes that mimic natural light can reduce symptoms, but people with disabilities often need a lower intensity of brightness due to sensitivity. The lightbox emits full-spectrum light, which is much brighter than typical indoor light and is much like sunlight. This light helps balance melatonin and serotonin levels, which can aid with sleep and mood. Lightboxes work best when used consistently in the morning for 20 to 30 minutes. Research shows that they can be successful 60 to 80% of the time.

“One thing we have seen with those who use light boxes is that it’s important to monitor the impact on the person, because if someone is already feeling energized and they use the lightbox, it can lead to mania. Therefore, if someone has a prescription to use the lightbox starting in the fall but can’t tell us how they are feeling, this is where staff need to monitor the person’s behavior and use that as an indication of their mood,” Marianne says.

Maintaining a regular daily routine and structure can also help by keeping the day predictable and reducing stress. A healthy diet rich in vitamin D—which comes from exposure to sunlight—can also help, as will therapeutic support that encourages the individual to talk about their feelings. Like many things, a healthy lifestyle that includes regular exercise, stress management, and a holistic approach is key.

“As with all mental health disorders, not just SAD, it is so important to take a holistic approach and look at the multiple dimensions of wellness, specifically focusing on the physical, social, and emotional aspects,” Marianne says.