Coping With Seasonal Affective Disorder When You Have Endometriosis

Here in the Sunshine State of Florida, the temperatures seem to blaze hotter each year.  The dog days of summer can cause seasonal affective disorder (SAD). People with endometriosis may feel like SAD makes their flare-ups even worse.

What is seasonal affective disorder?

Summertime Sadness is not just a Lana Del Rey song. Seasonal affective disorder (SAD) often impacts people during winter, but you might feel similar symptoms during other seasons. SAD is a kind of depression that is caused (or made worse) by seasonal changes. Depression presents with a variety of different mental and physical symptoms. These can include:¹

• Low energy
• Fatigue
• Body aches
• Brain fog
• Interrupted sleep
• Feelings of isolation or loneliness

People with chronic illnesses like endometriosis are already at risk for developing mental health issues. In a 2017 study published in the International Journal of Women's Health, medical researchers found that "pelvic pain has significant negative effects on women’s mental health and quality of life; in particular, women who suffer from pelvic pain report high levels of anxiety and depression."²

Summer depression can impact many endo warriors. During hot summer nights, you might struggle to get regular sleep. You might feel more physically or emotionally stressed as you sweat through sweltering days. Many people retreat indoors to beat the heat and humidity. But this time inside may make it difficult for you to get vitamin D from the sun.

Chronic pain and mental illnesses often present side-by-side. In my experience, physical discomfort can cause me to feel hopeless and emotionally exhausted. For me, endometriosis often causes joint pain, cramps, bloating, heavy bleeding, insomnia, fatigue, and other physical symptoms.

During a flare-up, you might be able to easily leave your home, go to work, or hang out with friends. In turn, that anxiety or depression can cause you to have trouble regulating the physical pain from your flare-ups. You might find yourself feeling lethargic and lonely.

Dehydration and inflammation

During the summer, I often feel more joint pain and inflammation. Why? When you're hot, you might sweat more than usual. You might spend more time sitting down in air-conditioned rooms, which can cause you to feel body stiffness. If you're sweating but not drinking enough water, you might not have enough body fluids to replenish your synovial fluid. These fluids cushion your joints so the bones in those joints can move without rubbing against each other. Dehydration can make the inflammation in your hips and back worse because your body cannot protect those joints.³

Endo warriors who bleed heavily need to restore the water that they lose during their periods. We need to drink water so our bodies can process the food that we eat and so our bodies can pump blood through our circulatory systems. Chronic dehydration can cause thick menstrual blood and anemia. Dehydration can also contribute to digestive issues and bleeding complications, which can worsen your endometriosis-related bloating, constipation, and period pain.⁴

Tips for coping with pain during hot weather 

While you might not be able to beat the heat or your chronic pain, these tips have helped me manage my endometriosis symptoms alongside my mental wellness. Maybe they will work for you too:

• Be proactive about your mental wellness. Contact a therapist or psychiatrist if you spend several weeks feeling more anxious, sad, lonely, lethargic, or tired than normal. Especially if those feelings start to hinder you from being able to complete your daily tasks or find joy in things you used to enjoy.
• Avoid dehydration by drinking plenty of water.
• Establish a sleep routine. Physical pain and mental illnesses can lead to insomnia. But your body and mind need rest to heal.
• If heat is preventing you from exercising, consider working out indoors or trying out lower-intensity outdoor activities.
• If you're feeling isolated inside your home during the hot summer months, try out new ways to socialize with your loved ones. You might want to invite your friends to video chats, virtual game nights, and picnics or nature walks in shaded areas.
• Consult with your doctor to monitor your vitamin D, iron, and dehydration levels.