Skin Picking and the Winter Blues: Understanding the Connection and Coping Strategies

The seasons are changing and with it comes shorter days and colder weather. It’s the time of year when many people experience changes in mood and behavior, sometimes called the “winter blues”. For some, it’s just a passing mood. For others, people, it’s more than just feeling a little blue. It’s a depression that can last throughout the season, disrupting their routine and sense of well-being.

Seasonal Affective Disorder (SAD) is a type of depression that usually occurs during the darker, colder months. For people living with skin picking disorder (also known as excoriation disorder) and other body focused repetitive behaviors (BFRBs), SAD can add a layer of complexity to an already challenging condition. Understanding how seasonal changes influence skin picking can help you understand more about what’s happening and find ways to manage your symptoms during the colder months.  

Understanding Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder (SAD) is a type of depression that occurs with the change of seasons, most often with the transition to fall and winter. SAD is thought to be caused by the seasonal reduction in sunlight, in turn disrupting the body’s circadian rhythms and serotonin levels, which impact mood regulation, sleep, and stress resilience.

Symptoms of SAD may include:

• Depression, feelings of sadness on most days
• Anxiety
• Changes in appetite, usually eating more, craving carbohydrates
• Low energy
• Feelings of hopelessness or worthlessness
• Difficulty concentrating
• Increased irritability or agitation
• Anhedonia (loss of interest in activities you usually find pleasant)
• Social withdrawal
• Sleep disturbance (usually oversleeping)
• In severe cases, thoughts of death or suicide

Though SAD can affect anyone, people with co-occurring mental health conditions like anxiety disorders, obsessive-compulsive disorder (OCD), or mood disorders may be more vulnerable to SAD's influence. These disorders also commonly co-occur with skin picking. 

The Connection Between SAD and Skin Picking

Many people with skin picking disorder notice changes in their mood and picking behaviors during the winter months. While the relationship between SAD and skin picking is not well-understood, several factors may make people living with skin picking more susceptible to worsening symptoms during the colder months.

Reduced Light Exposure and Serotonin Levels

Sunlight is known to boost serotonin, a neurotransmitter that plays a role in mood regulation and impulse control. Less sunlight in winter leads to lower serotonin levels, which can cause changes in mood. Depression frequently co-occurs with skin picking and can worsen symptoms. Low serotonin can also make individuals more prone to anxiety and stress, both of which are common triggers for skin picking. 

Increased Fatigue and Lack of Motivation

SAD is often accompanied by fatigue and low motivation, leading to a disruption in healthy routines. It may be harder to connect with your supportive friends and family or engage in those healthy habits that help you manage your stressors and urges to pick. The lack of social engagement removes a layer of accountability or motivation to avoid picking, potentially reinforcing the behavior.

Changes in routine can also leave you with more idle time, leading to feelings of boredom or restlessness. Boredom is an often cited trigger for picking. 

Stress and Anxiety from the Holiday Season

Anxiety is a common trigger for skin picking, and the change of season also ushers in one of the most stressful times of the year – the holidays. Between parties, family gatherings and the concerns about the questions that might arise, holiday stress is high and can exacerbate anxiety leading to more picking.  

The good news is, there are things you can do to navigate this seasonal challenge. With some planning and support, you can handle whatever the season brings. 

Strategies for Managing SAD and Skin Picking

Coping with SAD when you’re already trying to manage your skin picking can feel overwhelming, but there are strategies that can help. 

Light Therapy

Light therapy, using a lightbox that mimics natural sunlight, is one of the most effective treatments for SAD. Using a lightbox for a few minutes each morning can help regulate circadian rhythms, boost serotonin levels, and elevate mood. . It can help boost your mood, regulate your sleep-wake cycle, and reduce the lethargy associated with SAD. Of course, you want to discuss any changes in mood or therapies with your healthcare provider. 

Establishing a Daily Routine

Having a set schedule can be particularly helpful during the winter months. Seasonal changes can throw your daily rhythm off. By creating a routine, you can help keep your body in a routine that supports healthy habits. A routine can also help to stave off the boredom that can be a trigger to picking. And be kind to yourself. You’re doing the best you can during a stressful time.

Prioritize Your Mental Health 

Therapy, whether in-person or virtual, can provide you with the tools to manage both skin picking and SAD symptoms effectively.

• Both Cognitive Behavioral Therapy (CBT) and Habit Reversal Training (HRT) are commonly used to treat skin picking. CBT is also commonly used to help treat SAD. CBT can help to manage negative thought patterns, while HRT focuses specifically on addressing the picking behavior. 
• Mindfulness and relaxation techniques like deep breathing, meditation or progressive muscle relaxation (PMR) can reduce anxiety and stress, which are common triggers for skin picking.
• Medication, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed to manage the depressive symptoms of SAD and may help you better manage the urge to pick. While there is no medication specifically approved to treat skin picking, there is some evidence that certain SSRIs may be beneficial in the treatment of skin picking.  

Stay Connected with Your Support System

Feelings of isolation can exacerbate feelings of depression and urges to pick. Finding support, whether through friends, family, or support groups, can make a difference. Support groups, whether in-person or online, can provide encouragement, reduce loneliness, and offer helpful tips for managing symptoms in the winter months. 

SAD can lead to a cycle of low mood and increased skin picking. With a proactive approach and compassionate self-care, you can reduce the impact of seasonal changes on your skin picking and maintain your mental well-being no matter the season. 

References

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