Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Does OCD get worse in the winter? An expert weighs in

By Grant Stoddard

Dec 29, 20238 min read minute read

Reviewed byApril Kilduff, MA, LCPC

A wealth of evidence shows that external and environmental factors can affect your mood and mental health—like how much time you spend with friends and family, the amount of sleep you get, cultural and societal expectations, and even the amount of financial stress you’re under. Another issue affecting those living closer to either of the Earth’s poles is the annual phenomenon known as winter. 

Diminished mood during this time of year is often called the “winter blues.” But for some, this isn’t just a passing case of the blahs, but a more acute condition known as Seasonal Affective Disorder (SAD), says Nicholas Farrell, PhD, Director of Clinical Development and Programming at NOCD. Research has also found that several other mental health conditions may get worse during the winter. If you have Obsessive-Compulsive Disorder (OCD), you might wonder if it’s one of them. Let’s take a closer look. 

Why does winter affect people’s mood and mental health?  

Winter is one of the four seasons experienced north and south of the tropics. In the northern hemisphere, meteorological winter begins on December 1 and ends on February 28 (or 29th, if it’s a leap year). In the southern hemisphere, it starts on June 1 and ends on August 31. The seasons occur due to the Earth’s axial tilt and orbit around the sun and are characterized by specific changes in weather, daylight duration, and environmental conditions. During winter, the hemisphere tilted away from the sun, causing colder temperatures, shorter daylight hours, and longer nights.

There are several reasons why winter can impact people’s mental health. They can include:

  • Reduced Sunlight Exposure: Fewer hours of daylight during the winter mean less exposure to natural sunlight. And that can disrupt your body’s internal clock—also called your circadian rhythms—and affect the production of serotonin, a neurotransmitter that contributes to feelings of well-being.
  • Vitamin D Deficiency: Less sunlight exposure can also lower vitamin D levels. (In fact, research shows that people who live in areas of the country that have cold winters frequently have too-low levels of this vitamin.) Vitamin D is linked to mood regulation, and its deficiency has been associated with an increased risk of depression.
  • Sleep Disruption. In addition to altering serotonin levels, changes to your circadian rhythms can also lead to sleep disruptions, potentially contributing to feelings of lethargy and sadness.
  • Isolation: Harsh winter weather may discourage outdoor physical activities and social interactions, increasing feelings of loneliness. (Ever heard the phrase “cabin fever?” There’s something to that.) 
  • Genetic and Biological Factors: Studies suggest that some people are more prone to seasonal mood changes due to genetic and biological factors, making them more susceptible during the winter months. 

Mental disorders that can get worse during winter

Various mental health conditions can be influenced or exacerbated in the winter season—particularly due to reduced sunlight exposure and colder weather. Here are some of them:

Seasonal Affective Disorder (SAD): As the name suggests, SAD is a type of depression that occurs at a specific time of year, usually during the winter months. Symptoms may include low energy, irritability, difficulty concentrating, changes in sleep patterns, and a persistent feeling of sadness.

Major Depressive Disorder (MDD): People with MDD may experience worsening symptoms during the winter because of factors like reduced sunlight, social isolation, and changes in their usual daily routine.

Bipolar Disorder: Winter has the potential to trigger depressive episodes in people with bipolar disorder, especially if they are prone to seasonal mood changes.

Eating Disorders: People with conditions like anorexia nervosa or bulimia nervosa may face challenges during winter due to societal pressure related to body image, as well as the potential stress of holiday gatherings, which often center around food.

Sleep Conditions: Disorders like insomnia or seasonal variations in sleep patterns, such as hypersomnia, may be influenced by changes in daylight hours and temperature associated with winter.

Post-Traumatic Stress Disorder (PTSD): Those with PTSD may find that the winter season brings triggering events (such as certain holidays) that exacerbate symptoms related to trauma.

Anxiety Disorders: Conditions such as generalized anxiety disorder (GAD) or social anxiety disorder may be influenced by factors like isolation during the winter months, or the stress associated with holiday gatherings. 

Obsessive-Compulsive Disorder (OCD): OCD was once considered an anxiety disorder, and it shares certain similarities with the widespread group of conditions—but the relationship between OCD and seasonal changes isn’t quite as clear in current scientific research. Before we dive into whether this condition may get worse during the winter, let’s take a broader look at what OCD is.

What is OCD? 

OCD is a mental health condition characterized by persistent, intrusive triggers (obsessions) and repetitive behaviors or mental acts (compulsions) that are performed in an effort to alleviate anxiety. OCD affects approximately 2.5% of the global population, cutting across cultures, genders, and age groups.

People with OCD grapple with distressing intrusive thoughts, images, urges, sensations and/or feelings that provoke anxiety and distress, and engaging in compulsive behaviors acts as a temporary relief mechanism. Common obsessions include fears of contamination, concerns about harming oneself or others, or an intense need for order and symmetry. Compulsions may manifest as repetitive handwashing, tapping, or mental rituals like memory checking or rumination.

The impact of OCD on people’s lives can be profound, affecting daily functioning, relationships, and overall quality of life. Sufferers often spend a significant amount of time on compulsive rituals, leading to disruptions in work, social activities, and reduced feelings of well-being. Untreated OCD can lead to the development of other mental health conditions, including many of the ones listed above. What’s more, OCD often co-occurs with these other conditions. 

Now let’s get back to the topic of OCD and winter. 

Does OCD get worse in the winter? 

“While there is some anecdotal evidence suggesting that symptoms of OCD may worsen for some people during the winter months, the scientific literature on this topic is limited and inconclusive,” explains Dr. Farrell. “One recent paper published in the Archives of Neuropsychiatry found that the severity of obsessive-compulsive symptoms did not show meaningful seasonal changes. 

“It’s not quite so simple, however: The authors noted that people’s subjective well-being varied on a seasonal pattern, worsening in the winter, which is what we would expect. So, there was a general effect but not a specific effect on obsessive-compulsive symptom severity. That said, you might perceive that your obsessions and compulsions get worse in the winter, due to decreased sunlight and reduced access to the sorts of activities that tend to help manage mood and anxiety.”

Dr. Farrell adds that certain OCD obsessions may get worse in the winter. For example, fears about inadvertently hitting someone with your car—often referred to as hit-and-run OCD—are likely to intensify when it’s dark at 4 pm and there’s ice on the roads. He also says that fears about having a psychotic breakdown could become heightened when people are more isolated in the wintertime. 

“While concrete studies on winter-induced worsening of OCD are sparse, it’s important to recognize the interconnectedness of mental health conditions and how they may be susceptible to seasonal variation,” says Dr. Farrell. “Holistic mental health care should address the broader context of co-occurring disorders and their potential seasonal nuances for comprehensive treatment strategies.”

Strategies to reduce winter’s impact on mental health

This science-backed advice can go a long way toward improving your mood and overall mental health during cold, dark months.

While there’s evidence that these interventions can help alleviate winter’s effect on people susceptible to SAD and other mental health disorders, the gold standard treatment for OCD is an evidence-based approach called exposure and response prevention therapy (ERP), and it can help you recover from symptoms at any time of year. 

Exposure and Response Prevention Therapy (ERP)

ERP involves confronting your anxiety-provoking thoughts, images, feelings, sensations and/or situations (exposure) while preventing the accompanying compulsive rituals, thought patterns, or avoidance behaviors (response prevention). The goal is to break the cycle of obsessive thoughts and compulsive behaviors, reducing their overall impact on your life over time.

ERP is considered highly effective, with many studies supporting its efficacy as a first-line treatment. Several studies show that the great majority of people with OCD who commit to this approach experience significant symptom reduction and improved functioning. Moreover, ERP’s success often endures over the long term. In recent years, ERP has become more accessible due to advancements in supplemental support tools, increased insurance coverage, and improved telehealth services. 

Embarking on ERP therapy is a courageous step toward reclaiming control of your life from OCD’s grip. It offers a proven path to break free from obsessive thoughts and compulsions, empowering you to live on your terms once more. 

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