For many, lack of light can result in Seasonal Affective Disorder known as SAD a type of depression that is associated with the changing seasons. SAD can make it difficult to weather the winter months, and for those in the LGBTI+ community, SAD can be an especially difficult, possibly compounding problem.

SAD is thought to result from a decrease in exposure to sunlight. This decrease may disrupt your internal clock (i.e., circadian rhythm) and can also lead to a drop in serotonin levels. SAD can manifest in a variety of ways. The most common symptoms include tiredness, lack of energy, irritability, changes in appetite, weight gain, and social withdrawal.

Why should LGBTI+ be concerned about SAD?

According to the American Psychological Association, when compared to their heterosexual counterparts, gay men have “higher rates of recurrent major depression,” and individuals between the ages of 15 to 54 with same-sex partners had “higher rates of anxiety, mood, and substance use disorders and suicidal thoughts.” Because they are susceptible to depression, it is important that those in the LGBT+ population be aware of the effects brought on by SAD because “symptoms of depression may worsen seasonally.”

To combat the effects of SAD, many physicians recommend light therapy, also called phototherapy. During light therapy, the patient sits near a special light therapy box that is designed to mimic natural sunlight exposure. Antidepressant medications and psychotherapy are also often recommended.

Being aware of SAD and not simply dismissing the symptoms as the “winter blues” is the first step toward coping. Those in the LGBTI+ community, as well as others who may be susceptible to or have a history of depression, should be aware of the symptoms and the recommended treatment options.

Whenever there is a public emergency or a natural disaster, health centers generally become a nerve center of activity. However, when disaster is pending, health centers should take measures to ensure that they can provide the necessary assistance and resources to the area’s most vulnerable populations, including the LGBT community (LGBT Health Education. org). Specific issues health centers should be concerned about include: higher rates of homelessness, particularly for LGBT youth, making them difficult to locate in an emergency situation; LGBT seniors often live alone and don’t have children, making access to them and ensuring that they receive the right safety information in an emergency far more difficult; LGBT relationships aren’t recognized everywhere, complicating healthcare and first response issues; those in the transgender community are often placed in a different shelter from the gender which they identify; and some in the LGBT community may find it hard to trust first responders and medical professionals due to discrimination in the past. Bathrooms can be a problem for the transgendered as well. If and when possible, centers should provide gender neutral restrooms in order to save the LGBT population from embarrassment. Those in the community should also be prepared to stand up and advocate for themselves and one another in times of disaster and crisis.

With the help of LGBT community leaders, advocacy groups and others in the community, health centers should develop proper policies and procedures to deal with these distinct LGBT issues.

The staff at these medical centers should also be trained in LGBT-specific issues. Staff should be made to recognize couples without asking for documentation of their relationship status. Staff should be trained to recognize and use the preferred gender identity and name of a person who is transgender. Working with transgender people and same sex families to make their trauma and transition as smooth as possible should be a training topic for staff as well when managing an emergency situation.  Everyone working for the health care center should know the policies, procedures and best practices when dealing with the LGBT community in times of crisis. Those who are on HIV antiviral medications who have been cut off from their treatments during an emergency should have enough medication to last throughout the interim period. Emergency healthcare support and services should also be set up and policies and procedures for dealing with discriminatory acts, violence and other hate crimes against those in the LGBT community. In emergency situations it is generally the most vulnerable that are hurt the most.

Having the front line, vis-à-vis the healthcare community, on top of things will help protect the LGBT community and make sure they survive and do well during natural disasters and other emergencies.

Dr. M. Mirza, LGBT Health Wellness – May. 2014