What is seasonal depression?
Seasonal depression, known clinically as seasonal affective disorder or SAD, is depression that comes and goes with the seasons. NIMH describes it as a type of depression with a recurrent seasonal pattern, with symptoms lasting about four to five months of the year. For most people it starts in late fall or early winter and lifts in spring. A less common summer pattern also exists.
It is different from the ordinary dip many people notice when it gets dark at five in the evening. Plenty of people feel a little slower in January. SAD is when that change is significant enough to affect how you feel, think and behave, and when it returns at the same time of year rather than once.
Winter blues, holiday stress or SAD?
NIMH draws a useful line here. The depression of SAD is tied to changes in daylight, not to the calendar. Stress about the holidays, family visits, year-end work deadlines or a hard anniversary can all make late fall heavy, but those pressures are not the same thing as SAD.
That distinction matters in practice. If December is hard because of who will or will not be at the table, the conversation you need is probably about grief, family or stress. The first holidays after a loss is a different problem from a mood that sinks every year as the light goes, whatever is happening in your life. Of course, both can be true at once.
- A predictable pattern: low mood that arrives around the same time each year and eases when the season turns.
- Changes in sleep and appetite: wanting to sleep much more, craving carbohydrates, gaining weight.
- A pull to hibernate: canceling plans, staying in, losing interest in things you usually enjoy.
- The rest of depression: hopelessness, guilt, low energy, trouble concentrating, and for some people thoughts of death.
What are the signs of winter-pattern SAD?
NIMH lists the signs of SAD as those of depression in general, such as a persistent sad, anxious or empty mood, loss of interest, fatigue, trouble concentrating and feelings of worthlessness, plus some that are specific to the season. In the winter pattern, those extra signs are oversleeping, overeating with a particular craving for carbohydrates, and social withdrawal that NIMH compares to hibernating.
The summer pattern looks almost opposite: trouble sleeping, poor appetite, restlessness, agitation and anxiety. Not everyone has every symptom. If your low mood is not seasonal at all, our page on signs of depression covers the wider picture, and depression and motivation looks at the heavy, can't-get-started feeling that winter often brings with it.
According to NIMH, SAD is much more common in women than in men, usually begins in young adulthood, and is more common the farther north people live, because winter days are shorter. It is also more common in people who already live with depression or bipolar disorder. A diagnosis usually requires the seasonal pattern to have repeated for at least two consecutive winters, which is something a doctor or mental health professional can assess with you.
How is seasonal depression treated?
NIMH groups treatment for SAD into four categories that can be used alone or in combination: light therapy, psychotherapy, antidepressant medication and vitamin D. Light therapy and vitamin D are aimed at the winter pattern; therapy and medication are used for depression in general, including both seasonal patterns. NIMH's advice is to talk to a health care provider about the benefits and risks of each and which fits you.
Light therapy is a medical treatment
Light therapy means sitting in front of a very bright light box each day, usually first thing in the morning, through the darker months. NIMH describes the standard as a box of 10,000 lux used for about 30 to 45 minutes a day, which filters out ultraviolet light. NIMH calls it safe for most people, but notes that people with certain eye diseases, or who take medications that increase sensitivity to sunlight, may need another treatment or medical supervision.
Because of that, it is worth treating a light box as you would any other treatment: talk to your doctor before you buy one, and mention any eye problems, medications, or a history of bipolar disorder. A doctor can also help with the timing, which matters.
Talk therapy for SAD
NIMH describes a version of cognitive behavioral therapy adapted for SAD, called CBT-SAD. It works on the gloomy thoughts people have about the season itself, and uses behavioral activation: deliberately scheduling engaging, pleasant activities, indoors or out, to push back against the winter pull to withdraw.
In a randomized trial led by Kelly Rohan and published in the American Journal of Psychiatry in 2016, 177 adults with winter depression received six weeks of either CBT-SAD or light therapy. The two did equally well the first following winter. By the second winter, fewer people in the CBT-SAD group had a recurrence (27.3% compared with 45.6%), which the authors read as a sign that the effects of therapy may last longer.
Medication and vitamin D
Antidepressants can help with SAD, alone or alongside therapy, and NIMH notes that one, an extended-release form of bupropion, is approved by the FDA for preventing seasonal episodes when taken from fall into early spring. NIMH describes the research on vitamin D as mixed and warns that it can interact with some medications. Both are conversations for a physician or psychiatric prescriber. Laura Bass does not prescribe medication; our page on therapy, medication or both explains how the two fit together.
Getting ahead of the season
Because SAD is predictable, NIMH notes that people with a history of it might benefit from starting treatment before fall, though it adds that few studies have tested prevention. A plan made in September, with your doctor and, if you like, a therapist, tends to work better than one made in the middle of a bad January.
Alongside treatment, the ordinary things help more than people expect: getting outside in daylight, keeping a regular wake-up time, planning things to look forward to in the dark months, and telling the people close to you what this time of year does to you. Our coping skills section has more on building those habits.
Where counseling with Laura fits
Laura Bass is a psychotherapist in Charlotte, North Carolina, who works with adults, and depression and anxiety are among the concerns she sees. Counseling can be a place to understand your own seasonal pattern, plan ahead for it, and work on the thoughts and habits that make winter heavier. If you also use light therapy or medication, those stay with your doctor. You can read about individual counseling, see how therapy for depression and anxiety works, or contact Laura with questions.
If the low mood ever comes with thoughts of suicide or of not wanting to be here, do not wait for spring. Call or text 988 at any hour, and in an emergency call 911.
Common questions
Is seasonal depression real depression?
Yes. NIMH describes seasonal affective disorder as a type of depression with a recurring seasonal pattern, not a matter of disliking winter. It can be mild or severe. The difference from ordinary winter blues is that SAD noticeably affects how you feel, think and function, and comes back around the same time each year. A doctor or mental health professional can help you sort out which you are dealing with.
Can I just buy a light box and start using it?
Light boxes are sold without a prescription, but light therapy is still a medical treatment. NIMH notes that people with certain eye conditions, or who take medications that increase sensitivity to light, may need a different treatment or medical supervision. Brightness and timing matter too. Talk to your doctor before you start, and tell them about any eye problems, medications or history of bipolar disorder.
Does talk therapy work for seasonal depression?
Research suggests it can. NIMH describes a form of cognitive behavioral therapy adapted for SAD, which works on gloomy thoughts about the season and schedules engaging activities. In a 2016 trial, it did as well as light therapy in the first following winter, and fewer people had their depression return in the second winter. Many people combine therapy with other treatments.
Can you have seasonal depression in summer?
Yes, though it is less common. NIMH describes a summer pattern in which depression arrives in spring or summer and is marked by trouble sleeping, poor appetite, restlessness, agitation and anxiety, rather than the oversleeping and cravings of the winter pattern. Light therapy and vitamin D are aimed at the winter pattern; therapy and medication are used for both.