Seasonal depression—also known as seasonal affective disorder—is a type of depression that follows a seasonal pattern. Sometimes it’s referred to as SAD or winter depression because the symptoms appear during the fall and winter and disappear in the spring and summer. (A rare form of seasonal depression called summer depression or summer-pattern SAD presents in the spring and summer and resolves in the fall and winter. This article will address the more common winter form.)
People with seasonal depression often experience loss of energy, oversleeping, overeating, weight gain, cravings for carbohydrates, sadness, and social withdrawal. For some people, symptoms are mild. For others, seasonal depression significantly disrupts their daily activities and may be associated with substance abuse, problems at work or school, and suicidal thoughts or behaviors.
The cause of seasonal depression is unknown but environmental factors likely play a prominent part. As summer transitions into fall, the days become shorter, the nights longer, and the sunlight less intense. These changes in our environment can disrupt our circadian rhythm and reduce the brain’s production of serotonin, a neurotransmitter that plays an important role in regulating mood, appetite, energy, sleep, memory, learning, and sexual desire.1 Studies show that people with seasonal depression experience disruptions in circadian rhythm and serotonin levels.2
Because seasonal depression is a form of major depression, antidepressant medications are a common treatment. Sometimes they are necessary, but in most cases, there are better, more natural options that truly address the underlying factors. It is possible to reset your internal clock, boost serotonin levels, and reverse seasonal depression without prescription medication. Here are seven ways to get started.
#1 | Get more light.
Maximizing our exposure to natural light can help compensate for the shorter days and less intense light we get from the sun during fall and winter months. Any extra sunlight is good, but early morning rays can be particularly therapeutic because they contain more blue light than any other time of day. This kind of sunlight can reset our circadian rhythm and stimulate the brain to release neurotransmitters including norepinephrine, dopamine, and serotonin that increase alertness and improve our mood. Early morning sunshine also triggers the release of glucocorticoids that wake us up and help mediate our response to stress. Make the most of it by getting up as close to sunrise as possible and going outside for twenty minutes or more.
People with seasonal depression may also benefit from using a light box. The standard treatment of 10,000 lux for thirty minutes daily has been shown to significantly improve symptoms in two weeks.3 A study using less intense light for longer periods of time saw even faster results.4 People exposed to 2,500 lux for three hours at dawn and three hours at dusk saw significant improvement in the first three to seven days of treatment.4 The most common side effects of light therapy include headaches, nausea, and jitteriness. These symptoms are usually mild and tend to improve with continued use.3 Individuals with seasonal depression should use light boxes with full spectrum light which contains all of the blues, greens, and purples missing from fluorescent and incandescent light bulbs. To avoid eyestrain and headaches, position light boxes five to ten feet away in your peripheral vision and avoid looking directly into the light.
#2 | Maintain a regular schedule.
Keeping a regular schedule exposes you to light at consistent, predictable times which helps to reset your circadian rhythm. Wake up, go to bed, eat your meals, exercise, and use your light box at the same times every day as much as you can, seven days a week.
#3 | Exercise regularly.
Studies show that physical activity can help restore dysregulated circadian rhythms5 and support the body’s natural production of serotonin.6 A good goal for most people is two and a half hours of aerobic and strengthening activities per week, plus stretching after exercise. If you can, exercise outside during daylight hours to increase your exposure to natural light. If you are currently sedentary or have health concerns, talk to your doctor before you start working out and ask for individualized recommendations.
#4 | Go dancing.
Researchers studying dance movement therapy believe that it can improve mood, normalize serotonin levels, and stabilize the nervous system. After a twelve-week randomized, controlled study of adolescents with mild depression, those taking part in dance therapy showed significant improvement in psychological symptoms and they also had higher levels of serotonin.7
During the current COVID-19 pandemic, options for in-person dance classes and events may be limited. But any dancing will do, so turn on your favorite music and dance around your living room or find a virtual dance class online. (Thousands of free dance classes can be found on YouTube, for example.) Aim for fifteen minutes or more each day or an hour several times a week, and make a commitment to do it even when you don’t feel like dancing.
#5 | Get more vitamin D.
Our skin makes vitamin D upon exposure to sunlight, so production naturally slows during the fall and winter months. Vitamin D activates a gene needed for the production of serotonin and studies show that it can reduce negative emotions in people with major depression and individuals with low blood levels of vitamin D.8
Spending more time outside can increase the body’s own production of vitamin D. We can also get vitamin D from food. The best sources are fatty fish like salmon, trout, and mackerel, and fish liver oils. Smaller amounts of vitamin D are found in beef liver, egg yolks, and cheese. Vitamin D can also be taken in supplement form and it’s especially important for people whose blood levels are low. Before taking any supplements, ask your naturopathic doctor for individualized recommendations.
#6 | Try cognitive-behavioral therapy.
Cognitive behavioral therapy is a type of talk therapy, also known as psychotherapy, that teaches people different ways of thinking and behaving. It can be used to cope with specific challenges, overcome negative thought patterns, and learn how to better manage stressful situations. Cognitive behavioral therapy has been shown to be as effective as light therapy for seasonal depression. One randomized controlled study found that six weeks of standard light therapy (10,000-lux for 30 minutes each morning) was comparable to six weeks of cognitive behavioral therapy in twice-weekly group sessions led by a psychologist.9
You can find a cognitive behavioral therapist through a referral from your doctor or insurance plan, an employee assistance program, or a local or state psychological association. Choose a therapist who meets certification and licensing requirements for his or her particular discipline and has expertise and experience treating seasonal depression.
1Lambert GW, Reid C, Kaye DM, Jennings GL, Esler MD. Effect of sunlight and season on serotonin turnover in the brain. Lancet. 2002;360(9348):1840-2. https://pubmed.ncbi.nlm.nih.gov/12480364/
2 Melrose S. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression Research and Treatment. 2015;2015:178564.
3 Terman M and Terman JS. Bright light therapy: side effects and benefits across the symptom spectrum. Journal of Clinical Psychiatry. 1999;60(11):799-808;quiz 809. https://pubmed.ncbi.nlm.nih.gov/10584776/
4 Rosenthal NE, Sack DA, Gillin JC, Lewy AJ, Goodwin FK, et al. Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy. Archives of General Psychiatry. 1984;41(1):72-80. https://pubmed.ncbi.nlm.nih.gov/6581756/
5 Hower IM, Harper SA, and Buford TW. Circadian Rhythms, Exercise, and Cardiovascular Health. Journal of Circadian Rhythms. 2018;16:7.
6 Heijnen S, Hommel B, Kibele A, and Colzato1 LS. Neuromodulation of Aerobic Exercise—A Review. Frontiers in Psychology. 2015;6:1890.
7 Jeong YJ, Hong SC, Lee MS, Park MC, Kim YK, et al. Dance movement therapy improves emotional responses and modulates neurohormones in adolescents with mild depression. The International Journal of Neuroscience. 2005;115(12):1711-20.
8 Cheng YC, Huang YC, and Huang WL. The effect of vitamin D supplement on negative emotions: A systematic review and meta-analysis. Depression and Anxiety. 2020;37(6):549-564.
9 Rohan KJ, Mahon JN, Evans M, Ho SY, Meyerhoff J et al. Randomized Trial of Cognitive-Behavioral Therapy Versus Light Therapy for Seasonal Affective Disorder: Acute Outcomes. American Journal of Psychiatry. 2015;172(9):862-9.
Sarah Cimperman, ND is the author of the new book, The Prediabetes Detox: A Whole-Body Program to Balance Your Blood Sugar, Increase Energy, and Reduce Sugar Cravings. She graduated from NCNM in 2002 and has a private practice in New York City. Her expertise has been featured on Fox News and Huffington Post and in Natural Health magazine, Whole Living magazine, and the Well Being Journal, among other publications. Dr. Cimperman also writes two blogs, A Different Kind Of Doctor and The Naturopathic Gourmet.