Seasonal affective disorder is a form of depression that repeats during predictable seasonal shifts, impacting an estimated 5% of the global population—predominantly women. The condition typically stems from significant cyclical changes in daylight hours, with prevalence increasing in regions north of 40 degrees latitude (and less commonly in the Southern Hemisphere). Its etiology—or root cause—remains unclear to researchers.
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Norman Rosenthal led the team at the National Institute of Mental Health that first identified and described seasonal affective disorder in 1984. This 101 from NIMH explores the basics of the condition, from who develops it to how it is treated.
The hormone is secreted from the pineal gland in the brain and is key to the timing of sleep. However, the substance does not generate sleep itself. With seasonal affective disorder, the body misperceives the photoperiod—the time with light—and the cycle of sleeping and waking gets off-phase, leading to issues with circadian rhythms.
Using latitude, depression prevalence, and populations of women and those aged 18-30, this map shows the risk of experiencing seasonal affective disorder during the winter. Researchers weighted latitude most (50%) and demographics least (5% each for women and young adults). Overall risk is not a useful predictor of prognosis for an individual.
Most major depression is “stochastic”—brought on without a clear trigger. SAD—also known as major depression with a seasonal component—is unique in that its onset is predictable. Many of those affected can predict its occurrence accurately within a range of three weeks. This podcast explores this unusual feature of SAD, among other expert takes.
Before professional standards were adopted, practitioners used varying criteria to diagnose mental health disorders. By the 1970s, more objective lists were organized, culminating in this list of polythetic criteria—a list of symptoms where no single criterion is required, but a minimum number must be present.
Subsyndromal affective disorder is diagnosed when someone exhibits two of the nine major criteria for depression (but not more than five) as a result of seasonal changes. While it is milder than primary SAD, SSAD is still significant and impacts millions.
This prevalence trend mirrors the broader incidence of depression among women and is well-documented. Researchers suggest the disparity stems from differences in hormones, social role expectations, coping mechanisms, and more. Men may also present with depression differently, and seek help less.
Nothing is better than going outside and soaking up real sunlight. However, this is harder in winter, especially in very cold and cloudy regions. SAD lamps are designed to project 10,000 lux—a unit of illuminance, or how much light actually hits a surface (rather than how much is produced, like watts). This video discusses product options and practical considerations.
The study helped formalize research and diagnosis of seasonal affective disorder, catalyzing the development of therapies (like bright light) and leading to broader adoption of effective treatments. It also helped connect the influence of light and seasons on biological mechanisms in the human body, spurring exploration of circadian rhythms.
Despite its significantly lower incidence, summer-risk SAD is as significant as its winter counterpart. Rather than being prompted by less light, the summer version is typically spurred by high temperatures, strong light, distinct summer time social pressures (appearing in a bathing suit, for example), and pollen. Common treatments include keeping cool and prioritizing sleep.
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