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Seasonal Affective Disorder (SAD)

Seasonal affective disorder is a type of depression that returns at about the same time each year — most often in late fall and winter, and less often in spring and summer. It is common, it is real, and it is treatable. Light therapy, talk therapy and, for some people, medicine can help, and starting early can make the season easier. If you have thoughts of suicide, call or text 988 or call 911.

Get help right away if you are in danger. If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988, or chat at 988lifeline.org. In a life-threatening situation, call 911 (NIMH). The Lifeline is free, confidential and available around the clock (988 Lifeline).

Warning signs to take seriously include talking about wanting to die or being a burden; feeling empty, hopeless or trapped; making a plan or researching ways to die; withdrawing, saying goodbye or giving away important things; and using drugs or alcohol more often (NIMH). Thoughts of death or suicide are listed among the symptoms of SAD itself (NIMH).

Get urgent help too if you cannot function. Depression can affect how a person handles daily activities such as sleeping, eating or working (NIMH). If you cannot get through the day or look after yourself, do not wait for the season to pass — contact a health care provider or call 988 now. If you are having thoughts of harming another person, or you do not feel you can keep yourself or someone else safe, treat it as an emergency: the NHS in the UK says to call 999 or go to A&E in that situation (NHS); in the United States, call 911 or go to the nearest emergency room.

What is seasonal affective disorder?

Many people feel “down” when days shorten in fall and winter and feel better when longer daylight returns in spring. Sometimes these mood changes are more serious and affect how a person feels, thinks and behaves. That is seasonal affective disorder, or SAD (NIMH): a type of depression that comes and goes with the seasons (MedlinePlus). The symptoms last about 4 to 5 months out of the year (NIMH). Cochrane reviewers estimate that the prevalence of SAD ranges from 1.5% to 9%, depending on latitude (Nussbaumer-Streit et al., 2019).

Winter pattern and summer pattern

  • Winter-pattern SAD (winter depression) is the usual form. Symptoms start in late fall or early winter and go away in spring and summer. Along with the usual symptoms of depression, people may oversleep, overeat — particularly with a craving for carbohydrates, leading to weight gain — and withdraw socially, feeling like “hibernating” (NIMH). The NHS adds that some people feel more energetic than usual at the start of spring or summer (NHS).
  • Summer-pattern SAD (summer depression) is less common. Symptoms can include trouble sleeping, poor appetite leading to weight loss, restlessness and agitation, anxiety, and violent or aggressive behavior. Less is known about it, because most research has looked at the winter pattern (NIMH).

SAD is not the same as the “holiday blues.” NIMH explains that SAD is related to changes in daylight hours, not the calendar, so stress around holidays, family visits or work and school schedules is not the same thing (NIMH).

Symptoms

SAD includes the symptoms of depression: a persistent sad, anxious or “empty” mood most of the day, nearly every day, for at least 2 weeks; hopelessness; irritability; guilt or worthlessness; loss of interest; low energy; trouble concentrating; changes in sleep or appetite; unexplained aches; and thoughts of death or suicide. Not everyone has every symptom (NIMH). The NHS list is similar (NHS), and MedlinePlus also mentions a gloomy outlook (MedlinePlus).

Who gets SAD?

  • Women and young adults. SAD occurs much more often in women than in men, and it usually begins in young adulthood (NIMH).
  • Where you live. SAD is more common farther north, where winter daylight is shorter. NIMH gives the example that people in Alaska or New England are more likely to develop it than people in Texas or Florida (NIMH).
  • Mood and other conditions. SAD is more common in people with depression or bipolar disorder, especially bipolar II, and people with SAD also tend to have other conditions such as ADHD, an eating disorder, anxiety or panic disorder (NIMH). See our depression, bipolar and anxiety guides.
  • Family history. SAD sometimes runs in families (NIMH).

What causes SAD?

Researchers are still working this out (NIMH). The leading ideas involve light and two brain chemicals:

  • Serotonin. People with SAD, especially winter-pattern SAD, have reduced levels of serotonin, a brain chemical that helps regulate mood. Shorter winter days may stop the molecules that keep serotonin normal from working properly (NIMH).
  • Melatonin. People with winter-pattern SAD produce too much melatonin, a hormone that helps keep the sleep–wake cycle, which can increase sleepiness. People with summer-pattern SAD may have reduced melatonin, but NIMH notes these theories have not been systematically tested (NIMH). The NHS likewise says SAD is thought to be linked to reduced daylight in winter (NHS).
  • Vitamin D. NIMH says vitamin D deficiency may worsen these problems, because vitamin D is believed to promote serotonin activity and the body makes it when sunlight hits the skin (NIMH).
  • Thoughts and beliefs. Negative thoughts about winter or summer are common in people with SAD. It is unclear whether they are causes or effects, but they can be a useful focus of treatment (NIMH).

How SAD is diagnosed

A provider may ask you to fill out a questionnaire. NIMH lists three criteria: you have the symptoms of depression; the episodes occur during a specific season for at least 2 consecutive years; and the seasonal episodes are more frequent than episodes at other times of the year. Not everyone has symptoms every year (NIMH).

When to see a doctor: see a health care provider if you think you might have SAD, or if you have been diagnosed and treatment is not helping (NHS). Many people need treatment every winter to stop symptoms from coming back (NHS). Other guides that may help: sleep problems, chronic fatigue and medication safety.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Light therapy (a bright light box each morning, fall to spring), talk therapy such as CBT adapted for SAD, antidepressant medicine, and, for winter-pattern SAD, sometimes vitamin D. Starting before the dark season can help prevent or lessen episodes. Medicare covers a yearly depression screening at no cost and outpatient mental health visits at 20% of the Medicare-approved amount after the Part B deductible. Light box and medicine prices: being researched. Light therapy and CBT-SAD worked about equally well in one large trial; CBT-SAD seemed to last longer. Antidepressants take 4–8 weeks to work. Many people need to repeat treatment every winter.
Chiropractic No role in treating SAD. We found little research on chiropractic care for seasonal affective disorder. About $55 to $100 per follow-up visit paying cash, per The Pricer. Medicare covers only spinal adjustments for a subluxation. A broad review of manual therapies for depression called for more research in people with psychiatric diagnoses. Chiropractic care should not replace treatment for SAD.
Acupuncture Needle treatments, sometimes used alongside usual depression care. We found little research on acupuncture for SAD itself. About $90 to $185 per follow-up visit paying cash, per The Pricer. Medicare covers acupuncture only for chronic low back pain. For depression in general, a Cochrane review found low-quality evidence of a possible benefit. It is an add-on, not a substitute for light therapy, talk therapy or medicine.
Herbal medicine St. John’s wort is the herb most often promoted for depression. For SAD, we found little research on herbs or supplements, and a trial of vitamin D showed no benefit over a placebo. Cost estimate being researched. St. John’s wort can weaken or interact dangerously with many medicines, including some antidepressants and birth control pills, and may cause skin reactions after sun exposure. Talk to your provider first.
Massage therapy Relaxing hands-on bodywork for muscle tension and stress. We found little research on massage specifically for SAD. One national chain: about $70 to $90 a month on a 12-month membership, per The Pricer. Medicare does not cover massage therapy. A pleasant, low-risk extra for many people, but it has not been shown to treat SAD. Don’t let it delay care.
MBHA Wellness Coach Daily habits that support treatment: getting outdoors in daylight, regular exercise, a steady sleep routine, staying connected, using your light box consistently, and planning ahead before the dark months arrive. Cost estimate being researched. Supports — never replaces — care from a doctor or therapist. Studies of lifestyle changes in SAD are few and small, so expect small, steady steps rather than a quick fix.

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Conventional medicine (AMA)

NIMH says treatments for SAD fall into four categories that can be used alone or together: light therapy, psychotherapy, antidepressant medicine and vitamin D. Light therapy and vitamin D are treatments for winter-pattern SAD; psychotherapy and antidepressants are used for depression in general, including both patterns. There are no treatments specific to summer-pattern SAD (NIMH). The NHS lists antidepressants, talking therapies such as CBT, and light therapy (NHS). The details of light therapy are in their own section below.

Talk therapy (CBT for SAD)

Cognitive behavioral therapy (CBT) helps people challenge and change unhelpful thoughts and behaviors. The SAD version (CBT-SAD) is typically given in group sessions twice a week for 6 weeks. It replaces negative thoughts about the season with more positive ones, and uses behavioral activation: scheduling pleasant, engaging indoor or outdoor activities to offset the loss of interest people usually feel (NIMH).

  • In a trial of 177 adults with seasonal major depression, 6 weeks of CBT-SAD and 6 weeks of light therapy improved depression comparably, with similar remission rates (about 47% with each by one measure) (Rohan et al., 2015).
  • Followed for two winters, the groups did not differ in the first year. By the second winter, 27.3% of the CBT-SAD group had a recurrence compared with 45.6% of the light therapy group (Rohan et al., 2016), so the effects of CBT seemed to last longer (NIMH).
  • A Cochrane review of psychological therapies to prevent SAD found only one small study of mindfulness-based cognitive therapy (46 people), with very low-quality evidence and no clear difference from usual care (Forneris et al., 2019).

For help finding a therapist, see our depression guide.

Antidepressants, by class

Antidepressants can be effective for SAD alone or with talk therapy. They usually take 4 to 8 weeks to work; sleep, appetite and concentration often improve before mood lifts, and you may need to try several medicines (NIMH). We don’t list doses; your prescriber decides.

  • SSRIs (selective serotonin reuptake inhibitors) are sometimes used because SAD is associated with disturbed serotonin activity (NIMH). The FDA lists nausea, tremor, nervousness, sleep problems, sexual problems, sweating, agitation and tiredness as common side effects of this class, and seizures, abnormal bleeding or bruising and withdrawal symptoms as less common but serious. Other classes include SNRIs, atypical antidepressants, tricyclics and MAOIs (FDA).
  • Bupropion, extended-release (an atypical antidepressant per the FDA list, FDA) is the one FDA-approved for SAD. NIMH says that for many people it can prevent recurrence of seasonal depressive episodes when taken daily from the fall through early spring (NIMH). Its label says to begin in the autumn before symptoms start and continue through the winter (FDA label, Wellbutrin XL).

What the research shows

  • Preventing episodes: a Cochrane review of three trials (1,100 people) found moderate-quality evidence that extended-release bupropion reduces recurrence in people with a history of SAD, with more headaches, insomnia and nausea than placebo. For a group with a 30% yearly recurrence rate, about 8 people would need treatment for 1 additional person to benefit. The reviewers noted that even in a high-risk group, three out of four people will not benefit and will be at risk of side effects. They found no studies of other antidepressants for prevention (Gartlehner et al., 2019).
  • Treating an episode: a 2021 Cochrane update found only three small trials (204 people). One trial of fluoxetine versus placebo leaned toward the medicine but could not rule out no benefit; two trials found fluoxetine and light therapy about equal. The reviewers said the lack of evidence prevented overall conclusions, and up to 25% of participants stopped early because of side effects (Nussbaumer-Streit et al., 2021).

Safety

NIMH advises talking to a provider before starting or stopping any antidepressant (NIMH). The bupropion label carries a boxed warning that antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents and young adults in short-term trials, and says to monitor people of all ages for these thoughts. It lists seizure disorder and a current or past diagnosis of bulimia or anorexia nervosa as reasons not to use it, and tells prescribers to screen for bipolar disorder because it can activate mania or hypomania (FDA label, Wellbutrin XL). See our medication safety guide.

Vitamin D

NIMH says many people with winter-pattern SAD have a vitamin D deficiency, so supplements may help, but studies have produced mixed results: some suggest vitamin D is as effective as light therapy and others find no effect. It can interact with some medicines (NIMH). In a small placebo-controlled trial (34 completed it), vitamin D did not differ from placebo, though the authors called the study underpowered (Frandsen et al., 2014). A 2020 review concluded that no nutrition intervention, including vitamin D or B12, had yet shown efficacy for SAD (Yang et al., 2020). MBHA suggests asking your provider whether your vitamin D level should be checked before you start a supplement.

What it costs

Medicare Part B covers one depression screening a year in a primary care setting at no cost if the provider accepts assignment, plus individual and group psychotherapy and medication management. After the Part B deductible, you pay 20% of the Medicare-approved amount (Medicare.gov). The 988 Lifeline is free (988 Lifeline). Cost estimate for light boxes, therapy outside Medicare and medicines: being researched.

Find a medical doctor in our directory

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Chiropractic

Chiropractic care is not a treatment for SAD. We found little research on chiropractic adjustments for seasonal affective disorder, and nothing in the major government sources on SAD lists it as an option (NIMH, NHS, MedlinePlus).

The broader depression research

A 2026 systematic review of manual therapies for depression — chiropractic manipulation, massage, acupressure and others — screened more than 5,900 articles and included 97 studies. Seventeen of them enrolled people with specific psychiatric diagnoses (including major depressive disorder, adjustment disorder and seasonal affective disorder), and 15 of those 17 reported a significant reduction in depression symptoms. The summary does not report SAD results separately, and the authors concluded that more research is needed in people with psychiatric disorders (Schulz et al., 2026). That is not enough to say chiropractic care helps SAD.

Safety

NCCIH reports that spinal manipulation commonly causes mild-to-moderate temporary side effects such as increased pain, stiffness or headache, usually gone within 24 hours. Serious problems, including strokes involving neck arteries, are very rare, and the risk may be greater in people with underlying health problems. Share your health conditions and medicines with the practitioner (NCCIH). If you have been feeling hopeless or have thoughts of suicide, see a mental health professional or call 988 first. For physical aches that come along with low mood, see our back pain guide.

What it costs

The Pricer lists about $55 to $100 for a self-pay follow-up visit and $90 to $200 for a first appointment (The Pricer). Medicare covers only spinal adjustments by a chiropractor to correct a subluxation (Medicare.gov).

Find a chiropractor in our directory

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Acupuncture

Some people with SAD try acupuncture, hoping it will lift their mood during the dark months. We found little research on acupuncture for SAD specifically: our searches of PubMed turned up general reviews of complementary treatments for depression, but no SAD trial of acupuncture. The best evidence is for depression in general, and it is not strong.

What the depression research shows

A 2018 Cochrane review included 64 studies with 7,104 people with depression, most of them at risk of bias. Compared with no treatment or usual care, acupuncture may moderately reduce depression severity (low-quality evidence). Compared with sham acupuncture the reduction was small, also low quality. How it compares with medicine or psychological therapy is unclear, and most trials did not report adverse events well. The authors called for high-quality trials (Smith et al., 2018). NCCIH notes that in many studies the benefit of acupuncture has been greater against no treatment than against sham acupuncture, which suggests part of the effect may come from expectations and the relationship with the practitioner (NCCIH). A wider overview of complementary therapies for depression judged the evidence for all but two (St. John’s wort and mindfulness-based cognitive therapy) to be of low or very low quality (Haller et al., 2019).

Safety

Relatively few complications have been reported, but when acupuncture is not delivered properly it can cause serious problems, including infections and punctured organs. The FDA requires acupuncture needles to be sterile and single-use (NCCIH). Choose a licensed practitioner. If you take medicines, tell your acupuncturist and your prescriber.

What it costs

The Pricer lists about $90 to $185 per follow-up visit and about $125 to $230 for a first private visit, with community acupuncture around $50 to $90 (The Pricer). Medicare covers acupuncture only for chronic low back pain (Medicare.gov).

Find an acupuncturist in our directory

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Herbal medicine

No herb or supplement has been shown to treat SAD or to take the place of light therapy, talk therapy or medicine, and none is on the lists of recommended options from NIMH or the NHS (NIMH, NHS). We found little research on herbs for SAD specifically. For the people who do try them, the main issue is safety. NCCIH reminds us that supplements may interact with your medicines, and that the products you buy may differ from the ones tested in studies (NCCIH).

St. John’s wort

  • What it is used for. It is most widely promoted for depression. NCCIH says studies indicate it may be helpful for mild or moderate depression, and that it is uncertain whether this is true for severe depression or for periods longer than 12 weeks (NCCIH). Another NCCIH page says St. John’s wort isn’t consistently effective for depression (NCCIH). A 2019 overview found moderate-quality evidence that it worked better than placebo for mild to moderate major depression (Haller et al., 2019). Those studies were not specific to SAD.
  • Dangerous interactions. NCCIH says it has been clearly shown that St. John’s wort can interact in dangerous, sometimes life-threatening ways with a variety of medicines. It can weaken the effects of some antidepressants (including bupropion), birth control pills, transplant medicine, seizure medicines, some heart, HIV and cancer medicines, warfarin and certain statins. Taking it with certain antidepressants or other drugs that affect serotonin may increase serotonin-related side effects, which can be serious (NCCIH).
  • Sun and light. NCCIH says that taken orally in large amounts, or applied to the skin, St. John’s wort might cause severe skin reactions after sun exposure (NCCIH). Because NIMH and the NHS caution that medicines that increase light sensitivity may call for medical supervision of light therapy (NIMH, NHS), MBHA suggests telling your provider before combining St. John’s wort with a light box.
  • Other cautions. It may be unsafe in pregnancy, and side effects can include diarrhea, dizziness and trouble sleeping (NCCIH).

Melatonin and vitamin D

Because melatonin and vitamin D appear in the theories of what causes SAD, people sometimes try them. A Cochrane review of melatonin and agomelatine for preventing SAD found no studies of melatonin at all and one study of agomelatine with indeterminate results, so no conclusion could be drawn (Nussbaumer-Streit et al., 2019). For vitamin D, see the evidence in the Conventional medicine section above: results are mixed (NIMH).

What about diet?

A systematic review found that people with SAD tend to eat larger dinners and more evening snacks and to crave starchy foods, but that neither carbohydrate-loaded meals nor vitamin D or B12 supplements showed benefit for SAD, and no nutrition intervention had demonstrated efficacy (Yang et al., 2020). Eating regular, balanced meals is still sensible, but we found no food or supplement shown to treat SAD.

Never replace a prescribed antidepressant with an herb on your own.

What it costs

Cost estimate being researched.

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Massage therapy

Massage can ease tight muscles and help you relax, and many people find it comforting in a hard season. But we found little research on massage specifically for SAD, and it is not on the lists of treatments from NIMH or the NHS (NIMH, NHS).

What the research shows

The 2026 review of manual therapies for depression (97 studies) found that massage therapy was one of the most studied approaches; 32 of 45 massage studies reported a reduction in depression symptoms. The authors concluded that massage and a few other modalities were consistently associated with improvements, but that more research is needed in people with psychiatric disorders (Schulz et al., 2026). The review does not report SAD on its own, so treat it as a hint rather than proof.

Safety

NCCIH says the risk of harmful effects from massage appears to be low, though there have been rare reports of serious side effects such as a blood clot, nerve injury or bone fracture, some involving vigorous types of massage such as deep tissue. States license massage therapists (45 states and DC) (NCCIH).

What it costs

One national chain’s membership runs about $70 to $90 a month on a 12-month term, according to The Pricer (The Pricer). Medicare does not cover massage therapy (Medicare.gov).

Find a massage therapist in our directory

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MBHA Wellness Coach

An MBHA Wellness Coach can help you build the everyday routines that make the dark months easier and help you stick with the treatments your provider recommends. A coach is not a therapist or doctor and does not diagnose or treat SAD. Coaching works alongside — never instead of — the care described above.

It is worth being honest about the evidence. A 2024 systematic review of lifestyle changes for SAD (nutrition, exercise, time outdoors, sleep, music therapy and others) found only 6 small studies. Everyone, including the comparison groups, improved, the risk of bias was high, and certainty was very low. The authors could not draw a valid conclusion, though results pointed toward possible benefit (Rothenberg et al., 2024). These steps are low-risk and sensible, and the NHS recommends several of them, but they are not a proven treatment on their own.

Get daylight every day

The NHS suggests getting as much natural daylight as you can and trying to go outside during the day, every day (NHS). A coach can help you build a short outdoor walk into your routine.

Move your body

The NHS recommends regular exercise for SAD (NHS). SAD-specific trials are few, but for depression in general a 2026 Cochrane review of 73 trials found exercise may moderately reduce symptoms (low-certainty evidence), with little to no difference compared with talk therapy or medicine in the few trials that compared them, and uncommon side effects (Clegg et al., 2026). Pick something you enjoy and can keep up in winter, indoors or out.

Keep a steady rhythm

The NHS advises trying to go to bed and wake up at the same time every day, and not using electronic devices such as smartphones right before bed (NHS). NIMH lists oversleeping among the winter-pattern symptoms (NIMH), so MBHA suggests a consistent wake time. See our sleep problems guide.

Stay connected and keep doing things

The NHS recommends staying in contact with friends and family and keeping up with your usual activities (NHS). This is the same idea as behavioral activation in CBT-SAD, which schedules pleasant, engaging activities to offset lost interest (NIMH). When you feel like “hibernating,” a coach can help you pick one small, doable plan for the week.

Go easy on alcohol and drugs

The NHS says not to drink too much alcohol or use illegal drugs (NHS).

Make a plan before the season turns

Because SAD is so predictable, NIMH says people with a history might benefit from starting treatment before the fall (or before spring, for summer-pattern SAD), and that a provider can help with the timing (NIMH). A coach can help you make a calendar: when to schedule your provider visit, when to set up the light box, which activities to line up, and who to tell. See “Planning ahead” below.

What it costs

Cost estimate being researched.

Another approach

Light therapy: how it works and how to use it safely

Light therapy has been a mainstay for winter-pattern SAD since the 1980s. The idea is to make up for the weaker natural light of the dark months with bright light. MedlinePlus calls it the main treatment for SAD, while noting that some people do not respond to light alone and may need antidepressants or talk therapy, either alone or combined with light (NIMH, MedlinePlus).

How it is done

NIMH describes sitting in front of a very bright light box (10,000 lux) every day for about 30 to 45 minutes, usually first thing in the morning, from fall to spring. The box is about 20 times brighter than ordinary indoor light and filters out the potentially damaging UV light, which NIMH says makes the treatment safe for most people (NIMH). The NHS gives similar advice: if you buy a light box or SAD lamp, make sure it is bright enough (10,000 lux is standard), UV-free, and carries a recognized safety mark (UKCA or CE in the UK), and follow the manufacturer’s instructions (NHS). In the United States, MBHA suggests asking your provider to help you choose a product and set a schedule, rather than relying on package claims.

What the research shows

  • A 2020 meta-analysis of 19 randomized trials found bright light therapy beat placebo for depression scores and response rates in SAD. The studies were small and varied, with a moderate-to-high risk of bias, so the authors called for larger, higher-quality trials (Pjrek et al., 2020). In the head-to-head trial described above, light therapy and CBT-SAD worked comparably (Rohan et al., 2015).
  • The NHS notes that light therapy is not usually available on the NHS because there is not enough evidence to tell whether it is effective, although many people find that it helps their symptoms (NHS).
  • For preventing SAD, a Cochrane review found only one small study (46 people) with very low-quality evidence, so no firm conclusion could be drawn (Nussbaumer-Streit et al., 2019).

Other devices and colors of light

  • Dawn simulators brighten gradually during the last part of sleep. In a crossover study of 40 people, depression scores fell similarly with bright light and dawn simulation; four people preferred the dawn simulator because bright light caused eyestrain (Danilenko et al., 2015). In a 99-person trial, dawn simulation, a morning bright light and a high-output negative-ion generator each produced meaningful improvement, while a low-output ion generator did less (Terman and Terman, 2006).
  • Blue light. A 2022 meta-analysis of 9 trials (347 people, mostly with seasonal depression) found blue-light therapy was well tolerated, but its efficacy remains unproven (Do et al., 2022). A 2025 network meta-analysis of 17 studies concluded that white light appears to be the best of the visible-light options, with more large studies still needed (Wan et al., 2025).

Safety: eyes, medicines and bipolar disorder

  • Eyes. NIMH says people with certain eye diseases may need alternative treatments or should use light therapy under medical supervision (NIMH); the NHS says to speak to a GP before trying it because it might not be suitable if you have certain eye conditions (NHS). A systematic review of 43 articles found ocular complaints (discomfort and vision problems) in anywhere from 0% to 45% of participants, no evidence of ocular damage except one case report in a person also taking a photosensitizing antidepressant, and concluded that light therapy is safe for the eyes in physically healthy, unmedicated people. The safety in people with existing eye abnormalities or increased photosensitivity warrants further study (Brouwer et al., 2017). See our eyes guide.
  • Medicines that increase sensitivity to light. NIMH and the NHS both caution that people taking certain medicines that increase sensitivity to sunlight or light may need alternative treatments or medical supervision (NIMH, NHS). Ask your pharmacist whether any medicine you take is one of them.
  • Bipolar disorder and mania. SAD is more common in people with bipolar disorder, especially bipolar II (NIMH), and the NHS notes some people feel unusually energetic at the start of spring or summer (NHS). Light therapy can in theory trigger a switch from depression into mania or hypomania, so this deserves a conversation. A historical review of 41 studies of 799 people with bipolar disorder treated with light found 7 who switched into mania and 11 into hypomania. The author concluded that the highest reported switch rate was close to the roughly 4% expected during placebo treatment, but the rate rose to 18.8% among the 16 people with rapid-cycling bipolar disorder (Benedetti, 2018). A meta-analysis of 7 trials (259 people) found no difference in mood switches between active light and control (Lam et al., 2020), though it called the evidence for benefit positive but not conclusive. MBHA suggests that if you have, or might have, bipolar disorder, you use light therapy only with your prescriber’s knowledge and report any unusual energy, racing thoughts or reduced need for sleep right away. See our bipolar guide.

What it costs

Cost estimate being researched.

Another approach

Planning ahead: before the dark season

One of the hopeful things about SAD is that it is predictable. NIMH says people with a history of SAD might benefit from starting treatments before the fall (for winter-pattern SAD) or spring (for summer-pattern SAD) to help prevent or reduce symptoms, and that a provider can help decide on the best option and the best timing. NIMH also says few studies have investigated whether SAD can be prevented (NIMH). The NHS adds that many people need treatment every winter to stop symptoms from coming back (NHS).

What it costs

Cost estimate being researched.

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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