A line drawing of a sad woman next to a bare tree

Is it Seasonal Depression—or the ‘Winter Blues’?

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A Weill Cornell Medicine psychologist offers insights into the challenges that some people face during the dark, cold months

By Beth Saulnier

With the depths of winter upon much of the U.S. and beyond, Cornellians tapped a psychologist for insight into the season’s potential effects on mental health. Specializing in adult psychotherapy, Dr. Nicole Butler is an instructor of psychology in psychiatry at Weill Cornell Medicine and an assistant attending psychologist at NewYork-Presbyterian/Weill Cornell.

Could you define seasonal depression?

In the Diagnostic and Statistical Manual of Mental Disorders, it’s defined as a major depressive disorder with a seasonal pattern.

Dr. Nicole Butler

So essentially, what that means is it has its onset in fall and winter, and then it remits in spring and summer. For a diagnosis, someone would have to have this pattern for two years.

What are the symptoms?

The criteria for major depression include: feeling down or sad most of the day, nearly every day; having less interest or pleasure in things you used to enjoy; having low energy; feeling fatigued or sluggish; having problems with sleep; overeating or gaining weight; having difficulty concentrating; feeling hopeless or worthless; and having thoughts of not wanting to live, or suicidal ideation.

How common is it?

The prevalence depends on where you live; people farther away from the equator experience it at higher rates. The estimates are that in North America, it ranges between 2% and 9% of the population; in Europe, 1% to 3%; and in Asia, up to 1%.

What causes seasonal depression?

No one knows, but researchers posit three factors. The first is circadian rhythm; reduced sunlight in fall and winter may disrupt our internal clock and lead to feelings of depression. The second is serotonin, the brain chemical that affects mood; reduced sunlight can cause a drop that could also trigger depression. And third is that the change of seasons can disrupt melatonin levels, which can play a role in sleep patterns and mood.

The sun peeking through the War Memorial on a snowy day
Winter’s reduced levels of sunlight may play a role in seasonal depression. (Ryan Young / Cornell University)

In addition to location, are certain types of people more susceptible?

Yes, research shows that seasonal depression more commonly impacts young adults—between 18 and 30—and it affects women more than men.

How does one know if they have seasonal depression—or they just hate winter?

There’s something we call the “winter blues,” which researchers have found about 10% to 20% of people in the U.S. report experiencing. This is milder depression and doesn’t meet the diagnostic criteria for a major depressive episode.

If I know I’m prone to feeling depressed in the winter, how can I prevent it?

Because it’s seasonal, one thing that’s helpful is you can anticipate it and take precautions. A main treatment for seasonal depression is cognitive behavioral therapy, and a form of that is “behavioral activation”—scheduling activities into your daily life that you find pleasurable, and over which you have a sense of mastery. So book up your schedule, and plan those activities during the winter months.

Because it’s seasonal, one thing that’s helpful is you can anticipate it and take precautions.

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What about exercise?

Exercise, healthy eating, and maintaining a consistent sleep-and-wake cycle are things we encourage people to do year-round, because they can help keep stress levels lower. As we saw during the pandemic, people can get creative with their at-home workouts. But we also encourage getting outside, going on walks, and getting some vitamin D, which often decreases in the winter.

Some people recommend using a “light box”; what is it, and how can it help?

This is a device you use at specific intervals during the day; it produces light that tricks your body into thinking it’s the sun. There’s research showing it can be helpful for people prone to seasonal depression.

You should speak to your healthcare provider first—and make sure that your light doesn’t have the full UV spectrum, which can be dangerous. Don’t look at the box directly, but be in the room with it with your eyes open.

A student cross-country skiing on Libe Slope, above the War Memorial
Getting outside for some exercise can help improve your mood. (Jason Koski / Cornell University)

And what about travel—getting away to a sunny place for a week or so?

I love that question. Travel can be helpful in the same way as behavioral activation: it gets people out and doing activities. It gives them something to look forward to and to plan. Is it a long-term fix? Probably not, but it can certainly improve your mood.

What role can medication play?

It can be really helpful for people with depression, including seasonal depression. You should contact your physician or seek help from a psychiatrist.

These days, it can be challenging to find a mental health provider. What advice do you have?

I’d start with your insurance company’s website and see which providers are listed. If you can’t get in the door, ask your primary care physician for a referral.

And although I don’t encourage the idea of primary care physicians providing psychiatric medications without the oversight of a mental health professional, it can be a short-term fix. Another possibility is that oftentimes, universities and hospitals will have some sort of low-fee or sliding-scale clinic.

Lastly, are there any misconceptions about seasonal depression that you’d like to address?

With mental health issues in general, people are self-diagnosing and over-diagnosing disorders in a slang way. If someone’s having difficulty focusing, they might say, “I’m so ADD”—or, about a friend who’s having a mood swing, saying, “They’re so bipolar.”

The same can go for seasonal depression. There is a diagnosis with specific criteria for it, versus the “winter blues.” But if you think you’re experiencing seasonal depression, definitely consult a healthcare provider. The whole purpose of having diagnoses is so we know how best to treat someone.

If you or someone you know are having thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline.

(Top: Illustration by Cornell University; Butler portrait provided.)

Published February 15, 2023


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