Hi It's Dr. Rosenthal again, I am the psychiatrist who first described SAD. AMAA!

First, do whatever you can to bring more light into your life. This can mean getting outdoors and walking on a bright winter day, or making one room in your house as bright as possible. If those ordinary steps are not sufficient, consider getting one of the specially made light fixtures designed to deliver alot of light safely in one place.

Thanks! I also know you have written a book about meditation. What are the benefits of Transcendental Meditation and is the research legit?

There is a lot of terrific research about Transcendental Meditation (over 330 peer-reviewed articles by my latest count), which I have detailed in my book Transcendence, which has just come out in paperback

There are lots of benefits. Perhaps the easiest way to see them all at a glance is to check this out

Transcendental Meditation Infographic

Have you ever come across anyone that has the exact opposite symptoms? I've felt for over 20 years that I do. I feel more comfortable at night and in the dark and in cooler weather. Every spring for as long as I can remember taking note of such things, I become more agitated and depressed. But come October, I have tons of energy and enthusiasm. I'm sure it has a lot to do with where I live and the weather and the fact that I have very sensitive skin that is bothered by the sun and heat. People think I'm weird when I say I have "reverse SAD," but I very strongly feel that I do!

This! I absolutely abhor the sun. It literally makes me sick. I have gotten severe sun stroke twice in my life, too. But even aside from that, from as early as I can remember, I have always been at my absolute happiest during fall and winter. I genuinely feel a sense of grief whenever the sun comes out after a storm. The grey/blue light when it is overcast always feels the most warming and cozy to me. When the sun is down or clouds covering the sky I feel like a blossoming flower, as cheesy as that sounds.

Every time SAD came up in my psych classes as a psych major I'd have a hard time understanding it because I truly feel exactly opposite.

You know, I felt the same way as you guys up until a few years ago, when I noticed severe exhaustion setting in as the days became shorter. Probably has something to do with mt existing depression & anxiety, and the medication regimen I'm on. I hope to get a SAD light very soon. But I still prefer the cool weather to stifling heat (west coast of Canada here)!

Acrually, could someone have both summer and winter type SAD, and only feel fairly normal in spring and autumn? [edit: that is, feeling symptoms of both, but maybe not as debilitating as full-blown SAD]

Yes, there are definitely those who have both summer and winter depressions. Incidentally, all of these patterns are fully described in Winter Blues (4th Edition), recently published

See the link in the above reply

Lots of people have the reverse of SAD, just as you do. It's part of us all being wired differently. Here is a blog that I wrote specifically on the topic of summer SAD. I hope you find it useful Summer SAD

I'm afraid I don't really have a question, I just wanted to say that when I studied Psychology at school your studies were my favorite, and I find your AMA's fascinating.

That is terrific to hear; thank you. You know, I did all those studies and wrote those articles, but you rarely get feedback; so this is terrific

[deleted]

My pleasure Kombucha!

So I needed Wikipedia to know what SAD is.

But why would you call it a disorder? Can't somebody just be unhappy about winter because he/she prefers summer, without it actually being a disorder, just an inconvenience?

Unhappy is one thing; but people with SAD are REALLY unhappy, sometimes even disabled

[deleted]

Team up with someone else; having a study buddy can not only make things more enjoyable, but you often find you have complementary skills

I saw on Wikipedia that SAD isn't a disorder in and of itself, but rather a subset of major depression or bipolar. For someone who is in remission for the entirety of spring/summer/fall but who falls back into depression in the winter, does that mean an automatic diagnosis of MDD/SAD?

Wikipedia is contradictory on this point. Initially SAD was categorized as a form of major disorder, but many people who fall short of such a major category nevertheless have a lot of trouble with Winter Blues (a sort of milder SAD), so I don't get too hung up with diagnoses

What distinguishes winter blues from full blown SAD?

It's really a matter of degree. The way I think about it, SAD warrants someone going to the doctor (unless they are already taking lots of good advice); Winter Blues just makes you less energetic or enthusiastic. I don't know about you, but I like to have all the energy and enthusiasm I can muster; so I would treat Winter Blues. Also, a person can suffer Winter Blues one year and SAD the next, depending on weather, stress levels etc.

Thanks for the AMA, Dr. Rosenthal, I love your work. What SAD light for light therapy would you personally recommend as the best?

There are so many good ones; in principle, the light should be White light (fluorescent) Largish (at least 1 foot square) Properly screened for UV (to keep UV out) Then, there are several good companies

How do you feel our political debates are going??

They are very dramatic; I think it's good to see our candidates in action

Are you enlightened?

that's a big word; I think anyone who says he's enlightened probably isn't

Here's a graphic you may enjoyWinter Blues Infographic

love your work Dr. Rosenthal , You are doing amazing work by spreading by bringing the knowledge via your books.

Thank You. You've made my day

Having suffered from SAD for the past 10 years, when winter starts to roll around and the days start to shorten, I can't help but begin to start to look for the depression/symptoms within myself. My question is, do you think that by expecting to begin to feel SAD, it could almost become a self-fulfilling prophecy type of thing? I mean, could I in any way be finding the symptoms because I expect them to surface in winter? I have pondered this but don't know how to unravel the mind-body complexities possibly at play here. Any thoughts?

Yes, Auntbeez. I think it is just the opposite. You anticipate all these experiences because history has taught you that they occur, again and again. However, in this as in many instances, knowledge is power. And knowing there is so much to do yourself to help your SAD should be a comfort. Now, I recommend you get to work implementing all the elements that I recommend in Winter Blues. I know I do!

How does SAD affect those in the UK?

Is missing out on daylight mon-fri enough to cause it even if you get out in the sun at weekends?

I am just back from the UK and can tell you that SAD affects people very badly. Not only are you high in latitude, but there is a lot of cloud cover. I spoke to SADA, the SAD Association of the UK, which is the longest running SAD organization in the world. Unfortunately, sun on the weekend alone will not usually make up for lack of sunlight during the 5 week days.

My SAD hits me really bad in late summer, early fall (as diagnosed by Dr), I have been hospitalized twice in my life, both around the same time, is there a reason why SAD effects some people at different times of the year?

This is a great question. We don't know why different people are sensitive to different seasons, but it's very good to know what your particular season of risk is so that you can take action in advance of it. For example, one of my patients gets depressed every March or April, so we begin treating with antidepressants in February just in time to prevent them from occurring

[deleted]

Yes, I remember at one meeting, a colleague saying to me, "Come over here and let's stand under the lights because I'm getting depressed." They thought it was a joke. I think that if you want to work in new areas with new paradigms, you have to have a thick skin.

Mr. Rosenthal, it's an honour. I work in research on light and health, and by now, there's a lot going on in this field. We're doing our best to get this thing going.

I'm so thrilled that there are young people taking over the work that is so potentially rewarding. I hope you discover wonderful new things -- and have fun doing so

Thanks so much. I really enjoy the field, even though it is a tough thing to study. I am working on my phd right now, and hopefully you'll be able to read about my work next year.

Good luck; we need bright people like you in the field; I hope to see your work published one of these days

[deleted]

Light therapy REALLY works; it still amazes me. I used it both myself and in my practice. But don't depend on individual anecdotes. There are two separate meta-analyses that show that it works. Two companies that I have worked with are Verilux and Sunbox, which produce excellent products -- though they are by no means the only ones. Also, I should say, for the purpose of disclosure, that I have been a consultant to Verilux

Are there any specific medications that are effective in the treatment of SAD?

Several antidepressants have been found to be helpful for SAD: The Prozac family, for example (which includes Zoloft and Celexa and Lexapro) but also Wellbutrin, which can not only help SAD, but also prevent it from occurring if you start the medications early in the autumn

What do you think of comments by some physicians that 'increased meditation with eyes closed can actually trigger depression?'

Would it not be foolish then to prescribe meditation carte blanche to all patients?

I have not seen any cases of meditation triggering depression, though obviously anything is possible. It is foolish to prescribe anything "carte blanche" because everyone is different and people can have idiosyncratic responses to any intervention.

Hi Dr. Rosenthal,

I had the great pleasure of studying with Dr. Fred Travis for a year at MUM (2009-2010). During that time I was able to focus on learning about and experiencing the effects of TM. Later, I was able to review much of that material by reading your fantastic book. I still meditate to this day!

I have two questions:

1. I follow Dr. Travis's publications closely. Do you know of any other researchers whose work I might like to follow, or any other resources I should be aware of?

2. Recently I have been training in Olympic-style Weightlifting. The sport is the only activity I have found which requires a very high level of technical precision, and simultaneously absolute aggression. Our training style requires daily maximum attempts to train the mind/body to coordinate to execute the lifts correctly. I find that during these training sessions, my consciousness falls into a very deep level of silence, and that I can focus this sensation just before my lifts. It's when my mind is in this state that I make my heaviest lifts. Are you aware of any research on higher states of consciousness being triggered by activities other than meditation? I'm really having incredible experiences and I'm wondering if there is any research in this area.

Hi there: You are lucky to have studied with Dr. Travis, an exemplary researcher in the area. I suggest you also follow the work of Dr. Robert Schneider. We need more young researchers to take over from these giants.

Your comments about your weight lifting are fascinating. I believe there are many ways to induce changes in states of consciousness. Each is probably worth studying in its own right. A book by Jonathan Shear outlines several different techniques.

All the best

Thanks so much! Your work is truly inspiring.

Thank You

Do you know of any connection with MS, which is also correlated with northern latitudes? I have MS, and live at 53N in Western Canada. February always sucks for me.

My latest understanding was that MS is associated with VitD deficiency, especially in one's younger years. Most of us northerners need to take supplementary Vit D. I know of no evidence that light therapy will help -- unless you have some SAD too (which you may have, given your comments on February)

I've read about how the lack of sun triggers some chemical reactions in our brain, therefore, some people get sad or depressed. And I've felt it! My reaction (after a while) was:"Fuck this shit! I'm gonna run 5 miles", which I did and I think the endorphines being produced by a aerobic workout helped me out. Do you find any benefit on working out during this time? Because It's when my body tells me more to run and do stuff, despite the darkness and cold.

Exercise can definitely help -- though I'm not sure if swearing does -- I like combining exercise with extra light -- so I walk in the mornings even in the winter time or, if the weather is TOO awful, do my elliptical in front of the light box. Good luck this winter!

I've read you've said meditation can help with SAD. How does that work?

Part of why people get SAD is because of stress; meditation, by decreasing stress, can be enormously helpful for people with SAD

I live in Washington State, is this where SAD was discovered?

No, it was discovered at the National Institute of Mental Health in Bethesda, Maryland

Hi Dr. Rosenthal! Its so great to have psychology researchers on Reddit. Are there any neurological patterns associated with SAD? Is SAD diagnosed co-morbidly with any disorder(s) more often? If so, do you have any theories as to why this is?

Hi there: No clear neurological patterns, though there are lots of biological findings (like evidence of low brain serotonin, or lack of sensitivity to environmental light). SAD can be comorbid with almost any condition because seasonality appears to be a dimension of human behavior.

It has been said that SAD can strip devil fruits from the user. Another theory is that SAD is vital in the production of man made devil fruits, such as the one that Momonosuke consumed. Can you comment on the veracity of either of these theories?

I know little about devil fruits, unfortunately, as they sound intriguing.

[deleted]

I must disagree with you here. It is NOT a futile effort. I have had many patients with severe bipolar disorder who have ended up leading very rich, happy and productive lives. It take a good collaboration between the patient and a good doctor -- and supportive friends and family can make a crucial difference.

SAD makes sense when Winter is related to Depressive episodes - but can you shed some light on the inverse?

That is - How is the summer related to depressive episodes?

Great question, but no good answer. Too much heat OR two much light OR both have been suggested. So far we haven't found a good treatment (like cold therapy or dark therapy) that works as well as light therapy so we have to resort to conventional treatments like antidepressants.

The reason for SAD is the fact that the sun triggers serotonin production, correct?

That is one theory -- and a good one. Probably there are several reasons.

No, its because people get laid more in summer. not freezing = more likely to go out. more likely to go out = more likely to get laid. Durrrr.

There is actually some evidence to back up this theory

Do happen to have a son or male relative that is a substitute teacher in Hopkinton, Massachusetts?

No, I don't; at least, none that I am aware of

As someone who is interested in getting into psychology research, even as just a full time lit reviewer or something, what advice would you have? What books or texts would you recommend I read? I'm in year two of my psych degree and, well it turns out there's a lot to learn and a lot of specialities. I can't imagine ever having access to someone like you to ask this question again.

So in short, what should the budding psychologist read or know?

You know, a budding researcher should follow his or her instincts. See what intrigues you; what fascinates you. Now, with the whole web at your disposal, find out what subjects you want to know more about, whose writings you enjoy. Once you locate an area of interest, find a good mentor, think up a question or two you wish to pursue and you're on your way.

Is it possible to develop SAD in a more temperate climate, like the Southwest? Is it only linked to the shortening of the days or is snow a factor?

SAD can occur anywhere when there is not enough light. For example, Hawaii. In Hawaii, the hotels and resorts are in the sunny parts, whereas the locals often live in the shadows of mountains. My colleagues in HI talk about having people go to the sunny parts just to treat their SAD

thoughts on www.thelastpsychiatrist.com? He's been deconstructing psychological studies showing why they're poorly designed and what the actual purpose behind political policy on psychiatry is for the past 6 years.

I don't know much about this guy, but I tend to shy away from apocalyptic points of view, being basically an optimist and believing that we can make the world a better place by many means, including psychiatry

More suicides occur in Seattle than most places. Most people think its because of the weather, the dreariness. Any scientific thoughts or studies you've conducted to this?

I actually had not heard of the increased risk of suicide in Seattle. Are you sure that's correct? In general, there isn't a clear correlation between the amount of darkness in a place and the suicide statistics -- though it certainly seems to correspond to the level of misery (however you measure that)