Light therapy, psychotherapy, and medication are the primary seasonal affective disorder (SAD) treatments. Prozac and Wellbutrin may be the most used antidepressants for SAD.
Feeling lackluster as the seasons change can be a natural response to life transitions or the end of summer fun, but it can also be a sign of seasonal affective disorder (SAD).
Although not the first treatment for SAD, medication is often recommended. However, not all antidepressants may be as effective for SAD symptoms.
SAD is known formally as major depressive disorder with a seasonal pattern. It’s a condition that presents with low mood, gloomy thoughts, and feelings of hopelessness as the seasons change.
Like other mood disorders, symptoms of seasonal affective disorder can range in severity, sometimes involving suicide ideation.
Antidepressants are the go-to medications for seasonal affective disorder.
Among those, selective serotonin reuptake inhibitors (SSRIs) are the first-line SAD medications. They work by blocking the absorption of serotonin into certain nerve cells, which increases the amount of serotonin available in your brain. This, in turn, increases the transit messages of happiness, satisfaction, and calmness.
Common SSRIs for SAD treatment include:
In some cases, your health team may also recommend bupropion, a norepinephrine-dopamine reuptake inhibitor (NDRI).
While SSRIs remain among the preferred options for seasonal affective disorder treatment, bupropion is the only drug FDA-labeled specifically for the treatment of SAD.
Bupropion is also known as:
- Wellbutrin XL
- Forfivo XL
- bupropion hydrochloride
- bupropion hydrobromide
Bupropion is available in tablets in extended release, immediate release, and sustained release forms.
Despite being labeled as a depression treatment, the literature behind bupropion’s effectiveness is limited.
After its FDA approval, a 2013
Since that time, additional review examinations have noted bupropion’s potential, but continue to point out that more research is needed.
Perhaps this is one of the reasons why SSRIs are still more commonly used for the treatment of SAD.
A 2018 systematic review into pharmacotherapy and nutritional seasonal affective disorder treatments identified the SSRI fluoxetine as a proven and effective medication for the condition. The conclusion was reached after reviewing 36 research papers on the subject.
Fluoxetine was again listed as one of the most effective seasonal affective disorder medications in a 2022 review, which also listed the SSRI sertraline and the monoamine oxidase inhibitor, moclobemide. Moclobemide isn’t available in the United States, but it is in Canada, the United Kingdom, and Australia.
Fluoxetine is an SSRI also known as:
- Prozac Weekly
- Sarafem (discontinued)
Fluoxetine is available in capsule, liquid, delayed-release, and tablet forms.
Ultimately, your experience living with SAD is unique to you. Fluoxetine may be one of the most proven medications, but your health team may ask you to try different prescriptions if one isn’t working as expected for your particular case.
The exact causes of SAD are unclear, but experts believe it involves a relationship between sunlight exposure and the secretion of serotonin and melatonin.
Because of the role that sunlight plays in the development of seasonal affective disorder, light therapy is the go-to treatment for the condition.
In addition to light therapy, psychotherapy, complementary therapies, and lifestyle changes may also be recommended.
Light therapy for seasonal affective disorder involves daily exposure to a light box, emitting light at 10,000 lux.
While the light in SAD therapy boxes is significantly brighter than the usual indoor light of a home, harmful wavelengths are filtered out to prevent skin damage.
This form of seasonal affective disorder treatment is often performed in the mornings for 30 to 45 minutes.
Cognitive behavioral therapy (CBT) is the primary form of psychotherapy used to treat SAD.
CBT, a therapeutic approach that aims to help you reassess unhelpful thoughts and behaviors, has been specifically tailored to address seasonal affective disorder (CBT-SAD).
A CBT-SAD therapist may ask you to participate in a process called behavioral activation. This helps you replace negative thoughts about seasonal change with optimistic ones. CBT-SAD can also help you develop new coping mechanisms for when seasons shift.
The light therapy vs. CBT-SAD debate
Light therapy may be the go-to treatment for SAD, but that may not mean it’s the best treatment.
In 2015, a now highly-cited study on CBT-SAD vs. light therapy found CBT-SAD was superior for managing SAD symptoms and spacing out possible recurrence episodes.
The verdict remains mixed, however.
Authors of the 2018 research noted that both CBT-SAD and light therapy led to similar outcomes, but that certain situations may warrant the choice of one over the other.
In 2019, a review into the efficacy of light therapy found limited evidence proving it was effective as a preventative treatment.
In addition to traditional therapies like CBT and medication, other interventions may also help you cope with the symptoms of seasonal affective disorder:
- dawn simulation
- negative air ion treatment
- sleep hygiene
- sunlight exposure
- vitamin D
Dawn simulation is a form of light therapy that involves gradual exposure to increasing light (often through specialty alarm clocks).
In 2015, a small
Negative air ion treatment
Negative air ions are electrically charged air molecules often used for air purification.
In a small, controlled trial evaluation, researchers found exposure to negative air ions — particularly in the morning — significantly improved winter depression symptoms.
Optimal sleep habits, known as sleep hygiene, are one form of self-care that can impact conditions affecting your sleep-wake cycle, like SAD.
Getting a quality night’s sleep can mean:
- following a consistent bedtime routine
- creating a relaxing sleep atmosphere
- controlling sound, light, and temperature in your sleep space
- avoiding stimulating food or drinks before bed
- avoiding blue-light devices before sleep
Even on an overcast day, the sun is making it through the clouds.
While there’s limited research since the 1990s on outdoor exposure for SAD, a 2021 cross-sectional and longitudinal study of more than 400,000 participants in the United Kingdom found daily natural light exposure could boost mood and improve sleep quality.
Vitamin D supplementation
Your body’s natural vitamin D production can be negatively impacted by decreased sunlight exposure. Because vitamin D is considered important to serotonin function, low levels of this vitamin may enhance SAD symptoms.
Seasonal affective disorder medications are often the same SSRIs used for other depressive disorders.
Currently, fluoxetine is the most proven SAD medication, though bupropion is the only drug labeled specifically for the treatment of seasonal affective disorder.