“Erie, Pennsylvania is colder than cold. In Erie, Pennsylvania, there are 330 days of darkness and 35 of sunlight. It’s horrible not to see the sun.” 

p. 35, “From Doctor to Patient”

As detailed in his book “From Doctor to Patient,” author Dr. Diva Nagula’s experience attending medical school in Erie, Pennsylvania aligns with the 1 in 20 American adults that experience seasonal affective disorder.  Seasonal affective disorder, or SAD, is a form of depression that fluctuates with the seasons. Beginning in late fall or early winter, people with SAD begin experiencing typical signs of depression such as sadness, fatigue, hopelessness, anxiety, and/or change in appetite. However, there are more differences between SAD and depression than just the season of onset.  The demographics, symptoms, and treatment of people with SAD are different than those of depression. 

Differences Between SAD and Depression: Who gets SAD?

  • Gender. Women are more likely than men to be diagnosed with both SAD and depression. However, while women are two times more likely than men to be diagnosed with depression (Mayo Clinic, 2019), women are FOUR times as likely as men to experience SAD (American Academy of Family Physicians, 2000). 
  • Age. SAD has a lower average age of onset than depression. The average age of onset for SAD is 23 years old (Dryden-Edwards, 2016). Meanwhile, the average age of onset for depression is 32 years old (Morin, 2019). While depression seems to affect all age groups, prevalence of SAD generally decreases as people become older (American Academy of Family Physicians, 2000).
  • Geographic Location. People that live further from the equator are more likely to be diagnosed with SAD due to more limited daylight hours in the winter (Dryden-Edwards, 2016).

Differences Between SAD and Depression: Symptoms

According to the Mayo Clinic, there are symptoms specific to winter-onset SAD that go beyond regular depression symptoms (2017). These symptoms include the following: 

  • Oversleeping
  • Craving high-carbohydrate foods
  • Gaining weight
  • Heaviness in arms/legs
  • Relationship issues

Differences Between SAD and Depression: Treatment

Similar to treatment for depression, talk therapy and antidepressant medications can be effective in treating SAD. However, people with SAD also respond very well to light therapy. Light therapy involves spending 20+ minutes in front of a light box every day to help offset the decrease in absorption of natural sunlight outside. Additionally, new research shows promise that SAD may be able to be prevented by taking antidepressant medication before the winter months begin (Dryden-Edwards, 2016).

Considering SAD typically affects people most during January and February, it’s especially important to look out for your own and your loved ones’ mental health during this time of year. If you think you or someone you know is experiencing SAD, you can learn more about symptoms, treatment options, and current research here: https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml.


American Academy of Family Physicians. (2000, March 1). Seasonal Affective Disorder. Retrieved January 2, 2020, from https://www.aafp.org/afp/2000/0301/p1531.html.

Dryden-Edwards, R. (2016, October 31). Seasonal Affective Disorder Symptoms and Treatment. Retrieved January 2, 2020, from https://www.medicinenet.com/seasonal_affective_disorder_sad/article.htm#seasonal_affective_disorder_facts.

Mayo Clinic. (2017, October 25). Seasonal Affective Disorder (SAD). Retrieved January 2, 2020, from https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651.

Mayo Clinic. (2019, January 29). Women’s increased risk of depression. Retrieved January 2, 2020, from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20047725.

Morin, A. (2019, September 2). How Many People Are Actually Affected by Depression Every Year? Retrieved January 2, 2020, from https://www.verywellmind.com/depression-statistics-everyone-should-know-4159056.