Seasonal and atypical depression

Meet the patient

A 33-year-old theatre nurse books in every April. By May she is sleeping eleven hours, eating toast at midnight, and calling in sick. By October she is running half-marathons. This is her fourth winter like this and her second GP.[8][11]

Her referral says "winter blues, wants a light box." Her mood chart, drawn across two years in your consulting room, says something else: two full major depressive episodes, both autumn-onset, both remitting in spring, and nothing in between.[8][11]

Two axes decide her plan. When does it come (course) and which way do the vegetative signs point (features)? Confuse them and you will treat the wrong thing with the right device.[8][16][17]

References20Show ledgerHide ledger

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2. [2]Lam RW, Levitt AJ, Levitan RD, et al. The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder Am J Psychiatry, 2006.PMID 16648320
3. [3]Modell JG, Rosenthal NE, Harriett AE, et al. Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL Biol Psychiatry, 2005.PMID 16271314
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20. [20]Kim K, Kim J, Jung S, et al. Global prevalence of seasonal affective disorder by latitude: A systematic review and meta-analysis J Affect Disord, 2025.PMID 40614973