Norman E. Rosenthal, M.D.

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Norman E. Rosenthal, M.D.

Norman E. Rosenthal is the world-renowned psychiatrist and bestselling author who first described seasonal affective disorder (SAD) and pioneered the use of light therapy as a treatment during his twenty years at the National Institute of Mental Health.

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August 15, 2023

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As with winter depression, early treatment is often best for summer depression. The exact timing of treatment is often influenced by a person’s history.

Since there are no studies of treatments specifically geared towards those suffering from summer depression, clinicians turn to anecdotes, such as those described below, for what they can teach us.

Treatments for Summer SAD

1.

Cold temperature treatment

Elaine was in her midsixties when she came to the NIMH for help. She had suffered depression symptoms for 45 years and had come to realize that they clustered in the summer. Her only reprieve was her annual vacation in upstate New York, where she swam in the deep, dark, cold water of the Finger Lakes twice or three times a day. After a few days of that self-treatment, her mood lifted, and for the rest of the summer, the depression didn’t return. Subsequent treatment involved staying indoors in her air-conditioned apartment, which improved her mood throughout the summer. 

There is a long history of the use of cold baths for various psychiatric ailments, going all the way back to ancient Greece. Exposing people to cold or warm water was part of inpatient treatment as recently as the early twentieth century. Treatment was not always compassionate, and informed consent was often absent. For example, in nineteenth-century France, the bain de surprise (bath of surprise) was a tub of very cold water into which a person was plunged without warning. The element of surprise (or rather shock) was regarded as an important part of the therapeutic effect. 

Nowadays cryotherapy, in which individuals languish in cold chambers, is being advertised for all manner of maladies, though most (if not all) of them have not been approved by the Food and Drug Administration (FDA). Nevertheless, it would be fascinating to contemplate a study of such cryotherapy for people with summer depression; no doubt it would be easier than a trip to the Finger Lakes.

RELATED READ: 9 Best Cold Plunge Tubs Of 2023 To Promote Stress Resilience & Slow Aging

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Several people I know with summer depression or a combination of depression and agitation have reported feeling better when wearing dark glasses. The most activating part of the light spectrum is in the blue range, and many people use blue-blocking goggles at night to reduce the stimulating effects of blue light when they are trying to wind down and get a good night’s sleep. Wearing such goggles at night has also been found to help reduce manic or hypomanic symptoms in bipolar people,1 which are often fueled by sleep deprivation.

Consider using blue-blocking goggles if you experience summer depression, especially if you feel irritable or agitated. Another way to reduce blue light exposure at night is by installing apps on your computer and mobile phone that filter out blue wavelengths (though often they don’t do as good a job as the goggles). Fun fact: filtering light through blue glass was used in Europe in the nineteenth century for the treatment of mania.

3.

Shifting circadian rhythms

An early theory of the biological underpinning of winter SAD is that circadian rhythms, whose internal programs regulate the timing of all biological functions, somehow go awry during the winter. We know that these rhythms are orchestrated in part by the daily cycle of light and dark. Light may exert its beneficial effects on people with SAD (winter or summer) by resetting the clock to a more favorable position. 

Although this theory remains somewhat controversial, a colleague of mine with a longstanding history of summer SAD has implemented this practice to treat herself successfully for many years. Reasoning that her circadian rhythms might be running late, my colleague walks outdoors each day during the summer at sunrise and gazes at the eastern sky for just seconds. She is convinced that this simple practice has kept her in good spirits throughout the summer for many years.

This is just the observation of a single person, what we call in science “an N of one,” but the source is so credible, the effort involved so trivial, and the result so powerful that I feel obliged to include it here. 

Adapted from Defeating SAD (Seasonal Affective Disorder): A Guide to Health and Happiness Through All Seasons Copyright © 2023 by Norman E. Rosenthal M.D. published by G&D Media. Used with permission.

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