The Costly Expense of Turning Back the Clock
November second 2025 marked the dreaded day this year when we spring our clocks an hour back. This change may seem insignificant on paper, but for some, these shorter days and darker nights take a measurable toll on mental health. In Western nations seasonal affective disorder (SAD) has become a common diagnosis, and some cases even have specialised therapies. However, in nations where the negative and ignorant stigma around mental health prevails, these struggles often remain unheard of.
Seasonal affective disorder is a type of depression primarily driven by a change in seasons. It occurs usually around the same dates, and people affected by this disorder tend to feel tired and unmotivated during the winter months.
What Causes SAD?. The main theory is that the shorter days cause a part of the hypothalamus to stop working normally. This causes the overproduction of melatonin (which is a hormone that essentially aids with sleep) and the inhibition of serotonin production (a hormone that impacts mood and appetite), along with disrupting the body's natural circadian rhythm. The following are symptoms of the disorder:
Changes in sleep or appetite or unplanned weight changes; Feelings of irritability, frustration, or restlessness; Persistent sad, anxious, or “empty” mood most of the day; and decreased energy, fatigue, or feeling slowed down (National Institute of Mental Health et al. 25)
It is estimated that millions of Americans are affected by SAD, and it usually develops in early adulthood. It occurs more often in women than in men, and it is common in people already diagnosed with mental health issues such as depression, schizophrenia, bipolar disorder, eating disorders, ADD, and/or ADHD.
What are Treatments of SAD? Treatments for SAD include phototherapy, psychotherapy, and medication. Light therapy focuses on the exposure of very bright light for 30-45 minutes first thing in the morning. This treatment aims to combat the diminished sunlight access in the darker months. The light used is UV safe, however, people with eye diseases or people taking certain medications may show increased sensitivity and need other medications. Psychotherapy focuses on counselling, and its goal is to provide patients with a new outlook and changing habits that contribute to depression. Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that focuses on learning to change unhelpful/negative thoughts and behaviors. Antidepressant medication changes the chemical processes related to stress in the brain. This works best when taken with psychotherapy.
Treatments for mental health issues, including SAD, are far more accessible in Western nations than in developing ones. This is due to two factors, first the negative stigma around seeking mental health guidance, and the second being financial issues. For example, light therapy is inaccessible for lower income communities because of its high cost. Studies show that people with more wealth and education are more likely to actively seek out treatments related to mental health issues. This creates a huge disparity in lower income countries and communities that do not have access to such resources. Healthcare officials in these countries primarily lack adequate training to address these issues, and this is due to a lack of resources and cultural factors. In many cultures, mental health issues are seen as a source of shame, and the risk of social exclusion drives many away from even acknowledging the possibility that they may need help.
Seasonal affective disorder goes far beyond the nostalgic melancholy of winter. It's a condition rooted in biology, yet shaped by access and awareness. While effective treatments exist, they remain out of reach for many. As the days grow shorter, our commitment to equitable mental healthcare must grow stronger, so that no one is left unseen when the sun sets early.
References
Overview - Seasonal affective disorder (SAD). (2021, February 12). nhs.uk. https://www.nhs.uk/mental-health/conditions/seasonal-affective-disorder-sad/overview/
Seasonal affective disorder (SAD). (2021, December 14). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651
Seasonal affective disorder. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder