Seasonal Depression in New Jersey: What Treats It After the Clocks Change

Labyrinth Psychiatry Group · Published October 12, 2026 · Clinical review by Dr. Salvatore G. Savatta pending

What seasonal affective disorder is

Seasonal affective disorder, or SAD, is major depression that returns on a seasonal schedule. The National Institute of Mental Health describes symptoms that last about four to five months of the year, and a diagnosis that requires depressive episodes in the same season for at least two consecutive years, more often in that season than at other times. The winter pattern is far more common than the summer one.

Alongside the usual symptoms of depression, the winter pattern has three signatures: oversleeping, overeating with a pull toward carbohydrates and the weight gain that follows, and withdrawing from people, which NIMH describes as feeling like hibernating. NIMH also separates it from the holiday blues. SAD tracks the hours of daylight, not the calendar, which is why the clock change matters more than Thanksgiving.

Why the first week of November hits New Jersey hard

Daylight saving time ends at 2 a.m. on Sunday, November 1, 2026. The day does not get shorter that morning; the light moves. In Cranford, sunset on Saturday, October 31 is 5:56 p.m. On Sunday it is 4:55 p.m. Most people who commute, pick up children, or work a shift that ends at five lose their last hour of daylight overnight. The sun then sets before 5 p.m. every day until about January 20.

Two details in that table matter clinically. The earliest sunset of the year comes on December 7, two weeks before the shortest day, so the darkest evenings arrive in the first week of December, not at the solstice. And the clock change gives back a morning hour: sunrise moves from 7:25 to 6:26 a.m. That morning light is exactly what light therapy imitates, which is one reason the standard advice is to use the box first thing after waking.

Who is most at risk

NIMH’s risk list is specific. SAD occurs much more often in women than in men. It usually begins in young adulthood. It is more common the farther north you live; New Jersey sits between the Alaska-and-New-England end of that scale and the Texas-and-Florida end. It sometimes runs in families, and it is more common in people who already have depression or bipolar disorder, especially bipolar II. People with SAD also tend to have other conditions, among them ADHD, anxiety or panic disorder, and eating disorders.

The bipolar point is the one that changes treatment. If you have ever had a hypomanic or manic episode, both light therapy and antidepressants need extra care, because both can push mood upward. That history belongs in the first conversation, not the third.

What actually treats winter-pattern SAD

Bright light therapy

The box is 10,000 lux, about 20 times brighter than ordinary indoor light, with the ultraviolet filtered out. NIMH’s guidance is 30 to 45 minutes a day, usually first thing in the morning, from fall through spring. In the largest randomized trial, 177 adults with seasonal major depression were assigned to six weeks of either light therapy (10,000 lux, started at 30 minutes each morning and adjusted to response) or CBT-SAD. Depression scores improved significantly and comparably in both groups, with remission in about 47 percent of each on the clinician scale. People with certain eye conditions or on light-sensitizing medication should get medical guidance before starting.

CBT-SAD

Cognitive behavioral therapy adapted for SAD is typically two group sessions a week for six weeks. It works on the thoughts that come with the dark months and schedules activities that are worth getting up for. In the same trial it matched light therapy during the acute episode. In the follow-up two winters later, 27.3 percent of the CBT-SAD group had a recurrence against 45.6 percent of the light-therapy group, and more of the CBT-SAD group were in remission. During the six weeks of treatment the two improved symptoms at a similar pace; the difference was durability, and CBT-SAD lasted longer. Our psychotherapy program runs alongside medication management for exactly this reason.

Medication

Extended-release bupropion is the one antidepressant with an FDA indication for SAD, and the indication is prevention, not rescue. The prescribing information, revised July 2026, says to start it in the autumn before seasonal symptoms begin, at 150 mg once daily, moving to the usual 300 mg target after a week, and to continue through the winter season, then taper in spring. The evidence came from three placebo-controlled trials in adults with a history of major depression with an autumn-winter pattern. SSRIs are also used. NIMH’s reminder applies to all of them: antidepressants usually take four to eight weeks to work, and sleep, appetite and concentration often improve before mood does.

Vitamin D

Studied, and unresolved. NIMH describes the results as mixed: some studies found vitamin D as effective as light therapy, others found no effect. It also interacts with some medications. It goes on the list you bring to your evaluation.

Start in October, not December

NIMH says people with a history of SAD might benefit from starting treatment before the fall. The bupropion label says the same thing in its own words: initiate in the autumn, prior to the onset of symptoms. In New Jersey, the practical deadline is the clock change. If your last two Novembers followed the same script, the appointment to make is this month. If you are reading this in December, it is still worth making; both light therapy and CBT-SAD showed their effect within six weeks.

When “seasonal” is really recurrent major depression that needs more

Some people arrive in October describing winter depression and leave the evaluation with a different picture: episodes that start in the fall but no longer end in the spring, or that have not responded to two or more adequate antidepressant trials. That is treatment-resistant depression, and the seasonal label stops being the useful one.

For those patients the practice has two programs that do not depend on daylight. TMS therapy uses magnetic pulses to stimulate the brain regions involved in depression; NIMH describes it among the brain stimulation therapies used when medication has not worked. SPRAVATO (esketamine) is a nasal spray given in the office under supervision for treatment-resistant depression, per its FDA labeling. Our TMS vs. SPRAVATO page explains how the two differ. Neither is a first step for a first seasonal episode; both are real options when the pattern has outgrown light boxes and a second medication.

How an evaluation at Labyrinth works

Labyrinth Psychiatry Group is an adult psychiatry practice led by Dr. Salvatore G. Savatta at 11 Commerce Drive, Lobby Floor, in Cranford, with telehealth for patients across Union, Middlesex and nearby counties. The first visit is an evaluation: what the last two or three winters looked like, what has been tried, whether there has ever been a high as well as a low, what else is going on (sleep, thyroid, substance use, ADHD). The plan that follows may be light therapy with a check-in, medication management, CBT-SAD, or, when the history calls for it, the TMS or SPRAVATO program. Call 908-336-1187, use the appointment request form, or read what an evaluation includes first. Insurance and access questions are answered on their own page.

Questions people ask in October