Winter Depression in Southeast Idaho: Seasonal Affective Disorder and When TMS Can Help

Quick answer: Seasonal affective disorder (SAD) is major depression that returns at the same time each year, usually in fall and winter, and lifts in spring. Light therapy, therapy, and antidepressants are first-line treatments. Because SAD is a form of major depressive disorder, NeuroStar TMS, which is FDA-cleared for major depression, can be an option when winter depression keeps coming back or medications have not been enough. Roth Family Medicine & Mental Health offers evaluations in Pocatello and by telehealth across Idaho and Utah.

By late October in Pocatello, the light is already changing. By the winter solstice, Southeast Idaho gets only about nine hours of daylight, the sun comes up around 8 a.m., and it is dark before many people leave work. Add cold weather, inversions that trap gray air in the valleys, and fewer reasons to get outside, and it is easy to see why so many people here feel their mood slide as the year winds down.

For some, that slide is more than the "winter blues." It is a recurring depression with a clear seasonal pattern, and it is very treatable.

Seasonal affective disorder is not a separate illness from depression. In medical terms, it is major depressive disorder with a seasonal pattern: depressive episodes that start and end around the same time each year, most often beginning in fall or early winter and easing in spring, for at least two years in a row.

Researchers believe shorter days affect the body clock (circadian rhythm), melatonin, and serotonin signaling. People who live farther from the equator, people with a family history of depression, and people who already live with depression or bipolar disorder are more likely to notice seasonal changes.

Winter-pattern SAD often looks a little different from other depression. Common signs include:

• Low mood most of the day, nearly every day, during the darker months
• Sleeping much more than usual and still feeling tired
• Strong cravings for carbohydrates and weight gain
• Pulling away from friends, family, and activities, almost like hibernating
• Trouble concentrating and getting through the workday
• Feeling hopeless or worthless

If these symptoms return every fall and fade every spring, that pattern is worth bringing to a clinician. If you are having thoughts of suicide or self-harm, call or text 988 (Suicide & Crisis Lifeline) right away, or call 911.

The good news is that SAD responds well to treatment, and many people use more than one approach.

Light therapy. Sitting near a 10,000 lux light box for about 20 to 30 minutes each morning is one of the best-studied treatments for winter depression. Timing and eye safety matter, so it is worth reviewing with a clinician first, especially if you have bipolar disorder or an eye condition.

Psychotherapy. Cognitive behavioral therapy adapted for SAD helps people challenge winter-related thinking patterns and plan activities that protect mood through the dark months.

Medication. Antidepressants can help, and some people start a medication before their usual seasonal onset to prevent an episode. Medication decisions should always be made with your prescriber, and you should not stop or change a medication on your own.

Daily habits. Morning outdoor light (even on cloudy days), regular exercise, and a steady sleep schedule all support mood. Our article on vitamin D and depression in Idaho covers when testing vitamin D levels makes sense.

Because seasonal affective disorder is a form of major depressive disorder, transcranial magnetic stimulation is a treatment option for some people with winter depression. NeuroStar TMS is FDA-cleared for major depression in adults. It uses focused magnetic pulses to stimulate an area of the brain involved in mood regulation. There is no anesthesia, no sedation, and no systemic medication, and you can drive yourself home after each session.

TMS may be worth considering if:

• Your winter depression comes back year after year despite light therapy or other changes
• You have tried antidepressants without enough relief, or side effects made them hard to continue
• You prefer a non-medication option, or want to add one to your current care
• Your depression also lingers outside the winter months

A standard TMS course is five sessions a week for several weeks, so timing matters. Starting an evaluation in the fall can make it possible to complete treatment while the days are at their shortest. You can learn more in our guide on what to expect during TMS therapy, and if your depression has not responded to two or more medications, read what treatment-resistant depression means.

TMS is not right for everyone. People with certain metal implants in or near the head, or a history of seizures, may not be candidates, and a full evaluation comes first.

No. The winter blues are a mild dip in energy or mood that does not get in the way of daily life. Seasonal affective disorder is a form of major depression that returns at the same time each year and affects work, relationships, and daily functioning.

Many people do best when they start before or early in their usual season. If your symptoms tend to begin in October or November, now is a good time to talk with a clinician about a plan for this winter.

Seasonal affective disorder is major depressive disorder with a seasonal pattern, and NeuroStar TMS is FDA-cleared for major depressive disorder in adults. Whether TMS is a good fit depends on your history, past treatments, and a full evaluation.

Light therapy helps many people, but it is not right for everyone and it may not be enough on its own. It is often combined with therapy, medication, or other treatments, and it should be used under a clinician's guidance.

If winter tends to pull you under, you do not have to wait for spring to feel better. At Roth Family Medicine & Mental Health in Pocatello, we evaluate seasonal and year-round depression, build a plan that fits your life, and offer NeuroStar TMS for adults with major depression. Telehealth evaluations are available across Idaho and Utah.

Call (208) 904-4705 to schedule your free TMS candidacy call, or visit rothfamilymed.com to request an appointment.