🌤️ How to Thrive in Winter: Evidence-Backed Ways to Improve Seasonal Depression

drjoelasek
Jan 25
11 min read

Updated: Jan 26

As I sit here on the coldest day of the season so far and reflect on many of the people I know who struggle with winter’s impact, I happened to come across this article in the New York Times about thriving this time of year. After taking my dog for a walk and enjoying a bit of friluftsliv (more on that below), I am now sitting in front of a sunny window enjoying a warm cup of coffee and a bit of hygge (more on that below as well) to write about the scientific evidence and wisdom traditions that provide us with what we need to not only beat back the winter blues but to embrace all that winter has to offer.

Many if not most people experience an annual lull in energy, increase in appetite and/or desire to “hibernate” in northern latitudes this time of year. Up to 10% of people experience a more significant level of depression called Seasonal Affective Disorder (SAD), which is a type of major depression that follows a seasonal pattern. Research suggests it involves changes in brain chemicals such as serotonin and melatonin, which are influenced by sunlight and circadian rhythms. (National Institute of Mental Health). In this blog post, I’ll walk through a number of approaches that can make a meaningful difference in how we meet the season.

☀️ Bright Light Therapy

Why it works: Reduced amount and intensity of sunlight in fall and winter leads to disrupted circadian rhythms and altered mood-related brain chemistry. (PubMed) Bright light therapy mimics outdoor light to counteract these changes. (National Institute of Mental Health)

What the research says:

Several randomized controlled trials show light therapy significantly improves depression symptoms compared to placebo. After ~3–4 weeks, about 60% or more of people respond with marked mood improvement. (JAMA Network)
A meta-analysis of 19 trials reported that light therapy consistently outperformed placebo with moderate effect sizes on depression scales. (PubMed)
Though preventive data are mixed due to limited studies, many clinicians use light therapy early in fall in people with a history of SAD. (Cochrane)

Best practices:

Use a 10,000-lux light box as recommended by your health care provider, ideally within the first hour after waking (though other times of day can also be utilized). (NCCIH)
Daily exposure for at least 20–40 minutes is common.
While everyone is different, for those of us who begin to experience seasonal depression as early as late August or early September, starting light therapy early helps stave off the worst of seasonal depressive symptoms.

Caveats:

I find that people often use light boxes incorrectly: placing it in an incorrect location, too far away from their eyes, using it at the wrong time of day, for too short a time or too long a time. Additionally, light therapy isn’t recommended alone for people with undetected bipolar disorder, as it may trigger mania. For these reasons, I recommend that you always consult your health care provider before starting light therapy. (NCCIH)

💭 Psychotherapy — Especially CBT Tailored for SAD

Cognitive Behavioral Therapy (CBT) is a well-studied form of talk therapy that helps people recognize unhelpful thoughts and build healthy habit. My colleague Kelly Rohan and her team at University of Vermont’s Department of Psychiatry have adapted CBT specifically for SAD (CBT-SAD) and shown that it can be as effective as the best evidence-based treatments not only during acute episodes but actually may reduce recurrence better than light therapy alone in follow-up seasons. (NCCIH)

What the evidence shows:

Randomized trial comparing CBT-SAD and light therapy for acute seasonal depression showing comparable improvement. (PubMed)
Follow-up study finding CBT-SAD may reduce recurrence more than light therapy over multiple winters. (PubMed)

What Is CBT-SAD?

Cognitive Behavioral Therapy for Seasonal Affective Disorder (CBT-SAD) is a tailored adaptation of standard CBT, designed to address the unique psychological patterns that recur with seasonal depression. While traditional CBT targets depression broadly, CBT-SAD focuses on:

Season-linked negative thinking
Behavioral withdrawal during winter
Anticipatory dread of winter
Reduced engagement in rewarding activities

CBT-SAD is typically delivered over 6–12 structured sessions, either individually or in groups but any of us can incorporate these principles into our lives.

Core Components of CBT-SAD

🧠 1. Cognitive Restructuring of Winter-Related Beliefs

People with SAD often develop automatic thoughts such as:

“Winter ruins my life.”
“I can’t function when it’s dark.”
“Nothing enjoyable happens in winter.”

CBT-SAD helps individuals:

Identify these season-specific cognitive distortions
Evaluate their accuracy
Replace them with more balanced, flexible thoughts like
- “I can find things to do in winter that I enjoy/like….”
- “While I have less energy, I can make the most of the energy I do have.”
- “While I don’t do as many things outside in the winter as I do other times of year, I can do some things and use this time of year to do more cozy indoor things as well.”
Research suggests that changing these entrenched winter narratives may be one reason CBT-SAD shows longer-lasting effects than light therapy alone.

🚶‍♀️ 2. Behavioral Activation Tailored to Winter

Scheduling enjoyable and meaningful activities despite low motivation
Adapting activities to winter conditions rather than eliminating them
Building routines that promote consistency and engagement

This aligns closely with behavioral activation research, which shows that action often precedes motivation, not the other way around.

🌦️ 3. Coping With Seasonal Stressors

CBT-SAD addresses practical winter challenges that can worsen mood, such as:

Reduced daylight
Cold weather
Disrupted routines
Social isolation

Therapists work with clients to develop specific coping strategies (e.g., morning routines, outdoor plans, social scheduling) rather than relying on willpower alone.

🔁 4. Relapse Prevention and “Winter Preparedness”

One of the most distinctive features of CBT-SAD is its focus on future seasons and preparing for seasonal changes.

People learn to:

Recognize early warning signs of seasonal mood decline and get started on adaptive skills early
Create a personalized winter wellness plan
Apply cognitive and behavioral skills proactively each year

How CBT-SAD Compares With Light Therapy

Aspect	Light Therapy	CBT-SAD
Speed of symptom relief	Often rapid	Gradual
Targets biological factors	✔️	Indirectly
Targets thought patterns	❌	✔️
Skills learned for future winters	❌	✔️
Long-term relapse prevention	Moderate	Stronger

Because of these complimentary differences, I always recommend combining CBT-SAD with light therapy for optimal short- and long-term outcomes.

🏃‍♂️ 3. Regular Physical Activity

Physical activity releases “feel-good” chemicals such as endorphins and supports sleep and energy regulation.

What the science says:

Regular exercise is consistently recommended as an adjunct to standard SAD treatments. (Mayo Clinic)
Outdoor exercise has the added benefit of natural light exposure, amplifying mood support. (Scripps.org)

Practical Tips:

Aim for 30 minutes most days.
Even walks or gentle movement help regulate sleep and mood.

🛌 4. Maintain Consistent Sleep Patterns

Disrupted circadian rhythms play a big role in seasonal depression.

What the science says:

Setting regular sleep and wake times helps regulate melatonin cycles and can improve mood and energy. (Mayo Clinic)
Sleep schedule may be modified in winter allowing for a bit more time in bed, but generally we should be cautious about dramatic changes in sleep schedule such as going to bed too early or sleeping in too late. We should also be cautious about big changes in sleep schedule throughout the week. Your health care provider can help you set a sleep schedule as this tends to be very individualized.
Spending time outdoors early in the day also supports a healthier sleep-wake rhythm.

🍽️ 5. Diet & Nutrients

A nutritious diet supports overall mental health, though evidence for specific supplements is mixed.

What the science says:

People with SAD often have lower vitamin D levels, but high-quality trials show mixed results for supplementation alone. (NCCIH) Given that excessive Vitamin D supplementation may not be helpful or cause calcification of arteries, it may not make sense to supplement with high doses of vitamin D or supplement with Vitamin D if you are not deficient. (PMC) This is why I recommend consulting with a healthcare provider before supplementing with Vitamin D.
Omega-3 fatty acids and a balanced diet rich in whole foods may support general mood regulation, though SAD-specific evidence is limited. (Verywell Health)

Practical tips:

Focus on whole foods: fruits, vegetables, whole grains, lean (ideally plant based) proteins
Get vitamin D levels tested before supplementing
Consult with your clinician because supplements can interact with medications.

🧠 6. Social Connection & Enjoyable Activities

Maintaining relationships and scheduling fun activities can boost mood and counter isolation — especially important as daylight decreases.

While specific clinical trials are limited for SAD, broader research links social support and enjoyable engagement with better mental health outcomes.

💊 7. Medication — When Symptoms Are Severe

When SAD symptoms significantly impair daily life, antidepressants (like bupropion or SSRIs) can be effective. (Mayo Clinic)

Medication decisions should always be personalized and discussed with a healthcare provider.

🧘‍♂️ 8. Other Complementary Approaches

Melatonin: Limited evidence for sleep improvement; not clearly effective for mood alone. (NCCIH)
St. John’s Wort: Small, preliminary evidence but possible interactions with medicine. (NCCIH)
Dawn simulators and thoughtful indoor lighting are gaining attention for circadian support in. (AP News). I personally have seen dawn simulators as being quite helpful for those who have challenges getting up and out of bed in the morning.

🚭 9. Abstaining from substances — can improve mood, often quickly and dramatically

Last year, I wrote this blog post on the salutary benefits of abstaining from alcohol and cannabis on all aspects of health including mood, anxiety and all body systems.

Hygge: A Research-Informed Lifestyle Approach to Support Seasonal Well-Being

What Is Hygge?

Hygge (pronounced hoo-gah) is a Danish concept centered on coziness, comfort, connection, and intentional enjoyment of simple pleasures. It often includes warm lighting, shared meals, relaxed social time, comforting routines, and creating environments that feel safe and nurturing.

While hygge is not a clinical treatment for Seasonal Affective Disorder (SAD), emerging research and related psychological literature suggest that its core elements overlap with well-established mental health protective factors, making it a useful complementary strategy.

Why Hygge May Help With Seasonal Depression

🧠 1. Hygge Encourages Mindfulness and Reduces Rumination

Hygge emphasizes being present and savoring small, pleasant sensory experiences (warm drinks, candlelight, soft textures). This closely aligns with mindfulness, which has strong evidence for reducing rumination and emotional distress in depression. Mindfulness-based practices are known to support emotional regulation, particularly during periods of increased stress and low mood.

🤝 2. Social Connection as a Protective Factor

Hygge strongly values low-pressure, meaningful social interaction — shared meals, quiet conversation, or group activities without performance demands. Decades of mental health research show that social support buffers against depression, loneliness, and stress, all of which tend to worsen during winter months when isolation increases.

Importantly, hygge prioritizes quality over quantity of social contact, which may feel more achievable for people experiencing low energy or motivation during SAD episodes.

🌿 3. Reduced Stress and Nervous System Regulation

Environmental psychology research suggests that warm lighting, calm environments, and feelings of safety can reduce physiological stress responses. Hygge-style environments may help down-regulate the nervous system, supporting relaxation and emotional balance — a useful c counterweight to the stress and fatigue often reported in seasonal depression.

🧪 4. Emerging Research on Hygge and Well-Being

Although large clinical trials on hygge and SAD are limited, qualitative and observational research indicates that hygge practices are associated with:

Increased feelings of peace and emotional comfort
Improved coping during periods of stress or illness
Greater life satisfaction and emotional resilience

These findings suggest hygge may enhance subjective well-being, even when underlying stressors such as long, dark winters remain.

Hygge and SAD: How It Fits with Evidence-Based Treatments

Hygge works best as a supportive lifestyle layer that reinforces other treatments by:

Making winter feel more emotionally tolerable
Encouraging routine, connection, and enjoyment
Reducing avoidance and isolation
Supporting stress regulation and emotional comfort

In this way, hygge complements both biological and psychological approaches to seasonal depression.

Practical Hygge Habits to Support Winter Mood

You can incorporate hygge in small, accessible ways:

Create cozy spaces: soft lighting, blankets, warm colors
Mindful rituals: tea or coffee breaks, reading, cooking warm, nutritious meals, journaling
Gentle social rituals: shared dinners, board games, quiet conversations
Sensory comfort: candles, music, warmth, familiar routines
Seasonal acceptance: reframing winter as a slower, restorative season rather than something to “get through”

These habits encourage pleasure, connection, and presence, which are all linked to better emotional health.

Friluftsliv: Using Nature and Daylight to Support Seasonal Mood

What Is Friluftsliv?

Friluftsliv (pronounced free-loofts-liv) is a Scandinavian philosophy that translates roughly to “open-air living.” It emphasizes regular, meaningful time spent outdoors — in nature — regardless of weather or season. Unlike structured exercise programs, friluftsliv focuses on presence, enjoyment, and connection with the natural environment, rather than performance or intensity.

In Nordic countries with long, dark winters, friluftsliv is considered a cornerstone of mental resilience and seasonal well-being.

How Friluftsliv Can Help Seasonal Depression

☀️ 1. Increased Natural Light Exposure

Reduced daylight is a key biological driver of Seasonal Affective Disorder (SAD). Spending time outdoors — even on cloudy winter days — provides significantly more light exposure than indoor environments, supporting circadian rhythm regulation and serotonin activity.

Research consistently shows that daytime light exposure, especially earlier in the day, improves sleep timing, energy levels, and mood — mechanisms directly relevant to SAD. Friluftsliv encourages daily daylight contact, complementing structured light therapy.

🧠 2. Nature Exposure Improves Mood and Reduces Stress

As noted in a previous blog post, a large body of environmental psychology and neuroscience research shows that time spent in nature is associated with improvements in wellbeing including:

Reduced stress and cortisol levels
Improved attention, cognition, mood and emotional regulation
Reduced rumination and negative thought patterns

Nature exposure has been shown to activate brain networks associated with calm attention and emotional restoration — processes often disrupted in depression.

For people with SAD, whose energy and motivation may be low, friluftsliv’s low-pressure, non-competitive approach can be especially useful.

🚶‍♀️ 3. Gentle Physical Activity Without Performance Pressure

Friluftsliv often involves walking, hiking, sitting outdoors, or light movement — forms of low-to-moderate physical activity that are strongly linked to improved depressive symptoms.

Unlike traditional exercise prescriptions, friluftsliv:

Removes emphasis on intensity or goals
Encourages consistency over perfection
Makes movement feel purposeful and restorative

This aligns well with research on behavioral activation, mentioned above.

🧘‍♂️ 4. Mindfulness, Presence, and Emotional Regulation

Friluftsliv encourages slowing down, observing nature, and being present — experiences closely related to mindfulness, which has robust evidence for reducing depressive symptoms and emotional reactivity.

By engaging the senses (cold air, forest smells, changing light), friluftsliv helps shift attention away from internal rumination toward mindful, external experience.

Friluftsliv and SAD: Research Perspective

While friluftsliv itself has not been extensively studied as a standalone clinical treatment for SAD, its core components are well supported by research:

Natural light exposure → circadian and mood regulation
Physical activity → antidepressant effects
Nature exposure → reduced stress and rumination
Routine outdoor engagement → improved sleep and energy

Taken together, these mechanisms suggest friluftsliv is a lifestyle-based complement to evidence-based SAD treatments.

Practical Friluftsliv Habits for Winter

You can practice friluftsliv without living near forests or mountains:

Daily outdoor time: even 10–30 minutes in daylight
Nature walks: parks, trails, beaches, or tree-lined streets
Weather-appropriate mindset: dressing for comfort rather than avoiding cold
Outdoor pauses: sitting with a warm drink, observing surroundings
Seasonal reframing: experiencing winter as something to engage with, not endure

Importantly, friluftsliv emphasizes “there’s no bad weather, only inadequate clothing,” promoting adaptability rather than avoidance.

🌍 Friluftsliv and Hygge: A Complementary Dance

Hygge and friluftsliv address seasonal depression from complementary angles:

Hygge → indoor comfort, warmth, social connection, emotional safety
Friluftsliv → outdoor exposure, daylight, movement, nature connection

Together, they support both activation and restoration, helping people balance energy, mood, and resilience during darker months.

🧩 Summary: A Practical Winter Toolkit

Strategy	Evidence Level	Notes
Bright Light Therapy	Strong	First-line for winter blues/depression
CBT-SAD	Strong	Particularly durable
Abstaining from alcohol/cannabis	Strong	Improvements can occur in days/weeks
Exercise	Moderate	Supports wellbeing, overall health, mood and sleep
Sleep hygiene/routine	Moderate	Helps circadian alignment
Diet optimization, hygge, friluftsliv	Supportive	Good overall health and wellbeing
Vitamin D	Mixed	Consider testing levels
Antidepressants	Strong	Under medical advice
Complementary (melatonin, herbs)	Limited	Use cautiously

🧠 Final Thoughts

Like most wellness approaches, addressing winter blues/seasonal depression responds best to a multi-layered approach:

Biological: light therapy, sleep regulation, medication when needed
Psychological: CBT-SAD, behavioral activation, mindfulness
Lifestyle: exercise, nutrition, social connection
Environmental & cultural supports:
- Hygge for comfort, connection, and emotional warmth
- Friluftsliv for daylight, nature, movement, and presence

Winter blues and SAD are biologically based changes in our mood, physiology and behavior. The great news is that we don’t have to accept those changes lying down (actually that would likely make winter blues worse). Instead, combining evidence-based approaches along with traditional wisdom garnered over centuries of living in northern climes, can not only hold back the tide of winter but allow us to embrace and thrive within it.

📚 Additional Reading