By Stella Hufhines
The moment Ethan Coombs realized he was struggling with a mental illness, he was immersed in the pages of his old writing journal. “I am undoubtedly depressed,” read the title line of one entry, dated Sept. 27, 2022. Coombs practices writing down his moods and feelings each day for future moments of reflection. As he returned to his journals two years later, Coombs recalled the stark differences between his entries. In September’s entries, Coombs wrote of his dark moods, fatigue or lack of focus, while in May, his entries were full of gratefulness, positivity and happiness.
At the time of the September entries, Coombs was unable to wrap his mind around these mysterious feelings. But as he stumbled upon this entry in January 2024, his perpetual sadness made total sense to him. Now, Coombs knows exactly what was infecting his mind two years ago. He was diagnosed with Seasonal Affective Disorder (SAD) in 2023, a malady that has affected nearly every aspect of his life. Coombs has linked the plummet of his grades, lack of energy and tendency to self-isolate to the disorder.
SAD is a subtype of depression that is linked to the change in seasons. Although SAD can appear at any time of the year, it is extremely common in the winter due to the decreased amount of sunlight. How it differs from its associated diagnosis, depression, is that someone with SAD is only affected for three to four months out of the year, while depression is more long-term.
Typical symptoms of SAD include a disinterest in activities that were once enjoyed, change in appetite, decline in physical activity, sporadic sleep as well as difficulty staying focused and making decisions. These symptoms can evolve into serious mental and physical handicaps for those who are affected. SAD affects a large percentage of the population — up to 5% of all U.S. adults and an estimated 1 million children in North America.
January has been one of the leading months in suicide rates, claiming the lives of over 8,300 individuals in the last two years. Although not all of these suicides are attributed to SAD, there is evidence to show that SAD is extremely common in those who are already diagnosed with a pre-existing mental illness, specifically depression or bipolar disorder.
Despite its pervasive nature in the U.S. population, SAD is often downplayed as a trivial mental illness because it is confused with the winter blues, which most perceive as innocuous. However, the symptoms of SAD are anything but superficial. This preconception that SAD is harmless, along with the global stigma against mental health issues, makes those who endure the disorder often feel unseen and trapped in the shadows of silent suffering.
Ryan Freeman-Burchfield, founder of the Freeman-Burchfield Institute for Cognitive Behavioral Therapy and the only Beck Institute Certified Clinician in Arkansas, explained the mental health stigma “exists inside of us and our society.” Freeman-Burchfield said she believes this stigma creates shame associated with mental illness and can be detrimental to those who suffer.
“The consequence of minimizing SAD (or any mental health symptom) is that people will not seek the support they need and it is possible that their symptoms could worsen leading to suicidal thoughts and feelings,” Freeman-Burchfield said.
Coombs, a 23-year-old native of Northwest Arkansas, has grappled with this seasonal struggle for the past four years, but his symptoms appeared to be much worse than the average person. Unable to get any sleep at night, loss of motivation to see friends and the overall miserable veil smothering his mind, make the winter months insufferable for Coombs. When victims of SAD make it out of the trenches of winter, they are usually met with a newfound optimism in the spring, as their days become filled with sunlight and warmer weather. As February ushers in the promise of a sunlit salvation, Coombs said he feels a surge of hope. “In the spring when (my depression) starts to go away, I feel like I’m invincible,” Coombs said. “But It never goes according to plan.”
Spring and summer become his sanctuary, a time for passion projects, academic engagement and the erasure of the previous winter months. The euphoria, however, is short-lived, crashing down as autumn signals the return of his SAD.
The winter of 2021 was an especially troubling season for Coombs, but he did not attribute a specific factor to the intensity of his SAD. Instead, Coombs believes it was just a particularly bad episode “in combination with a lot of responsibilities I couldn’t delegate,” he said. Despite that specifically harsh winter, Coombs claimed when spring arrived, he quickly bounced back. “(The change) was so dramatic that I didn’t even feel like fall was that big of a deal because of how good I felt in the spring — until the next fall came,” Coombs said.
When Coombs’ symptoms began to creep back in autumn, all of his projects and excursions he had planned during the sunshine-filled summer came to a halt. As a psychology and music major at the University of Arkansas, deeply passionate about his studies, Coombs grapples with the impact of his mental health on academic pursuits. He said one glance comparing his fall and spring transcripts could provide a depressive diagnosis on its own. In the spring, Coombs consistently remains a straight-A student, but in the fall, no matter how many hours he is taking, his grades seem to plummet. During the fall semester, Coombs finds himself dropping classes he once eagerly anticipated, paralyzed by the lack of motivation and energy that his disorder brings.
According to his mother, Tina Matsubara, Coombs “was a quiet contemplator, who overthought everything” as a child. Growing up in Northwest Arkansas, Coombs’ life seemed pretty standard. Not showing any previous signs of mental distress, his parents were surprised as to why he started having relentless panic attacks around the age of 7. Coombs, who experienced these intense fight-or-flight responses, now questions the origins of these sporadic panic episodes. Although he said there is no definitive origin, Coombs wonders if the attacks coincided with frequently being left to his own devices as a child.
With a father who frequently worked late hours and a mother who also worked as a teacher and ran errands often, there was a consistency of being left alone with his brother for long periods.
Other than the summer months when his mother was not working, he recalled unusual moments when she was home for extended lengths of time. Although Coombs assumed she was sick, having taken off work, he now believes these moments were likely due to depressive spells.
Even though Coombs said he has always enjoyed being alone, these absences seemed to deeply distress him.
Growing up, Coombs’ older brother was diagnosed with depression at the early age of 8. Meanwhile, Coombs seemed to embody normalcy.
That’s why, when Coombs told his father of his diagnosis of depression at 20 years old, his dad was taken aback, almost as much as Coombs, himself, was. Coombs said he suspected both reactions were because he had gone so long without showing any symptoms.
“It seemed that, like with my brother, if (depression) was going to emerge, it would have probably happened earlier,” Coombs said.
Freeman-Burchfield views SAD as a prevalent mental disorder, especially when it already runs in the family. She said genetics play a large role in determining mental illness and emphasized how common it is for children to inherit such disorders from parents who grapple with identical challenges. Additionally, Freeman-Burchfield suggests that there might be a natural, instinctive element to SAD that contributes to its widespread appearance. “I think in the winter we are supposed to slow down generally,” Freeman-Burchfield said. “We’re humans, we are a type of animal in a way.” Although 5% of the U.S. adult population experiences SAD, Freeman-Burchfield believes that, in reality, far more are likely to experience it.
Calvin Ryerse, a 22-year-old living in New York City, has been struggling with symptoms of SAD for eight years, which is another testament to familial mental illness, as both his mother and grandmother share the disorder. This family history, along with his symptoms, suggests the presence of SAD, although Ryerse is undiagnosed. For Ryerse, his seasonal depression mostly manifests through a lack of energy and motivation. “It feels like moving through molasses,” Ryerse said, “which is a challenging way to spend five months out of the year.” Trudging through the thick mental fog of winter, Ryerse finds himself operating at a snail’s pace in his day-to-day life. For Ryerse, the winter of 2023 held a notoriously bad winter for him, as he was fired from his job in November, graduated in December and ended a relationship in February, all while dealing with his usual seasonal struggle.
Ryerse, who is a filmmaker, found that his most bearable winter was when he was working on his senior thesis film. Having a long-term creative project helped Ryerse get through the insufferable winter months.
“The best way to deal with it is to give myself a project to work on,” Ryerse said. “Having something to look forward to kind of cuts through that intense, cold heaviness.”
Another way in which Ryerse fights the symptoms of SAD is by being outside as often as possible — going on long walks and bike rides despite the cold.
Ryerse said he has not considered getting an official diagnosis because he was “feeling unsure about the process,” and is content with being undiagnosed. “There’s something easier living in the uncertainty of it — confronting the truth or the non-truth,” Ryerse said.
Freeman-Burchfield, who has been helping those with SAD since 2007, has many suggestions for treatment options; however, one of her top prescriptions for those with the disorder is time outdoors.
“I believe in nature,” she said.
Freeman-Burchfield has had her own mental struggles throughout her life and occasionally battles mild SAD. After recently undergoing wrist surgery, which left her feeling limited and partially immobilized, she fell back on one of her most suggested forms of healing: going on a hike. Despite the dead trees that look like skeletal sentinels, Freeman-Burchfield listened to the sound of flowing water from a nearby stream and the chirps of birds — a symphony of delicate flutes.
She strongly believes that getting outside, regardless of the nasty weather, can do wonders for those struggling with SAD. There are many forms of treatment for SAD, ranging from Ryerse’s focus on creative projects to Freeman-Burchfield’s suggestion to get outside, or different kinds of medication. Other common treatments include light therapy, exercise and different methods of talk therapy, however, no single form of treatment works for everyone.
Summer Rainn, who has been diagnosed with SAD since 2020, has been consistently disappointed in her attempts at finding solace through different treatments.
Rainn’s SAD symptoms greatly hinder her day-to-day life, she said. Shutting herself away from the outside world and friends, her self-isolation becomes a tortuous experience. It is difficult to maintain consistent habits with SAD, so Rainn’s routine tends to fluctuate. Being that her symptoms are so severe, Rainn has sought out many forms of treatment. Medication was her first venture, but it proved to make her condition even worse. “The times I was on medication, it turned me into a zombie, barely functioning as a human,” Rainn said. After her hopeless excursions in the world of pharmaceuticals, Rainn became interested in a more recent and debated form of medicine.
Things began to look up for Rainn when she received her medical marijuana card, which made her symptoms far less intrusive to her daily life. Many recent studies address the correlation between mental illness and marijuana, especially concerning depression. While there are mixed opinions on whether it improves or worsens the condition, there are many personal testimonies that claim the drug is integral to getting those with depression through the day. Outside of marijuana, listening to music seems to be the only other efficient way Rainn can cope with her symptoms.
Similar to Rainn, Coombs has tried almost every treatment option available in the hopes of easing his despair. Before resorting to medication, Coombs attempted to eliminate any environmental factors that could have been feeding his disorder. He endured months of dieting, blood tests, hormone evaluations, light therapy, exercise and a regimented sleep schedule, all to find that nothing truly stabilized his suffering. Medication is the only treatment that seems to lighten the effects of SAD for Coombs — much to his dismay. Coombs has never considered medication a long-term solution and instead views it as a risky last resort due to its possible impacts on the brain. Despite his hesitation toward pharmaceuticals, Coombs has high hopes for the future of healthcare and continues to abide by his same routine of medication, exercise and time outside.
It is common for people with forms of depression to have a hard time envisioning their future. However, Freeman-Burchfield suggests that those who have been diagnosed with SAD and have experienced their depressive cycle find it easier to look to the future. For someone experiencing symptoms of SAD for the first time, the unexplained nature of their emotions can be perplexing. Deciphering and discovering new feelings can be extremely difficult, especially in a world where mental health is frequently stigmatized.
Freeman-Burchfield said the reverse can also be true for those with SAD, where one feels a sense of dread as winter approaches. Although those who are diagnosed are aware that their struggle is seasonal, it can create a sense of apprehension when it comes to facing the colder months. They know that darker times are ahead, but there is nothing they can do to stop their symptoms from reappearing.
During a surprisingly warm February this year, Coombs said he was springing out of his seasonal slump and seemed unexpectedly optimistic when considering the future state of his disorder. As an undergrad psychology major, Coombs recognizes that, with graduate school ahead, he is going to stay busy for the following years. When he envisions his later career, Coombs does not see SAD in the picture and is fairly optimistic that his current treatments will continue to carry him through the winters. Trying to focus more on the present, Coombs has adopted the idea that “everything will work out eventually.”
“I’m probably not the typical depressed person thinking about their future because I’m very optimistic about this kind of stuff,” Coombs said.
But this is not always good, he said. Coombs attributed his overly optimistic mindset to his newfound enjoyment of day-to-day life, now that his depressive season was coming to an end.
Freeman-Burchfield said she believes mental health’s severity is often minimized and that there has been a historical stigma surrounding the topic. She mentioned that a transformative moment in reshaping conversations around mental health emerged with the onset of the COVID-19 pandemic. Being locked indoors and estranged from the outside world, COVID-19 brought a 25% increase in the global appearance of anxiety and depression according to the World Health Organization. While acknowledging the grim toll the pandemic took on mental well-being, Freeman-Burchfield highlighted a silver lining in the crisis — “it normalized mental health for a lot of people.”
Even in the wake of increased awareness and discourse surrounding mental health, Freeman-Burchfield highlights a persistent challenge in the way individuals approach their own well-being. “We maximize other people’s problems, but we often minimize our own,” she said. She encourages individuals to become active participants in understanding their emotional landscape, urging them to contemplate pursuing potential diagnoses, particularly in the case of SAD. “You are the expert on you,” Freeman-Burchfield said. “What you go through, what you experience — you are the expert.”
The societal norm to minimize personal feelings played a significant role in Coombs’ early diagnosis of depression. Even though Coombs had been struggling with symptoms of SAD for years before it was confirmed, he had programmed himself to blame times of emotional turmoil and sadness on factors other than his mental health. By blaming his feelings on these justifications, Coombs had never considered the possibility that he could be dealing with something more serious, which is why his diagnosis of depression hit him particularly hard.
Although the overwhelmingly large number of individuals suffering from SAD could be considered a crisis in itself, Freeman-Burchfield said she believes the bigger issue lies in the stigma against mental health. “People don’t know where to start, how to talk about it, or where to go,” she said. At heart, she thinks that by sharing mental struggles with others, people can connect with and inspire those who are suffering to recognize their own mental hardships. If this pattern repeats, the global mental health stigma might slowly begin to dissolve, Freeman-Burchfield said.
By confronting the bigger issue, individuals may begin to find peace in a more accepting atmosphere. Although Coombs can envision a bright future ahead, others may navigate the darkness by focusing on the day-to-day.
In the uncertain landscape of her future, Rainn said she finds herself navigating the present with a mix of determination and curiosity. All that she can currently do is keep using the treatments that get her through each day.
Concerning Ryerse’s future, instead of trying to fight his SAD, he has learned to accept and embrace the disorder. Ryerse said to avoid dreading the next November when his symptoms usually kick in, he finds ways to utilize his SAD. Ryerse views the winter as an opportunity to slow down, a season for intentional rest and introspection. Although the colder months can be tough for Ryerse’s mental health, he finds solace in the knowledge that spring will inevitably come, ushering in a wave of renewal and dispelling the shadows of his depressive mood.
Although no two victims of SAD will walk the same path, many may find comfort in an open conversation. By sharing personal stories and connecting with others affected, the individual experience becomes that of the group. In this transparent environment, those with SAD are learning to manage the seasonal cycle instead of trying to break it.