Seasonal affective disorder (SAD) is characterized by recurrent major depressive episodes with a consistent seasonal pattern in both onset and remission (or change to hypomania/mania) that is clear in the past 2 years and represents the predominant pattern over the lifetime. SAD is not a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), but it is subsumed under the “with seasonal pattern” course specifier that can be applied to major depressive disorder or bipolar disorders. Cases in which the seasonal pattern is linked to fluctuations in an identified seasonally linked psychosocial stressor (e.g., anniversary reactions, seasonal unemployment) are not considered SAD. A “winter-type” pattern of fall/winter depression onset with springtime remission is overwhelmingly the most common SAD presentation and ...

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