Synopsis
Recognise recurrent seasonal pattern and chronic depressive course through longitudinal evidence, exclude bipolar, sleep and physical causes, treat current severity using established depression care and build prevention around predictable timing and residual impairment.
- A seasonal pattern requires repeated temporal relationship between depressive episodes and a particular season, with remission or marked change outside that period; one difficult winter is insufficient.
- Map several years of mood, sleep, appetite, energy, function, treatment and activation against seasons, work patterns, anniversaries and social changes.
- Assess current severity, psychosis, suicide, function and dependants exactly as for other depression and do not wait for daylight or season to change.
Key red flags
Seasonally recurrent depression can still become severe, psychotic or suicidal and needs the same immediate risk formulation as non-seasonal episodes.
Investigation priorities
Establish repeated onset, remission, severity, treatment response and alternative recurring explanations.
Verify adequacy, adverse effects, preferred options, seasonal timing and previous relapse signals.
Management branches
Depressive symptoms appear to recur or worsen seasonally.
- Map several years of episodes, remission, function, treatment, sleep, work, social events and opposite-season activation.
- Assess current depression, suicide, psychosis and dependants and investigate bipolar, sleep and physical alternatives.