Cognitive-behavioral therapy may be better at treating seasonal affective disorder than light treatment, according to research published in the American Journal of Psychiatry.

Seasonal affective disorder (SAD) is a form of depression that affects over 14 million Americans, ranging from 1.5% of the population in southern states like Florida to over 9% in the northern regions of the country. An estimated 10-20% of all cases of recurrent depression follow a seasonal pattern.

It is believed to be caused by a hormonal imbalance triggered during the shorter days of winter. In people with SAD, the late winter sunrises interfere with circadian rhythms and cause levels of the sleep hormone, melatonin, to remain high into the morning. This results in fatigue and depression.

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