• Jan, 04, 2019

Poems for People with Seasonal Affective Disorder: Words for the Winter Blues


I understand that some may find the idea of poetry as therapy fanciful. That was certainly how many people felt when I first began to study seasonal affective disorder (SAD) over 35 years ago and suggested that those affected by SAD might benefit from therapy with bright light. One colleague whom I met at a professional event shortly after the publication of our first SAD article called me aside with a big grin and said, “Come, Norman, let’s stand under the light, I’m feeling a little depressed.” Nowadays such a remark might be taken seriously. But then it was said in high jest to signal the absurdity of the idea. So perhaps, it is fitting that my first essay on the healing powers of poetry should relate to a condition and treatment that were once thought fanciful, but are now fully accepted.

I have chosen the topic of poems for people with Seasonal Affective Disorder and the winter blues at this time in keeping with the dark season when mood and energy are in decline throughout the northern hemisphere. The approach of winter reminds me of the poet Ezra Pound’s parody of the old English spring song, the “Cuckoo’s Song,” which starts:

Sumer is icumen in
Lhude sing cuccu

In Pound’s version:

Winter is icumen in,
Lhude sing Goddamm

For those who are less than delighted with the dying of the light, not to mention the months of nasty weather before the crocuses poke their noses out of the ground, what words of comfort and diversion might poetry offer?

When the late journalist Sandy Rovner first interviewed me for the Washington Post in the early 1980s and wrote an article entitled “Seasons of the Psyche,” I asked her to solicit interested readers to write to me and let me know if any symptoms featured in the article resonated. The article was syndicated and, to my astonishment, thousands of people responded. The syndrome that became known as seasonal affective disorder appeared to be common, not the rarity that I had expected. Along with their letters, a few people sent poems about the winter that were meaningful to them, two of which I include here. The first by Emily Dickinson, although unfamiliar to me at the time, turns out to be well known. Here it is:


There’s a certain Slant of light

There’s a certain Slant of light,
Winter Afternoons –
That oppresses, like the Heft
Of Cathedral Tunes –

Heavenly Hurt, it gives us –
We can find no scar,
But internal difference –
Where the Meanings, are –

None may teach it – Any –
‘Tis the seal Despair –
An imperial affliction
Sent us of the Air –

When it comes, the Landscape listens –
Shadows – hold their breath –
When it goes, ’tis like the Distance
On the look of Death –

When I first read this poem, I was struck by its insights. Dickinson recognizes a direct effect of light on the way she feels – not just any light but “a certain Slant of light,” such as we see on winter afternoons when the sun sets early and is low on the horizon. In a magical act of synesthesia, she compares this visual downer to the sonorous “Heft of Cathedral Tunes.” She suggests that the pain caused by the angle of the light comes from above – “Heavenly Hurt,” and observes that “We can find no scar.” This last observation echoes a common concern of people with emotional disorders, for whom there is no external evidence of their pain – no scar, missing limb, leg cast, or deformity – which may lead them or others to question the legitimacy of their pain, thereby compounding it. Sometimes depressed people express envy towards those with obvious external signs of physical disability. People open doors for them, stand up in the subway or rush to help, or so it seems to the depressed person. More important than such concrete help, however, is the simple acknowledgement and validation given to those with obvious stigmata of illness. Not so for many who suffer from psychic pain, from heavenly hurt where no scar can be found.

Fly above clouds with Sun

Yet the absence of a scar does not prevent Dickinson from recognizing that there is real pain and that there must be a place that registers “internal difference Where the Meanings are.” That is where she suggests the weak light of winter has its oppressive impact. It would take nearly a century after the poem was written for scientists to begin to map the emotional brain, thereby localizing those regions where meanings are stored, and somewhat longer for the malady Dickinson was describing to be recognized by the medical community in the form of seasonal affective disorder. Dickinson muses that the malady feels as though it has been dispatched by an emperor – “An imperial affliction/Sent us of the Air” – like a letter with an official seal, embossed with the word “despair.” When the affliction comes, it affects the world around us, “the landscape listens,” and when it goes, it leaves a behind a disquieting feeling, like “the look of death.” The poem is as good a description of seasonal affective disorder – its cause, its symptoms, its physiology and its cost – as anybody could have given in the 19th century.

I have now read the poem many times and the mystery to me is how I get something from it at every reading. In the early days of SAD research, it validated my intuition that the syndrome really exists and is related to environmental light. Later I marveled at the poem’s economy of style, how every word matters. It was a gift to me from someone whose name I never knew or have long since forgotten and now I share it with you in the hope that you may find in it your own delight or comfort. I encourage you to read it aloud so that you can enjoy the music of the language. I have also recorded it so that you can listen to how it sounds when someone else reads it to you.

Let’s now move on to another poem I received from that first batch of correspondence, Bed in Summer by Robert Louis Stevenson.

Bed in Summer

In winter I get up at night
And dress by yellow candle-light.
In summer, quite the other way,
I have to go to bed by day.

I have to go to bed and see
The birds still hopping on the tree,
Or hear the grown-up people’s feet
Still going past me in the street.

And does it not seem hard to you,
When all the sky is clear and blue,
And I should like so much to play,
To have to go to bed by day?

Stevenson’s charming poem is lighter in tone than Dickinson’s. While apparently very simple, it offers profound insights. On the surface level, a little boy is lamenting that in winter he has to wake up in the dark, which feels like waking up at night. Even worse, as far as he is concerned, in summer he has to go to bed while it is still light outside and other creatures, such as birds and grown-ups are still walking about. How curious and unfair that seems.

At another level, Stevenson offers us insight into the biological rhythms of humans and animals. We are diurnal creatures, who naturally prefer to be active when it is light outside and sleep when it is dark. Thanks to the invention and widespread use of artificial lighting, humans have overcome many of the limitation imposed upon us by the length of the natural day or photoperiod. In recent decades, we have amplified these effects by the use of light that is far brighter than regular indoor lighting, which is basis for the light therapy used in the treatment of SAD. In addition, we have found that it can be very helpful to have a light come on in the bedroom before dawn on a winter’s day. We wake up more easily and, for those of us with SAD or the winter blues, it can improve our mood and energy. So, unlike Stevenson, we no longer need to wake by night.

Sun & snow

At the other end of the day, bright light can energize us in the evening, but if we use light too late, it can interfere with our getting to sleep. Studies have shown that blue light is the most potent part of the spectrum for influencing various biological effects of light, so we have developed methods to cut down on blue light exposure at night, for example, with blue-blocking glasses or computer apps designed to cut down blue light emission. Those who want more detailed information about the science behind the effects of light on dawn and dusk can find it in the box below.

I find it quite remarkable that Stevenson’s observation, articulated in his short but elegant poem, should have so many scientific and therapeutic implications. It is no wonder that someone was moved to send this poem to me in relation to my quest for the stories of people with seasonal affective disorder. Once again, a poet’s intuition offers us profound insights about our responses to the natural world, anticipating scientific developments that arrived many years later. Because it can be enjoyable to hear a poem read aloud, I have recorded it for you and it is embedded below.

Researchers have studied the basis for the biological rhythms associated with daylength and have found that in animals, they are controlled by a small structure in the brain called the suprachiasmatic nucleus (SCN). The SCN contains two clocks made up of clusters of neurons, one that responds to the onset of dawn and the other to the onset of dusk. These two clocks govern the times of waking and sleep onset respectively, as well as other biological processes. More recently, my friend and colleague Thomas Wehr, with whom I worked for two decades at the National Institute of Mental Health [NIMH], extended these findings to humans as well. During special experimental conditions, Wehr found that, just like other animals, healthy volunteers, allowed to lie down in artificial darkness, have the capacity to expand or contract their sleep length depending on their exposure to light and dark in the preceding weeks. When they have been going about their regular lives (which includes the use of ordinary artificial light), however, these same people, studied in the same lab conditions, show no difference in sleep length in summer versus winter.

Wehr and I teamed up to compare the sleep of people with SAD to those of healthy controls asked to sleep in darkened rooms during summer and winter. In contrast to the controls, people with SAD slept longer during winter than summer. So, even though they had been using artificial indoor lighting at home during the winter, they did not perceive this extension of the illuminated day as a summer signal (as did the healthy volunteers). We concluded that people with SAD are subsensitive to ordinary room light, which may explain why their mood and physical responses differ in winter compared with summer, and why they need light that is far brighter than ordinary room light in order to feel well during winter. Early morning hours have been found to be the most beneficial time for light therapy. Even smaller amounts of light exposure at that time, which simulate a summer dawn, may help you feel better and prevent you from feeling, as Stevenson so aptly puts it, as though you are getting up at night.

Healing Seasonal Affective Disorder & Winter Blues

Life After SAD
Fortunately, we now have many ways to treat SAD and the winter blues: light therapy, cognitive behavior therapy, exercise, meditation and antidepressants. What can poetry add to this already crowded therapeutic smorgasbord? One of my patients, a fellow scientist at the NIH and lover of poetry, brought to my attention “The Snowman” by Wallace Stephens, which starts with an interesting line, “One must have a mind of winter.” If you suffer from SAD or the winter blues, it is important to get into the right mindset to make the most of winter, understanding that it is a difficult time, particularly for those of us who are susceptible to the effects of darkness. Stevens points out some beautiful aspects of winter, such as “the junipers shagged with ice, the spruces rough in the distant glitter.” Such beauty is likely inaccessible to a person suffering from the symptoms of SAD or the winter blues. Once you have found treatments that reverse the symptoms, however, it can be exciting to rediscover the joy that winter perhaps afforded you as a child before the winter symptoms became entrenched: winter sports, fireside comforts, holidays with loved ones, friendship and camaraderie. The quiet of a dark winter day can also be conducive to meditation. You might even enjoy poetry and literature about the grandeur of winter that previously left you stone cold.

Very recently there are reports that anatomical connections have been discovered between the eyes and emotional centers of the brain in both mice and men, which may explain the pathways by which dark and light influence emotions. If Emily Dickinson were alive today, I’m sure that would come as no surprise. She pointed out that “the brain is wider than the sky,” and left it to others to sort out the details.

If you have come across any poems that you have found enjoyable, comforting, inspiring or healing (they don’t necessarily have to relate to the subject of the present blog post), please leave them in the comments section below, so I can share them with my readers.

Norman Rosenthal, M.D.
Psychiatrist, executive coach and
Author of Winter Blues (Guilford 2013)

Your engagement is appreciated!

In the “write a comment” section below I encourage you to share comments about this blog post, as well as to leave your favorite poem(s) and what they mean to you. I will monitor this and re-post selected favorite poems on my blog and the Poetry Rx Facebook group.