In a positive light? experiencing Seasonal Affective Disorder (SAD) and the promise of biosolidarity

ABSTRACT

This paper explores Seasonal Affective Disorder (SAD) as an idiopathic and idiographic phenomenon in a discussion about (low) light and social relations. Tracing a history of unsuccessful biosociality around SAD via archived and contemporary testimony, the paper uses narrative responses from a recent qualitative survey to explore how and why winter depression might be a difficult experience around which to form community. With brief reflections on a series of public workshops led by the research team in Scotland, we suggest that social and cultural geographies of creative practice are one vehicle for fostering new kinds of environmental biosolidarities, arguably rendered essential in the face of uncertain climatic futures that threaten increasingly disruptive light-mental health relations. More broadly, we discuss our contributions to human geographies of light-dark relations, SAD and biosociality. We conclude the paper with a call for more nuanced account of social, cultural, and emotional geographies of environmental illness.

RESUMEN

Este artículo explora el Trastorno Afectivo Estacional (TAE) como un fenómeno idiopático e idiográfico en una discusión sobre la (baja) iluminación y las relaciones sociales. Al rastrear una historia de bio sociabilidad fallida en torno al TAE a través de testimonios contemporáneos y archivados, el artículo utiliza las respuestas de una encuesta cualitativa reciente para explorar cómo y por qué la depresión invernal podría ser una experiencia difícil en torno a la cual formar una comunidad. Con breves reflexiones sobre una serie de talleres públicos dirigidos por el equipo de investigación en Escocia, sugerimos que las geografías sociales y culturales de la práctica creativa son un vehículo para fomentar nuevos tipos de bio solidaridades ambientales, que posiblemente se vuelven esenciales frente a futuros climáticos inciertos que amenazan relaciones luz-salud mental cada vez más disruptivas. De manera más amplia, discutimos nuestras contribuciones a las geografías humanas de las relaciones entre la luz y la oscuridad, el TAE y la bio sociabilidad.

Résumé

Cet article examine le trouble affectif saisonnier (TAS) en tant que phénomène idiopathique et idiographique au sein d’un débat sur la lumière (faible) et les rapports sociaux. Retraçant, à l’aide de témoignages contemporains ou archivés, une histoire de biosocialité infructueuse pour le TAS, il se sert des réponses à un récent questionnaire qualitatif pour explorer pourquoi et comment la dépression hivernale pourrait être une expérience difficile autour de laquelle il serait possible de former une communauté. Avec de brèves réflexions sur une série d’ateliers pour le public menés par l’équipe de recherche en Écosse, nous suggérons que les géographies sociales et culturelles de la pratique créative sont un vecteur pour promouvoir de nouveaux types de « biosolidarités » de l’environnement, qui sont sans aucun doutes devenues essentiels face à certains avenirs climatiques qui menacent les rapports de plus en perturbateurs entre la santé mentale et la lumière. De manière plus générale, nous présentons nos contributions aux géographies humaines des rapports entre la clarté et l’obscurité, le TAS et la biosocialité.

KEYWORDS:

• Biosolidarity
• idiopathic
• idiographic
• Seasonal Affective Disorder (SAD)
• creative research
• lived experience

Palabras clave:

• Bio solidaridad
• idiopático
• idiográfico
• Trastorno Afectivo Estacional (TAE)
• investigación creativa
• experiencia vivida

Mots clefs:

• biosolidarité
• idiopathique
• idiographique
• Trouble Affectif Saisonnier (TAS)
• recherche créative
• expérience vécue

Introduction

I am not the only SAD one.

Maybe it’s ok to be ‘affected’ if all these other people are affected too.

It feels a little less all-consuming to know that people have been dealing with this for so long.

The comments above were written on three little cardboard tags as part of a creative activity reflecting on participant experiences during a public workshop series held in Glasgow during Winter 2022–2023. The focus of the series was Seasonal Affective Disorder (SAD) and creative strategies to live well in winter. SAD is an uncertain environmental condition: since its initial diagnosis in the 1980s, its causes, symptoms and treatments have been debated by clinical psychiatrists and members of the public alike. Indeed, its very validity as a diagnosis and ‘biosocial category’ has been questioned. Much of this scepticism has centred on the difficulties of translating the ambiguities in individual experience of seasonally affected mood into clinically defined criteria (Traffanstedt et al., 2016). SAD has often been disputed by a prevailing professional culture of psychiatric diagnosis focused on the ‘capture’ of generic clinical phenomena, reluctant to confront the complex and varied configurations of psychological, cultural and biosocial processes that shape and connect individual experience (Callard, 2014, pp. 530).

Participant input from the public workshops – briefly signposted above – gives insight and voice to the often overlooked and more interpersonal experiences of SAD. These entail reflexive modes of encounter that ‘being-with-others’ enables through the recognition of relatable ‘shared experiences’, as well as the positive benefits that can accrue as individuals connect over stories, tips, worries and hopes. This experience of what we understand by ‘biosociality’ also opens up to the possibility of new forms of ‘community’ or even ‘biosolidarity’, the latter defined as proactive forms of collective inquiry about how to build new, more supportive forms of life to respond to uncertain mental and environmental challenges (Bradley, 2021). Bradley (2021, pp. 554) argues that ‘lay understandings of biosocial identity formation’, involving particular ‘kinds of socialities and identities’, cohere around both ‘new sites of knowledge’ (Gibbon & Novas, 2008, pp. 3) and where that ‘knowledge is gained through diagnosis’ (Bradley, 2021, pp. 545). In our case, SAD biosociality is emerging from proximities with others who experience similar embodied depression in low light, rather than from diagnosis per se. We explore – with respect to organizational histories of SAD advocacy – how such ‘biosociality is fragile, fraught, and is dependent on labour for its ongoing sustainability’ (pp.551), but also, and inspired by Bradley (2021), how this kind of community-making can lead to ‘biosolidarity’: work with and for others.

To write on biosociality is thus to join an existing field where scholars have illuminated how bodily states, health conditions and (often) genetic profiling bring disparate people together in biomedical relations ‘often imagined as a new form of social solidarity’ (Dimond et al., 2015; also, p.1; Bradley, 2021; Chatjouli, 2013; Friedner, 2010; Hacking, 1995; Wiese et al., 2018), and as just one dimension of wider relational ‘biosocial becomings’ (T. Ingold & Palsson, 2013, pp. 9). Within social and cultural geography, thinking with biosociality can illuminate the ‘diverse disabling and enabling geographies’ that characterize human experience (Wilton & Horton, 2020, p. 1021; and see Brown et al., 2019), and in our case, we are seeking biosocial attunement to seasonal depression as a lived and shared experience, with the methods and outcomes from our workshops indelibly tied to – and actively seeking to deepen – such attunement.

In this paper, then, we examine the tensions arising at the interface of environmental and biosocial relations within SAD experience – as well as the possibilities and challenges of community efforts to reconfigure these tensions – by reconceptualizing SAD in terms of pluralistic and changing experiences with distinctly idiographic human geographies. Our arguments depart from scholarship on ‘idiopathic environmental illnesses’ (IEI), addressing environmental intolerance or illness ultimately of ‘unknown cause’ but usually still associated with biochemical, physical or otherwise adverse behavioural reactions to uncertain properties of surrounding environments (Black & Craver, 2022). These properties are often cast as unknown toxicities within the environment reckoned to cause multiple and varying intolerances and sensitivities amongst individuals and groups, typically associated with modern environmental pollutions and disruptions or, in another lexicon, unanticipated ‘chemical’ and ‘toxic geographies’ (Romero et al., 2017; Davies, 2022) carrying negative consequences for human (and other) bodies. In the context of SAD, however, the concept and vocabulary of IEI allows us to consider a different kind of uncertain environmental phenomenon with capricious and problematic relationships to mental health: namely, light.

We advance our thinking about the interrelated individual and collective experiences of SAD, light and, increasingly, seasonal disorientation within the climate crisis through findings from research with people in the West of Scotland, especially the Glasgow area, who feel themselves significantly affected by lowered wintertime light. We begin with a detailed discussion of our key analytical concepts of idiopathology, the idiographic, biosociality and biosolidarity. We then provide reflections on geographies of light and SAD. Our core sections reflect on the challenges and possibilities of SAD biosociality through two empirical examples. We reflect on the rise and fall of the Seasonal Affective Disorder Association (SADA) in the UK, exampling an unsuccessful attempt at biosolidarity. We then reflect on similar themes through the medium of our own survey research, before discussing initial experiences arising from – and more practical ambitions associated with – our experiments in SAD biosolidarity through the public workshop series. We conclude with speculative comments about SAD biosociality futures as folded into differentiated geographies of diminished and fluctuating light under the press of climate-affected seasonal disruption.

Idiopathic, idiographic and the biosocial

The concept of IEIs was first introduced by Randolph (1959, 1966), who founded a movement of ‘clinical ecology’ in the 1950s premised on human failure to adapt to modern chemicals that are difficult to identify or trace. IEI nonetheless remains a controversial and uncertain formulation, science and experience (Zucco & Doty, 2022) and ‘evades epistemological capture’ (Coyle, 2004, p. 64). In a 1999 position statement, a leading professional body summed up the to-and-fro of debate about IEI in the later-twentieth century:

The patient experiences wide-ranging symptoms, but evidence of pathology or physiologic dysfunction in such patients has been lacking in studies to date. Because of the subjective nature of the illness, an objective case definition is not possible.(American Academy of Asthma, Allergy and Immunology, 1999, npn)

Thus, although IEI provides useful terminology for conveying complex environmental experiences, it is commonly received as a difficult, even suspicious, concept within prevailing psychiatric cultures that aspire to ‘objective’ diagnosis (Callard, 2014) precisely because of an IEI’s uncertain, personal and ‘subjective’ nature.

Such phenomena may, though, find a more welcoming home when set alongside long-standing debates in human geography. Indeed, we might expand our understanding of the significance of – and clinical scepticism towards – IEI by connecting to a much-cited written exchange in geographical theory from the mid-twentieth century: the so-called ‘Hartshorne-Schaefer’ debate (Hartshorne, 1939, 1954, 1955, 1959; Schaefer, 1953). Here, the concerns of IEI resonate with Hartshorne’s ‘idiographic approach’, a neo-Kantian construct used to describe ‘a tendency to specify … typical of the humanities’ and ‘linked with understanding the meaning of contingent, unique, and often cultural or subjective phenomena’ (Sui & Kedron, 2021, pp. 1278). For Hartshorne (1939), this tendency translated into his celebrated emphasis on ‘areal differentiation’, the claimed hallmark of the geographer’s mission, as the patient reconstruction of areal or regional specificity. It was then aggressively opposed by the ‘nomothetic approach’ favoured by Schaefer (1953) as a ‘properly’ scientific version of geographical inquiry, seeking instead to disclose, define and universalize ‘general laws’ across phenomena, transcending regional contexts in the process, in emulation of both the natural sciences and (emerging) social sciences. Nomothetic law-seeking ambitions gradually became hegemonic in Anglophone professional geography as spatial science during the 1950s-1960s, but from the 1970s many human geographers – deploying a diverse range of philosophies and vocabularies – sought to revitalize an idiographic sensitivity to the details and differences of people, place and practice (Cresswell, 2014).

Idiographic approaches offer an alternative style of reasoning – diverging from the scientific orthodoxy present in spatial science and most biomedical disciplines – which seeks to understand experiences, relations and questions of causation through careful analysis of the ‘particular aspects of phenomena’, rather than pursuing generalizable accounts (Entrikin, 1985, pp. 245). Viewed from within the debate just outlined, a geographical adaptation of IEI with an idiographic flavour would be focused more squarely on the complexity of the relational environment in question, rather than hoping to trace particular elements in isolation. The characteristic biomedical impulse to generalize that rejects the idiopathic and IEIs – that distances from the particularities seemingly hostile to the gold standards of objectivity and certainty – can perhaps be tempered, at least in part, by an idiographic openness to the variabilities (across people, place and practice) seemingly integral to the likes of SAD. Thus configured, IEIs do not so much offer an unspecific, ‘subjective’ diagnosis, but recommend a different attitude attuned to the kaleidoscopic, geographically disparate ‘everyday worlds’ of lived experience (Toombs, 1995, pp. 10).

An idiographic attitude, which we configure as inherently geographical, is particularly apt for understanding SAD – and countering nomothetic debates about its ‘clinical validity’ – because the condition is intimately associated with seasonal variabilities in the quality of available light. Crucially, these temporal variations themselves fluctuate spatially, subject to many interrelated factors that affect shifts in quantity and rhythmicity of individuals’ encounters with daylight: most obviously variation in latitude, but also local topography, levels of precipitation and snowfall, cultural practices, the built environment and other human-driven phenomena like urban smog (Mersch et al., 1999). Given its environmental complexity and potential ephemerality, there is hence value in analysing light idiographically, accepting it as an uncertain but suffusive environmental element that ‘shades’ human experience in profound ways, with its exact effects unavoidably varying from place-to-place as well as person-to-person. In SAD there remain many uncertainties about how light and mental ill-health intersect – there is no clear-cut nomothetic law in play, partly due to place-based specificities – and so we approach SAD by taking seriously idiopathic light-affective experience within an idiographic framing. Although we are not straightforwardly adopting IEI terminology to define SAD experience, we choose to deploy this concept/language with reference to problematic relationships between environmental light and depression. As such, the environmental illness under discussion is not framed as due to an unknown modern toxicity, but rather as one whose status parallels the particularities, confusions, scientific (dis)interest and debate around IEI. To engage with the idiopathic is to engage with an unknown specificity that can still be meaningful to humans and groups, namely those who embody idiopathic conditions.

Returning to how we introduced our paper, this orientation speaks to SAD’s troubled biosociality, given that ambitions to foster biosolidarities around SAD must contend not only with the uncertainties and disputed character of the condition but also with significant individual, cultural and geographical unevenness in its occurrence, distribution and effects. Equivalent concerns have been voiced about geographical and social-scientific treatments of ‘the biosocial body’ by Hayes-Conroy et al. (2022) when considering what they cast as relational body-milieu interconnection. Like these authors, we resist pinning down ‘biological explanation’, genetic or psychological markers, pre-dispositions or other nomothetic criteria in order to ‘capture’ a given health condition, which for us is SAD, and thereby to resolve its mystery as an IEI. Instead, we approach SAD via embodied biographical ‘becomings’ with light – tied to affective disorders – characteristic of different, specific places, asking how such becomings might be understood as strange and uncertain but also simultaneously shared. (Kearns and Reid-Henry 2009, pp. 557), we agree that ‘how we know the world is constitutive of how we come to know ourselves as biophysical beings’. As human geographers, moreover, we are interested in how different kinds of cultural and social expressions of – and responses to – SAD as an environmental condition reinforce or limit the formation of SAD-related biosocial identities. How, for instance, do idiographic experiences here shape and make claims on nomothetic diagnoses? In the following section, we retrieve numerous lines from the above discussion when reconstructing the story of SAD as an uncertain environmental condition, illustrating further the possibilities and fragilities of SAD biosolidarity organized around mutable relationships with light.

Light’s geographies, SAD’s geographies and the recognition of SAD

SAD is an environmental illness of recent invention and remains one with uncertain, disputed status. SAD was first recognized as a mental health condition in 1987 in the Diagnostic and Statistical Manual-III-R of the American Psychiatric Association. By 2013, the condition was no longer assigned a discrete entry in DSM5’s diagnostic criteria, instead being reclassified as a sub-type of major depression characterized by low mood with seasonal patterns. The UK National Health Service states that ‘the exact cause of SAD is not well understood’ and ‘SAD can be difficult to diagnose’ (https://www.nhs.uk/mental-health/conditions/seasonal-affective-disorder-sad/overview/). The NHS online entry lists the symptomology of SAD as ‘winter depression’, persistent low mood, a loss of pleasure in everyday life, and feelings of lethargy or despair that can affect normal functioning. While causes of SAD are not entirely understood, it is obviously contingent on environmental conditions, and environmental light in particular (N. E. Rosenthal, 2009), most likely linked to a reduction of sunlight that impacts the physiological production of hormone-types melatonin and serotonin which are themselves known to be associated with feelings of depression and sleepiness. The body’s internal clock (its ‘circadian rhythm’) is also affected by lowered light conditions and reduced exposure to sunlight, technically determined as a reading of the level of environmental illumination by the unit-measure lux (Geddes, 2019), perceptible most notably during shorter autumn and winter days. People experiencing SAD-symptoms during wintertime are less inclined to spend periods of time exposed to natural light outdoors, which can compound their situation. It is unclear why some people experience SAD and some do not, although Targum and Rosenthal (2008) suggest geographic location and genetic disposition have a role, while Fonte and Coutinho (2021) suggest the significance of co-morbidity with other psychiatric conditions.

As presented above, SAD’s uncertain environmental relations involve, in part if not wholly, idiopathic experiences of light, inviting questions about how we can usefully theorize relationships between light, the lived body and placed contexts so as to understand light’s role in human experiences of environmental and seasonal change. The challenge resides in pairing an idiographic interest in the particular, the culturally and geographically distinctive, with a receptivity to the openness of the idiopathically unknown. A recent essay addressing the fundamental question of ‘What in the world is light?’ notes how ‘[l]ight has no stable ontological foundation, not because in the present state of knowledge we are still some way from a definitive explanation, but because what light is depends on where we are coming from’ (I. Ingold, 2021, p. 85). The absence of any definitive answer, social anthropologist Ingold observes, results in a world where the views of the physicist and the phenomenologist appear very much at odds. Thus, a significant intellectual challenge is demarcated:

Light is among the fundamental constituents of our universe; but it also lies at the heart of human experience. It is both so near that it invades our being, and yet so far that besides it our human presence pales into insignificance. We know a great deal about it, and yet we do not know what it is. It could be an energetic ray, a beam, the illumination of surfaces, an atmosphere. It could be the shining of the sun, the moon and the stars. It could be a flickering flame, a lamp or torch, the glowing embers of a fire. It could be whiteness, or a spectrum of colour. It could be release from darkness, an enlivening of the spirit, divine presence, the power of reason. Indeed, light could be all of these things, but only because – as we pass from one thing to another – we continually shift the grounds of definition. (p.85)

The rigour and reach of Ingold’s interrogative enquiry notwithstanding, his mission is to establish a means by which light’s existence can be understood as a natural universal that is found everywhere, while his exercise of establishing ‘where we are coming from’ demands that theories of light are charted on a map of ideas and associated cultural representations.

What perhaps goes unaddressed here, though, is the possibility of light being a phenomenon that is experienced geographically, in particular ways by particular people in particular places: namely, an idiographic version of light where its presence in life-worlds is filtered according to variables such as situation, location and latitude. Perfectly ordinarily, the availability, quality and intensity of light that we experience varies according to ease of access to green space or proximity to the coast, even being modulated by the orientation of a living room in relation to the sun’s daily passage across the sky. Thus, light, and its seasonality, is an elemental part of regional human geographies consequential for, and correlative with, individual health and wellbeing (see Vannini et al., 2012 and Flack, 2023, on ‘dark histories’; and Shaw (2015) on dark and the self). The localizing and particularizing of experience ought also to encompass what can be referenced – after anthropologists Le Gallic and Pritchard (2019) – as the lore of luminosity, wherein the cultural mediation and socialization of light gives it substance and texture, lending prominence and affording significance, both in public (Ebbensgaard, 2022; Edensor, 2017) and private space (Bille & Sørensen, 2007). Alternatively, becoming attuned to light can drive shared efforts to mitigate against the affective impact of over-illumination, notably in parks or regions where darkness becomes a quality worthy of protected status (Dunn & Edensor, 2024; also; Högström & Philo, 2023).

While it is indeed unclear why some individuals are especially sensitive to low light and others are not, what is also hard to ascertain is why certain kinds of idiopathic conditions are recognized as sufficiently shared, by many people in many different circumstances, to be the basis for biosocial community-making and others not. Contested conditions such as Myalgic Encephalomyeltic (ME) or Chronic Fatique Syndrome (CFS), Gulf War Syndrome or Long Covid give rise to thousands of people, medicks included, who ‘gather together’ to form a biosocial community, advocate, fund and campaign and educate (Callard & Perego, 2021), but there is no equivalent mobilization around SAD at present. Light is, by its very nature, diffuse. So too, it seems, are the biosocial connections around negative affects of low light, and we might identify a paradox whereby a phenomenon perceived as ‘everywhere present’ is often unrecognisably so. That uneven relations with light might lead to pathological human states risks remaining all but unrecognized except by small cohorts of affected individuals. The efforts of these cohorts to secure recognition, to create gatherings, collectives and even communities are what energizes the remainder of our paper.

A SAD story: SADA and ‘unsuccessful biosolidarity’

In the UK, SAD has had a complex social life which can be told through a short history of community-making: one resulting in dissolution and fragmentation more than biosocial coalescence and solidarity. The Seasonal Affective Disorder Association (SADA) was a UK-based voluntary organization, established with the stated intention of helping people of all ages affected by SAD. SADA existed between 1986 and 2017, held registered charity status, and operated as a patient-led organization. Initially, it attracted plenty of media interest, partly prompted by the work of prominent academic and clinician Norman Rosenthal, author of Winter blues: Everything you need to know to beat Seasonal Affective Disorder (2012). The account offered here draws on oral testimonies presented in 2013 at a ‘witness seminar’ organized by the University of London’s History of Modern Biomedicine Research Group, funded by The Wellcome Trust (Overy & Tansey, 2014), along with material from recent communications and interviews with former SADA committee members as part of data-gathering activity on lived experiences of SAD.¹

While serving as SADA’s chairperson, Helen Hanson described the situation -in email correspondence: ‘Hundreds of SAD sufferers treat themselves, guided by information gleaned from the media and us. Their stories are often untold and the experience of this very specific form of depression goes unexplored’. Jennifer Eastwood, Honorary Life President of SADA, plotted the organization’s history, flagging some of the problems encountered with establishing an authoritative patient-led voice for SAD:

Over 25 years SADA has studied and advised on the treatment of tens of thousands of people. Although we don’t have many scientific publications, we have had huge numbers of people, probably well over a million. I started SADA in 1987. After the first radio programme … we began to get thousands of enquiries from the public. There was a period of several years when … I sometimes received a thousand or more letters a day, delivered in sacks from the post office. Nobody really believed me, but I took a sack of letters to a meeting, emptied them onto the floor, and showed my colleagues what was going on. Most of the writers claimed to have some degree of SAD and I know you can discount a large number of those as manageable, but nonetheless distressing, winter blues but some of the things I read were horrendous. When I see that there’s not a single UK psychiatrist in this room, it makes me wonder what I’ve been doing for the last 25 years because it’s really tragic. There’s a hell of a lot of misery out there. (Overy & Tansey, 2014, pp. 44)

Some difficulties SADA faced were ordinary operational ones, not least because it remained largely low-tech. After the advent of the worldwide web (as then known), SADA continued to produce mail-out, print-copy newsletters for subscribing, fee-paying members; the passive nature of the membership, rather than their militancy, was noted as an ongoing challenge and difficulty by one interviewee.

Perhaps the key issue identified, however, was the challenge in maintaining credibility among clinicians. Over time, the initial spike of interest that SADA had attracted from medical professionals drifted and dwindled. Meanwhile, biological and psychological inquiries and scientific funding gravitated towards circadian rhythm research, a field where the particularity of SAD experience could get lost:

We revamped and produced a new handbook we wrote lots of articles and we sort of co-opted a few scientists to write occasional articles … but we were charity run by volunteers and we were up against charities, who were real charities with salaried workers, and they could … pay for fancy websites … and SAD had kind of gone off the agenda, if you like, [since] we had no support really from experts. (Betty, Former SADA member, Interview October, 2022)

When SADA members put themselves in public view, the media did respond, raising public awareness of the condition, although this coverage would sometimes prompt negative reactions, including disbelief that sufferers were depressed by winter or the weather – with the significance of light perhaps subsumed by the UK’s peculiarly ‘meteorological culture’ (Veale et al., 2014):

I mean we’re absolutely obsessed with the weather in the UK aren’t we? We get quite a lot of different kinds of weather, so I do think that there’s a lot of it to do with our weather patterns that play into it. We’ve also got that sort of British stoicism that we are ‘just grin and bear it’. I got splashed across the Daily Mail – I’d been used as a case study - but I just got so much abuse … from people telling me to stop being pathetic. You know it’s hard when you’re trying to be open and honest about something. We still have … an attitude of ‘just get on with it’ and especially when it’s something to do with life. I mean SAD sounds [pulls face] – the acronym doesn’t help!’ (Shona, former SADA member, edited extract, Interview, October 2022)

Like many idiopathologies, the legitimacy and validity of SAD experience was subject to scrutiny, some scepticism, and mixed opinions from clinical professionals reflected in its ‘downgraded’ status assigned in DSM-5 as a type of depression with a ‘seasonal pattern’ (2013).

Notably, contestation also arose over possible courses of treatment for SAD as much as it did over the nature of SAD experience itself. One proposed solution which captured the popular imagination was ‘light therapy’ administered artificially via an electric light box. Though variously researched, evidence of the efficacy of light box use was insufficient to secure recommended treatment status by the National Institute for Health and Care Excellence (NICE), an all-important credential in the UK (Overy & Tansey, 2014, pp. 27). Rosenthal was among those who saw the lack of support as economically driven, tied in part to limited support from a pharmaceutical industry which did not stand to profit from this, mechanical, treatment route. Rosenthal also noted a wider international pattern of retreat:

There is also widespread evidence of denial of SAD in places where it’s prevalent as evidenced by the Swedes now retreating from saying that light therapy works, and the professionals here in the UK retreating as evidenced by the NICE criteria. (Overy & Tansey, 2014, pp. 31)

The dismissal or denial of SAD, seen as an environmental condition of unknown origin, is partly connected to the way it is established as a problem with its own uncertain psychiatric status, as well as research and treatment being insufficiently established by ‘gold standard’ randomized control trials supported by a powerful pharmaceutical lobby.

Rosenthal added that ‘[t]he entire psychiatric canon hangs upon conditions that exist only in syndromal form, absent of any biological marker, so it doesn’t really seem fair to hold SAD to a higher standard’ (ibid: 38). Such a treatment of SAD also flew in the face of the numbers involved, although of course those numbers could not be conclusively or definitively enumerated:

If we know that a third of the UK population suffers to some degree from winter blues up to full blown SAD, so we’ve got a third of our population that are feeling like crap for half the year every single year, and why do we think that’s okay? (Shona, former SADA member, Interview, October, 2022)

It may therefore be most accurate to observe that at least some of the debate over the ‘legitimacy’ and ‘validity’ of SAD is not so much about whether SAD is real, but about the nature of its reality. It involves an uncertainty and disagreement about the status of patients’ epistemic claims, a common feature of interdisciplinary scholarship on IEI (Dömötör et al., 2019), linked to clear organizational, structural and medical reasons why SAD continues to exist as an uncertain environmental illness with poorly determined treatment pathways. The absence of certain crucial affordances – caught between ambivalent clinical interpretations and vacillating public interest – is arguably why the situation here does not mirror more fully (Rabinow’s 2005, pp. 188) vision of a burgeoning biosocial community: ‘Such groups will have medical specialists, laboratories, narratives, traditions, and a heavy panoply of pastoral keepers to help them experience, share, intervene, and “understand” their fate’.

Communicating SAD and seasonal geographies

The relative failure of SADA, the main patient-led charity, or of any organized or more widespread biosocial SAD community, is perhaps also connected to the nature of the condition as it is lived and experienced. In our own qualitative research, emerging narratives note difficulties connecting with others experiencing SAD symptoms due to the depressive tendency of withdrawing from ordinary social interactions, alongside the constant seesaw of feelings associated with winter light. In our survey of 350 respondents across the UK, and spotlighting the West of Scotland, we have emerging indications of why people affected think it might be difficult for them to ‘form community’, ‘to connect’, ‘cohere’, ‘action and agitate’ around SAD, precisely at the time it is most profoundly experienced. Firstly, it is essentially an anti-social condition:

I feel very disconnected with many people over the winter months. (BSS, 1)

It puts great strain on my relationships with family and friends. (BSS,2)

I tend to isolate in winter, refuse invitations (or accept them and then regret it). Friends sometimes think I’m in the huff or being boring, when actually I know I just don’t have the inclination or energy to socialise. (BSS, 3)

Secondly, SAD experience generates interest but also disdain – the suffering associated with winter light is seen as unbelievable, not worthy of denoting as a condition – meaning that, as such, it is a recognized affectual state, but one accompanied by unsure and uncertain relations that seem to somehow work against collectivity. As such, SAD experience can be viewed as simply a product of winter and as idiographically closed-off, irrelevant to others elsewhere, in that winters in the West of Scotland are notoriously low in light, cloudy and damp, if often very wet, with little snow-glare to brighten short days. As these long-form survey responses indicate, in such environmental conditions SAD may be experienced but not acknowledged as an epistemic collective reality:

People tend to roll their eyes when it is mentioned. There was no such thing as SAD 50 years ago, we just got on with it. (BSS, 4)

Have tried to look for self-help groups in my area, and people that are feeling the same as myself but to no avail unfortunately. (BSS, 5)

People just pass it off as winter and don’t recognise it as a condition. (BSS, 6)

Where our project is based means that idiographic light conditions meet idiopathic environmental illness experiences meets sceptical and long-established cultures of stigma, stoicism and denial regarding mental health and illness – something arising in Scotland more generally even for those illness categories undisputed by psychiatric science (Ewens et al., 2022; Parr et al., 2004). Indeed, if those sceptical of SAD as distinct illness experience might attribute the cause to anything, it would be the environment, albeit a local ‘SAD-ogenic’ environment not straightforwardly replicated elsewhere (a play on related terminology, perhaps in opposition to ‘salutogenic environments’: Shortt et al., 2011). In this view, to be SAD-affected by low light in winter is to live in Scotland – it is a Scottish problem – an idiographic reality born of land, weather and latitude but not necessarily something shared with others elsewhere.

Alternatively, another twist in the reasoning here is that SAD as an environmental illness is not allowed to be a Scottish problem, precisely because of the diffusion of low-light and cultural norms – or ‘where we are coming from’, in Ingold’s, 2021 terms – being simply ‘natural’, an unavoidable fact of place and circumstance, shared by all peoples and who have a responsibility simply to manage it as best they can (without complaint or calling on the services, ideas and practices of others). Thus:

People understand, but it is not addressed as a specific issue. It’s just part of living here, no point whinging. (BSS, 7)

People tend to think you’re just fed up or moaning. ‘You live in Scotland, what do you expect?’ Or ‘We all feel crap in winter’ (BSS, 8)

Just a general feeling of ‘it’s Scotland’, get on with it. (BSS, 9)

There’s a perception that it’s a Scottish, stoical thing. (BSS, 10)

Most people seem to accept lower mood in winter in this area. (BSS, 11)

This argument suggests that certain places featuring low winter light and poor winter weather may also become characterized by social and cultural conditions engendering a pressure to tolerate these environmental oppressions. SAD biosociality may hence be particularly difficult to identify or indeed promulgate in Scotland as part of something larger, more extensive, more far-reaching, perhaps embedded within wider common cultures of neglectful or aversive wintering behaviours, and ways of living, particular to a damp, dark north-west UK. At the same time, and as survey participants themselves observed, the potential to develop alternative cultural practices of inhabiting seasonally darkened places can be a source of hope: examples from other places, such as Sweden’s internationally popularized culture of ‘cosiness’, or hygge (Bille, 2015), and alternative experiments to re-engage with the environment (Hunt, 2018). On the one hand, these possibilities point to further contours of the diffuse and variegated geographies of SAD, ones animated by experiences of trying and learning new ways to live with light and low-light. At the same time, these observations recall Bradley’s (2021) emphasis on the labour required to foster cultures and practices of biosolidarity, and mark the significance of the biosocial body – subject to the wearying, isolating and self-doubting experiences of SAD – as a subject calling for more attention in its own right.

An applied cultural geography of wintering with SAD others

Having acknowledged some of the challenges previously faced by the UK SAD community in maintaining momentum and gaining recognition in clinical communities and health services, including the particular challenge of recognition in West of Scotland communities, we are ourselves interested in creatively experimenting to devise and share alternative strategies for building greater SAD biosocialty, re-opening the potential for collective practices of biosolidarity (Bradley, 2021) that work with the needs of hitherto-isolated individuals and alert them to contemporary networking possibilities. The programme of research for our current project included the public workshop series mentioned earlier occurring in autumn and winter 2022–23, co-designed with both a visual artist-poet and psychosocial psychiatrist, comprising seven Glasgow-based events with self-selected SAD-affected participants (20 registered following a recruitment drive: see Endnote 1).

Our intention was to create a type of ‘biosocial space’ where participants could experiment together out-of-doors with creative activities, generating dialogue between things seen, heard, and written about SAD experience. The workshops were spread over the course of a single winter to provide a low-demand structure of support for winter-affected participants, and to cultivate a sense of camaraderie through shared rituals and new collective rhythms of gathering to catch up with one another and reflect on experiences from the preceding weeks. Workshop design centred on creative experiments prompting curiosity about weather-and-light worlds and the tones of winter light; these activities were designed in dialogue with the team’s artist partner and in response to key challenges of SAD-affected life identified in the project survey (via ‘sky framing’, ‘makeshift sun bowers’, ‘place-making’, ‘letter writing’, ‘indoor light design’, ‘SAD-sociality’ and ‘collective poetic manifesto’: Finlay et al., 2023). Activities took place in small groups or pairs, encouraging intimate dialogue, followed by group sharing and reflection, cultivating rhythms of attention and expression that participants were encouraged to build into their day-to-day lives using a creative ‘seasonal journal’ and their own ideas for outdoor and light-based seasonal experimentation. More remains to be reported about the design, benefits and challenges of the workshops – including participants’ autonomous continuation of ‘seasonal gatherings’ following the conclusion of the research. Nonetheless, this outline of their content, noting their joint role as a space for creative experimentation and collective rhythmicity, starts to show how creative-led, collective activities became a space in which to ask participants – and for participants to ask themselves – what activities occasioned a re-think of their SAD experience and how they might in future anticipate embodying winter differently.

From the earliest stages, feedback was strikingly positive. Since our first meeting in October 2022, as ‘changing the clocks’ ushered in Scotland’s reduced wintertime light, participation in a group that collectively identifies as SAD-affected provoked profound emotional responses and shifting perspectives among participants. As the opening quotations for this paper indicate, this new feeling of being together changes illness experience and what it ‘means’ to be SAD: as one participant writes, they have been rethinking ‘openness and readiness’ for SAD times, while another notes ‘feel[ing] less like an over-dramatic kid for struggling’. In the workshops, environmental experiences and the spatialities of light itself, so central to SAD, have been considered and shared, and as a result the group explored and proposed key conceptual changes: ‘It’s not “the dark”, it’s the light!’. These specific words reveal how collective thinking initiated fresh understanding of the fundamental problem causing SAD, suggesting possible new strategies in response. Instead of fixating on battling through the dark, their focus turned to what light is available and what can be done with that light. Thus, these collectively explored changes in perspective could promote new forms of ‘SAD agency’. As another participant reflects in their evaluation notes, ‘maybe need to change what I/we frame’.

What does this amount to in biosocial terms and why should we care? At the time of writing, our SAD winter workshop series is complete, but rather than that being the end-of-matters – an emergent sense of community – articulated by the participants themselves – has developed around their shared experience of seasonal depression (see Figure 1). That much is clear:

There is power in community. You don’t have to endure and overcome SAD alone.(Evaluation, Workshop 3)

The comfort of listening to one another and recognising parts of yourself … (Evaluation, Workshop 3)

Knowing more about how SAD affects me can help me help others in my community.(Evaluation, Workshop 6)

Figure 1. Emerging biosociality in the ‘Wintering Well’ workshop programme. (photograph by authors).

As our workshop participants continue to meet and converse independent of us, the researchers, it remains an open question as to whether their biosocial activities will build into something ongoing and outward-looking – seeking and supporting others beyond our initial collective – and whether something we might call biosolidarity could ensue. In Bradley’s (2021) work on body-focused repetitive behaviours (BFRB), she notes that biosocial validity is more likely to accrue from engagement with and acknowledgement from similar others than from the medical diagnoses of clinical practitioners, even as the latter is welcomed by many. In discussing BFRB, Bradley (2021, p. 10) shows how many forms of biosociality are not just uncertain, but also processual, taking shape over time and through interaction: ‘biosociality is complex, and the different interpretations, expectations and practices of coming together with shared experiences of illness are deeply nuanced’. Even in these early stages of analysis, our workshop series has provided significant evidence of exactly this complexity and nuance in experience of collective self-inquiry and self-advocacy. So far in our early work of sharing SAD experiences with communities elsewhere, via creative and practical resources (a guide-book, a ‘toolkit’ and ‘a CBT resource’, produced with workshop attendees), we see enthusiasm for ‘living differently’ in winter light, but future research must investigate whether these resources can translate – via idiographic adaptation, experience and response – to varied localities beyond Glasgow.

Conclusions: speculative futures with diminished and reimagined light

We began this paper by weaving together a commentary on the uncertainties involved in gathering the idiopathic, idiographic and the biosocial with reference to SAD, and continued by contemplating how the geographies of light, SAD and SAD biosociality may be inter-related. In the heart of the paper, we have told a short story about why it might be difficult to foster biosocial relations – let alone fuller-formed biosolidarities – around SAD as an environmental illness, based on its history and, to some extent, its geography, at least in Scotland. At the same time, we have also discussed how idiographic attentiveness to the lived experience of being SAD in one city-region in Scotland might have potential to cultivate new forms of biosocial relations via creative ways of noticing light and SADness together. The latter story is brief and reflects the stage of a research project for which a particular biosolidarity journey is ongoing, its destination as yet uncertain. Nonetheless, we have offered a brief insight into how ‘being in-place’ with actual ‘environmental experience’ may help to change experience and discourses around SAD (Bodden et al., 2024a), and as such we would claim to have made a ‘geographical contribution’ to clinical accounts of SAD (Bodden et al., 2024b). We now conclude with some final speculative comments, ones which, ironically perhaps, start to exceed idiographic perspectives on SAD in efforts to recover shared and shareable experiences of idiopathic SAD which might inform trans-local biosolidarities.

In an era of climate change where patterns of seasonality and weather-worlds are predicted to become ever more unpredictable – with seasons truncating or expanding variably year-by-year – we might envision a near-future where expected levels and qualities of light at given times of the year no longer arrive so dependably, potentially with significant socio-environmental ramifications. At northerly latitudes, we might speculate on the likelihood of new regional winters characterized by still damper conditions, more enveloping gloom overhead, and as a result, sequences of days or prolonged periods where sunlight levels are lower. Will ‘Winter Blues’ get bluer, cases of seasonal depression more widespread? Elsewhere, regionally specific environmental problems – annually occurring summer wildfires in western Canada or frequent dust storms in the Middle East – already result in long-lasting atmospheric haze events where the sunshine of summer skies is occluded, darkened by drifting layers of soot, sand and other airborne particulates. In these regions, another axis of troubled light-poor health-lowered mental health might arise under smoggy, smoky grey skies resulting from entirely different environmental causes (and pathologies: Santana et al., 2021). Such scenarios suggest that access to light may diminish, even in lower latitudes, with profound mental health implications for people sensitive to SAD.

The destabilizing impacts of climate uncertainty have increasingly been recognized as forms of ‘ecological anxiety’ (Boyd et al., 2022). We are speculatively interested in exploring this relationship – possibly the blurred line – between people self-identifying with symptoms associated with SAD and those suffering from more diffuse ecological anxiety. Conceivably, it may be necessary to entertain a widening spectrum of those afflicted by extended SADnesses where an existential sense of loss – a sense of ‘solastagia’, to use the evocative phrase of environmental philosopher Albrecht et al. (2007) – felt in relation to seasonality exists in concert with a more narrowly defined biochemical response to insufficient amounts of natural light. In positing this scenario, we are keenly conscious of the need both to take such an area of overlap seriously and to avoid undermining the idiographic circumstances and personal experiences of those who consider it an unhelpful conflation of distinct conditions, demanding different responses and treatment options. Here, though, it is worth citing anthropologist Hacking’s insistence that the labelling, or ‘dynamic nominalism’, deployed when ‘making up people’ can operate as a form of care and advocacy: ‘if new modes of description come into being, new possibilities for action come into being as a consequence’ (Hacking, 2007, p. 166). Hence, if and when people come together to discuss their embodied seasonal depression and ecological anxiety as a result of low light, they may create new possibilities for biosolidarity around dark, light and gloom, drawing on idiographic contexts but forging trans-local connections.

Thus, by way of conclusion, and drawing on emerging evidence about everyday experiences of SAD and changing light, our appeal is for the compilation of more nuanced social, cultural, and emotional geographies of environmental illness – more idiographic idiopathology. In an ongoing project such as ours – also carrying with it the obligation of generating research impacts beyond academia – and following from recent published commentary by Bradley (2021), we are also conscious of twin (or parallel or split) objectives: the first directed at critical inquiries where we seek to make sense of the lived experience of SAD; but the second where there is a potential crossover, leading to worlds beyond the academy, from understanding biosociality to enabling biosolidarity. As we look ahead, we see more not less opportunity for this collective purpose as we contemplate the future and a trans-local climate-changed environmental politics of light.

Acknowledgments

We thank artist Alec Finlay and Professor Chris Williams of Five Areas for their collaborative work in the design of Wintering Well and the wider project. We acknowledge the Wintering Well participants for their insights into the ongoing benefits of SAD biosociality. Our critical reader, Chris Philo, and the anonymous referees helped us improve the paper and its purpose. The research ‘Living with SAD: practicing cultures of seasonality to “feel light” differently’ was funded by ESRC grant ES/V002473/1.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The work was supported by the Economic and Social Research Council [ES/V002473/1]; Economic and Social Research Council .

Notes

1. ‘Living with SAD’ is a 2.5 year ESRC research project bringing together cultural geography, social psychiatry and CBT tools. We recruited individuals who self-identify as experiencing symptoms of SAD (only some of which will have a diagnosed disorder and who receive treatment) to help reflect on what active-cultural-behavioural interventions make a difference to how it is possible to (re)occupy winter seasons and outdoor light. The study is deliberately situated in West of Scotland health board areas, a region renowned for extended winter gloom as the result of latitude, high precipitation, overcast conditions and low seasonal light levels (with 9% SAD incidence). A University of Glasgow ethics application covered ethical recruitment and informed consent, GDPR and risk. We worked with project partners ‘Living Life to the Full: Five Areas’ and their online newsletters and advertisements to advertise a survey with opt-in pathways for research interview and workshop participation. The survey recruited 350 people, from this pathway 5 people opted to undertake 6-week time-space diaries, 15 individuals took part in semi-structured biographical interviews and 20 people were recruited for the Wintering Well programme for 7 sessions with entry and exit mood surveys and semi-structured interviews (with over 90 people expressed interest and forming a large email network).