Have You Accepted Seasonal Affective Season as Normal?

For the first time in as long as I can remember, I don’t have seasonal affective disorder. And it’s not because I’m relaxing on a sunny beach somewhere. My gaze is squarely fixed at a grey sky spitting out sleet and hail in subzero Toronto. I managed to achieve what seems like an impossible feat due to a few changes – some simple, some radical.

Full disclosure: I started writing this two weeks ago post-holiday with New Year optimism, and since then, the edges of winter unhappiness have managed to get their grip on me again.

Like most things in mid-life, these unfun situations creep up on you. Like dirty dishes gathering haphazardly around the kitchen sink and not making their way magically into the dishwasher. The belief that January equals survival mode crept in on me unnoticed, but the pile-up was getting disdainful. For years, I told myself this was just how winter worked.

A large part of why January drained me for nearly two decades is simple: I worked through half of the holiday season.

Seventeen years in emergency medicine (as a clerk, resident, and now staff) taught me that working Christmas and New Year’s is one of the greatest holiday buzzkills imaginable. Witnessing profound tragedy during what society insists is a happy time messes with the brain’s internal compass.

Sign a death certificate over here.
Sign Santa’s name on gifts over there.

Is it horror? Is it joy? Is it both?

Healthcare workers become experts in psychological compartmentalization. But that skill comes at a cost.

What I’ve learned — slowly — is that I have a shift-work and moral distress set-point. I can tolerate a certain amount of sleep disruption, hallway medicine, and emotional load. But once I cross a threshold, I stop feeling like myself.

That’s usually when the thought creeps in on the drive to work:

“Ugh. Back to that place again.”

My nervous system waving a white flag, but I wasn’t listening.

Shift work isn’t just unpleasant — it’s biologically disruptive.

Large studies show that compared to day workers, shift workers have:

• 40–60% higher rates of depressive symptoms

• Significantly higher rates of chronic insomnia and circadian rhythm disorders

• Increased risk of cardiovascular disease and certain cancers, including breast and colorectal cancer

Healthcare workers are particularly vulnerable because shift work is layered on top of emotional trauma, moral injury, and constant vigilance. And yet, we tend to frame the solution as “be more resilient.”

I have a 4AM shift tomorrow, and I worked until after midnight this past Saturday.

It’s constant jetlag.

But that’s what our healthcare system requires right now.

If we want safe, sustainable care, we need structural change that protects both patients and the professionals caring for them — not endless adaptation from exhausted humans.

Reducing the number of ER shifts I work has allowed me to genuinely enjoy practicing medicine again.

Let’s be clear: emergency medicine still requires emotional containment. That’s the job. But there’s a difference between functional dissociation and chronic depletion.

This change came with real financial consequences. I’m still figuring out budgets, trade-offs, and which activities my daughters can realistically do. I took on a lower-paying clinic role that I deeply enjoy and am building from there.

Radical life change is painful. But when it comes to brain health, it often delivers the biggest return.

I was pre-contemplative about changing my clinical work for nearly three years before the right opportunities started to emerge. If this isn’t your season for a radical pivot, there are evidence-based, lower-lift interventions that help.

Vitamin D functions like a hormone in the brain — and it directly regulates serotonin production. A well-cited paper in The FASEB Journal showed that active vitamin D (calcitriol) turns on the gene for tryptophan hydroxylase-2 (TPH2), the key enzyme your brain uses to make serotonin.

In a large meta-analysis (31,000+ participants), people with the lowest vitamin D levels had ~31% higher odds of depression than those with the highest levels.

I was fully aware of this.

So, for five years, I faithfully took 1,000 IU of vitamin D daily. I assumed I was covered.

I wasn’t.

Despite supplementation, I had severe vitamin D deficiency, confirmed on bloodwork. I wrote in a previous popular post on cortisol here, about my visit to an integrative MD . Under their medical supervision, I completed a short course of higher-dose replacement (5000 IU/day x 2 weeks, now 2500 IU/day maintenance) — and I’m confident it has helped stabilize my mood and energy this winter.

Vitamin D deficiency:

• Affects 30–50% of adults in northern latitudes

• Is more common in winter, indoor workers, and shift workers

• Is associated with depressive symptoms, fatigue, and immune dysfunction

Taking vitamin D is not the same as having adequate levels.

I now have two light therapy lamps: one at my desk, and one near my Peloton that I use during rides.

This isn’t placebo.

Clinical trials show that bright light therapy — typically 10,000 lux for 20–30 minutes each morning — is a first-line treatment for seasonal affective disorder. It works by suppressing melatonin, stabilizing circadian rhythms, and improving serotonin signaling.

Morning timing matters far more than evening use. Importantly, SAD treatment does not require UV light (which carries skin cancer risk). Bright visible light is sufficient and evidence-based.

Between the radical shift of reducing ER work, and the low-lift shift of buying vitamin D drops and lux lamps off Amazon, I’ve made a medium-level shift in my ability to be mindful. Still very much a work in progress.

I’ve noticed that my nervous system does not do well with starting the day by scrolling. So I stopped. Completely. I replaced it with five minutes of reading mantras on the Mantra app. I’m also trying to retool Substack so it serves me long-form essays instead of Notes — because I come here for slower thoughts, not short-form soundbites.

I’ve also noticed that every time I post here, my nervous system doesn’t enjoy the highs and lows — wondering about open rates, reads, comments, or likes. I’m actively trying to let that go.

Writing is one of my favourite things. I’m practicing gratitude for the fact that I even have a platform where people can read my words — and that sometimes, if I’m lucky, something resonates. After years of unsuccessfully trying to “be mindful,” I finally have the slightest handle on what it actually means.

Select your thoughts every day like you would select your clothes. That’s a mantra that one of my favourite yoga instructors said at the beginning of class. For 2026, I’m trying to pair this reminder with getting dressed everyday.

I’m preparing to launch my book later this year, and it feels like there are a million tasks to get done — and never enough time, especially with snow days called at the last minute. But harder than the tasks, is the self-talk and self-criticism that I must manage.

Probably the single most important thing I can do to have a “successful” book launch is to not lose my mind in the process, to actively work on my anxiety levels purposefully and intentionally by not skipping things I know keep me grounded (workouts, guarding my mind, writing, and quality time with my family).

But still, on that topic, a quick update.

I’ve been working on my first book, now entitled Rise After Silence, for the past 4-5 years, I’m nervous about its release into the world because of the deeply personal details I share. To take pressure off perseverating over things I can’t control, like reviews or how many books are sold (although please, Review it! Buy it! Share it! BTW - a full-sized book makes a really great coffee table coaster), I’m focusing on trying to organize a launch concert that will feature other artists.

So, please mark your calendars tentatively for Oct 2-4 weekend if you have any interest in attending.

But instead of living for the future — hoping my book launch is “successful” — I’ve accepted a quieter truth: most books don’t sell well. And that’s okay.

I wrote a book. I get to become an author.

Enjoying that feeling today might be a higher high than anything a year from now, when I could choose to ruminate over C-list sales.

What can you enjoy today instead of assuming everything will go wrong? (She says —with authority —still assuming it will all go wrong).

Seasonal affective disorder is common — but common doesn’t mean inevitable.

Sometimes the answer is medication (I officially bless you and your 5-HTP or SSRI - just don’t take them together, it can land you in the ER with serotonin syndrome)
Sometimes it’s vitamin D + lux lights.
Sometimes it’s fewer shifts.

Sometimes it’s letting yourself have something to look forward to, even if it doesn’t work out exactly as planned.

Often, it’s a combination.

Wishing you a gentler sail through seasonal affective season — as I still call it after all these years.
xo

Dr. Anne