Dear Dr. Roach: I read your answer to a recent question about seasonal affective disorder (SAD). You mentioned that folks can get SAD in the summer but didn’t discuss treatment options. I’ve tried caffeine and alcohol; they don’t seem to work!

More seriously, I’ve discussed moving hemispheres with my wife so that we could have an endless winter, but I doubt that we could really afford it. Plus, she seems to like the heat and the sun. I’ve also tried to take jobs that offer long, indoor hours in the summer. But at some point, I have to go outside, and this is when the depression starts.

My doctor offered to prescribe antidepressants, but I’d rather find nonpsychoactive drug therapies. Any help you can give me would really be appreciated; summers are horrible, and it feels like I have a heavy weight on my shoulders for three months out of the year. — T.

Answer: For the minority of people with SAD and summer depression, the treatment is the same as with other types of depression. Both medication therapy and psychotherapy can be used. Of course, it makes sense to limit your hours outside. But as you say, it’s almost impossible to limit this to zero, and it sounds like you have a very profound response to being outside. Keeping your bedroom cool at night may also help.

I do want to correct your terminology about psychoactive drugs. A psychoactive drug has significant effects on psychological processes such as thinking, perception and emotion. Medications for depression, such as the SSRI class, have minimal effects on these psychological processes.

Most of my patients who have taken these tell me that they don’t feel like the medicine is affecting their mind; rather, they feel like the medication reduces the effect that their depression has on their psychological functioning. They feel that the medicine gets them back to feeling themselves.

I am not suggesting that these medicines work for everyone; they don’t. I am also not saying that there aren’t people who do experience psychoactive effects; a few people do. I’ve seen people have a dissociative reaction where they feel as though they are watching a movie and aren’t really present. But when this happens, we stop the treatment, and symptoms go away.