Review: Defeating SAD, by Norman E. Rosenthal, M.D.

Blurb

In his landmark new book, Defeating SAD, Dr. Norman E. Rosenthal, who first described Seasonal Affective Disorder (SAD) and is
the foremost authority on the subject, offers an up-to-date guide to
overcoming the miseries that millions experience with the changing
seasons.
In his lively style, Rosenthal offers advice on how to identify, treat
and overcome both winter and summer varieties of seasonal affective
disorder, as well as the less severe, yet bothersome, winter blues.
Having pioneered the use of bright light therapy for SAD and
relying on his decades of experience treating SAD patients, Rosenthal offers strategies and techniques for defeating the condition,
including cognitive-behavioral approaches, diet and exercise advice,
medication, and meditation.
Dr. Norman Rosenthal is the author of Poetry Rx released last year to
rave reviews including:

• The New York Times The Well Book List of 8 Favorite Books in
  2021 for Healthy Living
• The subject of a New York Times op ed by Jane Brody

My Review

Thanks to Anne at Random Things Tours, and to the publisher for sending me a copy of this book.

I’m ambivalent about this book. Sorry, Anne, I promised a fair, honest review, and I won’t tag the author.

I found the description of SAD and the treatments available very interesting. As a person with non-seasonal depression that gets worse at different times of year – summer because I don’t get enough sleep and winter because it’s so dark and I live in a place where I’m uncomfortable and can’t go for long walks in the woods like I used to do in Immingham – this is really helpful and informative. The advice on light therapy is comprehensive and provides a lot of guidance on the use and purchase of appropriate light boxes. The thrust of this book is that light therapy, in combination with exercise, meditation, and medication is an effective treatment for SAD and should be investigated with the support of professionals.

I treated myself to a sunrise/sunset clock based on the advice in this book, and it has helped with somethings, although I do have an infect as I write this, so it could be exhaustion. I also found the information about medication really helpful, since I found out my venlafaxine is an SNRI, not an SSRI, which means it targets serotonin and norepinephrine, not just serotonin, and that it causes weight gain and can cause increased blood pressure. I could have done with being told this when I started taking venlafaxine in 2017. Providing this information to people on medication for depression is a boon, and needed if patients are to make informed decisions about their healthcare.

I liked the emphasis on the need for a combination of treatment methods to deal with seasonal depression, especially the discussion of meditation and exercise as supports. I agree, they’re really quite helpful and I always feel awful if I don’t get out for a walk or go swimming but it’s really hard if you’re depressed or in a seasonal slump.

The book is easy to read and squarely aimed at the non-professional market. The inclusion of extensive notes and references to papers for the professional who wants to look deeper is a useful bonus.

And, now we’re on to the stuff that makes me ambivalent. Big warning for fatphobia, weight talk and eating disorder triggers.

Rosenthal demonstrates repeatedly that he is fatphobic; he seems to think the gain of a bit of winter weight due to comfort eating is a terrible thing. Sorry, but if I’m depressed and a biscuit cheers me up long enough to get something done, or even leave the house for a walk, then I’m eating the damn biscuit. A fatphobic HCP bullying you about gaining weight does not help when you’re depressed! He also says carbs are addictive. Nope. Carbs are the primary fuel of the body and the brain, starving yourself of carbs will fuck you up, and you will be obsessed with getting them. That is not addiction, that is your body driving you to find a fuel source.

Do not weigh yourself every day! Do not spend all day fixated on your weight (phrasing it as ‘keeping your weight in mind all day’ means the same thing). If you have a history of eating disorders this is guaranteed to restart it; if you have history of disordered eating, you might just end up with an eating disorder; if you’ve been lucky enough to get through life without having your relationship to food and your body fucked up by diet culture, this will do it.

This psychiatrist is practising beyond his competency and giving dangerous dietary advice. His experience is in depression and Transcendental Meditation, not dietetics or nutrition, eating disorders or anything else in this realm. He is talking purely from personal experience and from the sounds of things has a really disordered relationship to food. If he hasn’t already caused harm with this attitude, I would be greatly surprised.

Overall, this book is a useful introduction to SAD and light therapy, but ignore the stuff about diet.

---

About the author

NORMAN E. ROSENTHAL is the world renowned psychiatrist and bestselling author who first described seasonal affective disorder (SAD) and pioneered the use of light therapy as a treatment during his twenty years at the National Institute of Mental Health. A prolific researcher and writer, he has written more than three-hundred scholarly articles and authored or co-authored ten popular books, including Poetry Rx, the New York Times bestseller Transcendence and the national bestsellers The Gift of Adversity, and Super Mind.