Latitude, weather patterns, and culture make the Granite State a hotspot for SAD. The treatment system hasn’t caught up.
By Granite State Report
In late January, New Hampshire does something quietly brutal to the human brain.
In Concord, the shortest days of the year bring barely nine hours of daylight — sunrise around 7:15 a.m., sunset a little after 4 p.m., with the actual usable light often squeezed by overcast skies.(Sunrise-Sunset.org) You wake up in the dark, drive to work in the gray, and by the time you’re done answering emails, it’s night again.
Most Granite Staters shrug and call it “winter.” But the data tell a harsher story.
Nationwide, about 5% of adults are estimated to experience Seasonal Affective Disorder (SAD) — a form of major depression that follows a seasonal pattern, usually starting in fall and lifting in spring.(American Psychiatric Association) In New England, more than 10% of residents report significant seasonal mood change, and 3–5% meet criteria for full-blown SAD.(Connecticut Public)
And New Hampshire is near the worst of it.
Psychiatrist Norman Rosenthal, who first described SAD in the 1980s, cites research that found winter seasonal depression in nearly 10% of people in New Hampshire, compared with about 1.5% in sunny Florida.(Norman E. Rosenthal, MD) That’s a sixfold difference, largely driven by latitude and light.
Add in a mental health workforce shortage, a culture that treats suffering as a private problem to be powered through, and youth who are already in trouble — and you get a seasonal depression crisis that’s bigger than most Granite Staters realize.
This isn’t just “winter blues.” It’s a structural problem rooted in where we live, how we live, and who can get help.
What Seasonal Affective Disorder Actually Is (And Isn’t)
Clinically, SAD isn’t a cute subcategory of being grumpy in February. In the DSM-5-TR (the main diagnostic manual for mental disorders), it’s recognized as major depressive disorder with seasonal pattern.(American Psychiatric Association)
The National Institute of Mental Health defines SAD as a type of depression that:
- Happens at the same time each year, usually fall and winter
- Lasts about 4–5 months
- Has all the core symptoms of depression — low mood, fatigue, loss of interest, changes in sleep and appetite, trouble concentrating, and sometimes thoughts of death or suicide(National Institute of Mental Health)
Winter-pattern SAD often comes with its own signature features:
- Oversleeping (hypersomnia)
- Intense carbohydrate cravings and weight gain
- Social withdrawal — essentially, emotional hibernation(National Institute of Mental Health)
That’s very different from “I’m cranky because it’s slushy.”
At the biological level, reduced sunlight disrupts the brain’s circadian rhythm (our internal clock), serotonin (a mood-related neurotransmitter), and melatonin (the hormone that regulates sleep). Research on “non–image-forming vision” — the light-sensitive circuits in the eye that don’t form images but instead speak directly to the brain’s clock — suggests that some people may be genetically more vulnerable to these winter light changes.(Wikipedia)
New Hampshire is built to stress-test that system.
Why New Hampshire Is a SAD Hotspot
1. Latitude and Light: The Physics Are Against Us
New Hampshire sits between roughly 42.7° and 45.3° north latitude, squarely in the band where winter day length becomes short enough to significantly alter human biology. Concord itself is around 43.2° N.(TimeBie)
On the shortest days:
- Concord gets about 9 hours of daylight; the longest summer days are roughly 6 hours longer.(Time and Date)
- Sunset hovers in the 4:10–4:20 p.m. range, meaning most working adults miss the sun entirely on weekdays.
Large epidemiologic studies and meta-analyses have found higher rates of SAD at more northern latitudes, where winter days are shorter and the contrast between summer and winter light is greater.(ScienceDirect) Rosenthal’s early work, comparing states like Florida and New Hampshire, is part of that picture.(Norman E. Rosenthal, MD)
In plain terms: New Hampshire’s light environment in winter is ideal if you’re a spruce tree. It’s rough if you’re a human with a 24-hour mood system that expects sunlight.
2. Weather: Gray, Sloppy, and Relentless
Day length is only half the story. The quality of winter light in New Hampshire is uniquely demoralizing.
The Center for Life Management (a community mental health center in Derry) notes that New Hampshire’s winter weather “can change on a dime” — snow to rain to sleet to sun in a single day — with long stretches of cold, gray conditions that track closely with worsening mood.(Center for Life Management)
National analyses of SAD risk emphasize that it’s not just cold temperatures and fewer daylight hours, but cloudiness, fog, rain, and snow that drive winter depression risk.(GoodRx) New Hampshire routinely checks all of those boxes from November through March.
GoodRx Research created a county-level SAD risk index using weather and daylight data and found that New Hampshire includes counties with high risk for winter depression. Interestingly, the state appears in a group of high-risk states whose residents also search heavily for “seasonal depression.”(GoodRx) In other words, people here aren’t just imagining it — they’re desperately Googling what’s happening to them.
3. Mental Health Baseline: A Lot of People Are Already Struggling
New Hampshire is often held up as a relatively healthy state, but when you zoom in on mental health, the picture is less reassuring.
According to NAMI New Hampshire, about 221,000 adults in the state — more than five times the population of Concord — live with a mental health condition.(NAMI) A 2022 blog from The Partnership @drugfreeNH, sponsored by the state, highlighted:
- 37.7% of New Hampshire adults reported symptoms of anxiety or depression in February 2021
- 17% of youth ages 12–17 had a major depressive episode in the past year(The Partnership)
Worse, 56.6% of NH youth aged 12–17 with depression received no care in the previous year.(The Partnership) That’s not a winter statistic — that’s structural.
Layer SAD on top of an already high burden of depression and anxiety, and winter becomes not just unpleasant, but dangerous.
4. A Culture That Says “Handle It Yourself”
New Hampshire’s unofficial mental health policy could be summarized as: “You’re fine. Tough it out.”
That’s not speculation; it’s precisely how many Americans describe their own barrier to treatment. National survey data show that for people who say they needed mental health care but didn’t get it, the single most common reason is the belief that they should “handle it themselves,” ahead of cost or logistics.(North American Community Hub)
Combine that with the state’s “Live Free or Die” ethic, a long tradition of rural self-reliance, and a political culture suspicious of state intervention, and you get a potent stigma cocktail. People write off serious symptoms as “just winter,” or a personal failing, instead of a treatable brain condition tied to sunlight.
The Partnership’s seasonal depression explainer notes that people often minimize SAD, assuming it’s normal to feel that bad in winter — even when it’s clearly affecting work, school, and relationships.(The Partnership)
In practice, that means Granite Staters don’t show up for help until things have gone seriously sideways: job loss, addiction, suicidal thinking, or crisis-level family conflict.
The Treatment Gap: Why Help Is Hard To Find
New Hampshire’s mental health system has been under strain for years. SAD isn’t the only reason, but it’s one more load on a structure already bending.
1. Workforce Shortages
At New Hampshire Hospital, the state’s main inpatient psychiatric facility, an NHPR report in early 2024 found vacancy rates of around 30% for both registered nurses and mental health workers.(New Hampshire Public Radio) That means fewer beds, longer waits, and more burnout for the staff who remain.
A 2024 DHHS health care workforce report notes that primary care practice concentrations — including behavioral health — are significantly lower in rural parts of the state, with regions like Greater Sullivan County facing some of the most severe shortages.(NH DHHS)
A 2025 one-pager from advocacy group New Futures puts it bluntly: “our state’s health care workforce continues to face critical shortages that affect access to quality and timely care… patients are struggling to get the care they need when they need it.”(New Futures)
Federal maps of Health Professional Shortage Areas (HPSAs) show multiple New Hampshire counties designated as having mental health provider shortages, especially in rural areas.(Rural Health Information Hub)
When you’re dealing with a condition that hits predictably every winter, that kind of capacity mismatch is a recipe for chronic unmet need.
2. High Risk, Low Treatment
The GoodRx analysis of SAD risk and medication fills reveals another unsettling pattern: some states — including New Hampshire — show high risk for winter depression but relatively low prescription fills for the only FDA-approved medication for SAD prevention, bupropion XL (Wellbutrin XL).(GoodRx)
There are several possible explanations:
- People are using other antidepressants instead of bupropion
- Communities are relying more on non-medication approaches like light therapy and counseling
- Or: high unmet need — people are suffering but not getting any treatment at all
That last possibility lines up uncomfortably well with the youth data showing that more than half of NH adolescents with depression received no care.(The Partnership)
3. Youth on the Front Line
Young people are especially vulnerable to seasonal mood shifts. The Partnership @drugfreeNH notes both the high rate of youth depression and the tendency for youth with mental illness to self-medicate with substances instead of seeking help.(The Partnership)
Nationally, adolescents with untreated depression have higher risks of addiction, school dropout, and suicide.(The Partnership) In New Hampshire, a state already grappling with substance use and suicide, ignoring winter pattern depression in teens is playing with fire.
What Actually Works for SAD
The bleak part is the physics and the workforce. The hopeful part is that SAD is one of the most treatable forms of depression — if people can access care early enough.
Here’s what the evidence says.
1. Light Therapy: Replacing the Missing Sun
The gold-standard first-line treatment for winter-pattern SAD is bright light therapy: sitting near a specially designed light box that delivers about 10,000 lux of full-spectrum light — roughly 20–40 times brighter than indoor lighting — for 20–30 minutes each morning.(National Institute of Mental Health)
Decades of research, starting with Rosenthal’s work, have shown that correctly used light boxes can significantly improve mood, often within 1–2 weeks.(The Washington Post) The key details:
- Timing matters: The morning is best for most people, because it shifts the circadian clock earlier, counteracting winter’s tendency to push it later.
- Consistency matters: Skipping days limits the benefit.
- Safety matters: People with certain eye conditions or bipolar disorder need medical guidance before starting.
Public health organizations and major clinics like Mayo Clinic now routinely recommend light therapy as a core part of SAD management.(Mayo Clinic)
2. Cognitive Behavioral Therapy for SAD (CBT-SAD)
Light boxes treat the biology. Cognitive Behavioral Therapy for SAD (CBT-SAD) goes after the thought patterns and behaviors that winter amplifies: catastrophizing about weather, withdrawing from friends, abandoning routines, and mentally writing off four months of the year.
Clinical trials have found that CBT-SAD can be as effective as light therapy in the short term, and may have more durable benefits across future winters, because it teaches people skills they can reuse.(The Guardian)
In New Hampshire, where winter absolutely will come again, that durability matters.
3. Medication
Antidepressants are not a failure of character; they’re a tool.
- The FDA has specifically approved bupropion XL for preventing winter depressive episodes in people with SAD.(GoodRx)
- Other antidepressants (SSRIs and SNRIs) are also commonly used, often alongside light therapy.
For people whose seasonal depression is severe, recurrent, or complicated by other conditions (like bipolar disorder or substance use), medication can be lifesaving — especially when winters are long, treatment access is spotty, and relapse is predictable.
4. Lifestyle and Environmental Strategies
None of these replace medical care, but they can meaningfully move the needle:
- Morning outdoor light exposure, even on gray days, helps reset circadian rhythms.(Axios)
- Regular exercise, particularly outdoors, improves mood and sleep and is repeatedly recommended by expert organizations.(Verywell Health)
- Sleep hygiene — consistent bed/wake times, limited night-time screens — protects the fragile winter clock.
- Social connection counters the “hibernate and disappear” instinct that worsens depression.
The problem isn’t that we don’t know what works. The problem is that New Hampshire hasn’t fully adapted its systems and public spaces to the reality of living at 43° north.
New Hampshire’s Opportunity: Creative Community Solutions
If you accept that New Hampshire’s winters are biologically stressful, then you can stop moralizing about people who “can’t handle” them — and start designing communities that make seasonal depression less likely.
Here are concrete, realistic moves that cities, towns, schools, and institutions in New Hampshire could take.
1. “Light Libraries” and Public Light Rooms
Concept: Just as libraries lend books, they could lend light therapy lamps — or designate bright “light rooms” that residents can use in the morning.
- Local mental health organizations like Center for Life Management and NAMI NH already educate about SAD and treatment options.(Center for Life Management)
- Partnering with public libraries, town halls, and senior centers to create “sun rooms” — spaces lit to near light-box levels in the early morning — would make treatment feel normal and accessible, especially for people who can’t afford a device or don’t trust online health products.
Why it matters: GoodRx’s finding that New Hampshire has high SAD risk but relatively low bupropion fills suggests that people may be under-treated or leaning heavily on non-medication strategies.(GoodRx) Giving those strategies real infrastructure could help.
2. Winter-Smart Schools
Teenagers are hit hard by sleep disruption and seasonal mood swings. Yet most New Hampshire high schools still start early, indoors, under dim fluorescent lights.
Evidence-based tweaks:
- Morning “light homeroom”: 15–20 minutes in a bright, sun-facing space (or with high-lux lighting) at the start of the day.
- Outdoor movement breaks even in cold weather — short walks, not football practice.
- Proactive screening for seasonal mood changes, using tools schools already use for general mental health.
The youth data (17% with major depression; over half not receiving care) demands that schools treat winter mood not as an individual weakness but as a predictable environmental challenge.(The Partnership)
3. Winterized Public Spaces
If you walk around many New Hampshire downtowns in February at 5 p.m., the message is: Go home. Nothing is here for you.
Municipalities could counter that by designing for pleasant winter evenings:
- Brightly lit, heated indoor walking loops in civic centers, malls, or large churches, open to the public for a couple of hours each night.
- Co-located support groups, AA/NA meetings, and youth drop-in hours in these spaces — essentially turning them into winter “villages” rather than empty buildings.
- Micro-grants for local businesses that invest in cozy winter lighting, early-evening events, and community dinners, especially during the hardest months (January and February).
This isn’t just feel-good urbanism. Social connection and physical activity are two of the most effective non-medication buffers against SAD.(Verywell Health)
4. Telehealth for the North Country and Rural Towns
HPSA designations and state workforce reports make clear that rural areas of New Hampshire face the steepest provider shortages.(NH DHHS) For them, telehealth is not a luxury — it’s the only practical way to deliver CBT-SAD, psychiatry consults, and ongoing follow-up.
Policy priorities:
- Ensure broadband access for rural and low-income households.
- Fully reimburse tele-mental health at parity with in-person care, including group therapy and CBT-SAD programs.
- Support community spaces (libraries, town offices) where people can privately connect to telehealth if home internet is unreliable.
5. Public Campaigns that Name SAD — Explicitly
Right now, most New Hampshire mental health messaging is generalized: “You’re not alone. Help is available.” That’s important, but winter-specific depression deserves winter-specific messaging.
DrugFreeNH’s seasonal depression article is a model: it clearly distinguishes “feeling down” from depression and SAD, lists concrete coping strategies, and names local resources like 2-1-1 NH, The Doorway, and the NAMI NH resource line.(The Partnership)
Imagine a statewide campaign every October that:
- Explains SAD in clear, non-jargony language
- Encourages people to track mood across seasons
- Normalizes light therapy, therapy, and medication
- Directs people to 988, 2-1-1 NH, and local community mental health centers
That’s not culture war territory. That’s basic public health.
Where Individuals Fit In — Without Carrying It Alone
The structural problems — latitude, workforce shortages, underfunded services — are not on individual Granite Staters to fix. But there are things people can do right now, within that reality.
If you notice your mood reliably crashing every fall or winter:
- Track it. Write down when symptoms start and stop. Patterns over 2–3 years are a strong clue this is SAD, not random.(National Institute of Mental Health)
- Bring that data to a clinician — primary care, therapist, or psychiatrist. It’s easier for them to act if they can see the pattern.
- Ask explicitly about light therapy, CBT-SAD, and whether a preventive medication plan (like starting bupropion before symptoms hit) makes sense in your case.(GoodRx)
- Don’t ignore suicidal thoughts, intense hopelessness, or total shutdown of daily functioning just because “it happens every winter.” That’s crisis territory, even if it’s predictable.
If you’re in crisis — winter or not — help is available:
- 988 Suicide & Crisis Lifeline (call or text 988) – 24/7, free, confidential.(The Partnership)
- 2-1-1 NH – connects you to local resources, including mental health and substance use support.(The Partnership)
- NAMI NH Resource Line – helps families and individuals find supports in the Granite State (1-800-242-6264, press 4).(The Partnership)
None of that fixes the tilt of the Earth’s axis. But it can change how painful winter has to be.
Watch and Learn: Recommended Videos on SAD
These videos are good starting points for readers who learn better by watching than by reading journal articles:
- Understanding seasonal affective disorder (SAD) – Mayo Clinic Health System
https://www.youtube.com/watch?v=1Ujh9hHJ-hA (YouTube)
- Seasonal Affective Disorder – Mayo Clinic Health System (overview of symptoms and treatment)
https://www.youtube.com/watch?v=TWtrS8Qvo1Q (YouTube)
- Mayo Clinic Minute: Lift your mood with light therapy
https://www.youtube.com/watch?v=D4peUlUQ3zI (YouTube)
- Do SAD lamps really work? – Dr. Zoe Williams explains how light therapy works
https://www.youtube.com/watch?v=QYwcRSZWwHg (YouTube)
The Bottom Line: New Hampshire Needs to Stop Pretending Winter Is Neutral
Taken together, the evidence is blunt:
- New Hampshire’s latitude and winter light patterns biologically predispose residents to seasonal mood disruption and depression.(ScienceDirect)
- Local data suggest high overall mental health burden, especially among youth, and large gaps in care.(The Partnership)
- Workforce shortages and rural HPSAs mean even motivated people may struggle to find treatment.(NH DHHS)
- Yet SAD remains culturally underplayed — a punchline about “winter blues” rather than a predictable, treatable public health issue.
The physics of New Hampshire winters aren’t changing. What can change is how seriously the state takes the mental health consequences — and how creatively communities respond.
You don’t have to love winter. But in a state that routinely asks its residents to endure months of gray cold, it’s time to stop congratulating toughness and start building systems that make seasonal survival less of a personal test and more of a shared responsibility.
Key References & Further Reading
- National Institute of Mental Health – Seasonal Affective Disorder (symptoms, risk, treatment)(National Institute of Mental Health)
- American Psychiatric Association – Media advisory and patient information on SAD prevalence and diagnosis (about 5% of U.S. adults; ~40% of the year)(American Psychiatric Association)
- Norman Rosenthal, M.D. – Early work on SAD and geographic prevalence; NH vs. Florida comparison(Norman E. Rosenthal, MD)
- GoodRx Research – Which US States Are at High Risk for Seasonal Affective Disorder? (SAD risk index and medication fill analysis; notes on New Hampshire)(GoodRx)
- The Partnership @drugfreeNH – Understanding Seasonal Depression: More Than the Winter Blues (NH-specific stats and resources)(The Partnership)
- Center for Life Management (Derry, NH) – Seasonal Affective Disorder, What It Is, and How It Impacts New Hampshire Residents(Center for Life Management)
- NH DHHS & New Futures – Reports on health care workforce and mental health provider shortages in New Hampshire(NH DHHS)
- NAMI New Hampshire – State fact sheets and annual reports; mental health prevalence and advocacy resources(NAMI)
In a state that prides itself on hard truths, the hard truth here is simple: New Hampshire has a seasonal depression problem bigger than our stories about “toughing it out.” The sooner we treat winter as a mental health season — not just a weather pattern — the fewer people we’ll lose in the dark.
