Norman Rosenthal felt a penetrating chill when he left work on Nov. 1, 1976.
It wasn’t just the premature cold – temperatures were in the 30s — and the knifing winds on Riverside Drive in Upper Manhattan, the kind that drive the brittle leaves to skitter percussively.
From his perspective, it also was the darkness before its time.
He wasn’t in Johannesburg anymore.
The night-and-day difference
Rosenthal, who would become one of the nation’s most well-known psychiatrists, was new to Gotham.
He had moved from his native South Africa to Gotham in July 1976 to assume his residency at the New York Psychiatric Institute, in Washington Heights.
At first, he was amazed at the bonanza of summer daylight.
“The summer days felt endlessly long, and my energy was boundless,” he recalled.
Understandable, given the day-length difference between New York and his home land, which he had left in midwinter. Plus, he never had experienced days this long even in the Johannesburg summer.
The sun also sets
At a latitude comparable to that of Hollywood, Fla., and Baja, Calif. Johannesburg is about 1,000 miles closer to the Equator than Washington Heights.
The latest sunset of the year in Johannesburg occurs around 7 p.m., at the summer solstice, which happens in December on that side of the world. About 14 minutes and 40 seconds pass between sunrise and sunset.
In New York, the latest sunset occurs after 8:30, and daylight lasts 16 hours and 13 minutes. Not until September, around the time of the equinox, did the sun set before 7 p.m.
What Rosenthal did not anticipate was that come Nov. 1, it would be setting over the Hudson River at 4:54 p.m.
Chilling effect
Not only had the days been shortening, but as the clock approached 2 a.m. on the day before – which was Halloween – a national ritual played a trick on him. New York and most of the country moved the clocks back an hour. This was not the practice in Johannesburg. “There was no need,” recalled Rosenthal, his voice still retaining more than traces of his South African accent all these decades later.
The routing of the light had a profound effect on his energy level and moods, Even on clear days, “When the sun shone, its rays struck the earth at a strange oblique angle,” he recalled.
“I had a sluggishness and a lethargy and difficulty creating and producing that I had not experienced.”
Then, with the arrival of the spring of 1977 and the lengthening days, he felt reinvigorated.
These sensations no doubt were common experiences among New Yorkers and the rest of us who reside in the midlatitudes. Most of us, however, are not psychiatrists transplanted from a brighter and warmer side of the planet.
Rosenthal was on to something. The effects of the seasonal contrasts directed him on to a new career path and shed important light on the way people respond to the shrinking daylight and the avaricious darkness of the cool months.
The road to SAD
The path to discovery so often relies on serendipity as much as determination. That was the case with Rosenthal. At a party in New York he had a chance meeting with psychiatrist Alfred Lewy.
Lewy and colleague Tom Wehr had just made an import discovery about melatonin, a hormone the body produces in darkness. Unlocking some of melatonin’s mysteries would be a “critical step” in exploring how humans responded to seasonal changes and in developing treatments.
Rosenthal accepted a research fellowship at the National Institutes of Mental Health, in Bethesda, Md., where he joined both Lewy and Wehr. They pursued the questions that piqued their mutual interests.
Yet, according to Rosenthal, it wasn’t a high–powered psychiatrist who would make the most significant contribution to their research; rather a wiry, youthful-looking man with no medical training.
Herb Kern had read about the institute’s explorations and came to it seeking help with an emotionally crippling condition that beset him every year. Kern had kept scrupulous records of how, with the annual waning of the light, without fail the energy leaked from his body. He had trouble making decisions, lost interest in sex, and wanted to “withdraw from the world.” He had been treated with anti–depressants, only to experience horrific side effects.
When the days lengthened, “the wheels of my mind began to spin again.”
A second patient, identified by the pseudonym “Bridget,” who described herself as “a human bear,” appeared at the institute with strikingly similar complaints.
Two cases were enough to inspire Rosenthal’s confidence that the team was getting somewhere. Rosenthal decided to put out a casting call.
He got in touch with the influential late Washington Post health columnist Sandy Rovner, who by the nature of her occupational mission no doubt would have been on the lookout for fresh material.
‘Bear’ facts
“’I should have been a bear.’” So began the Rovner column published on June 12, 1981. Her piece included extensive observations from Rosenthal. He was quoted as saying that the “bear” in question, “says she was like the grasshopper who played through the summer, forgetting that the winter had ever been, until the fall came.”
Rovner ended the piece with an open-ended plea from Rosenthal.
The researchers, he said, “would like to hear from anyone with distinctly seasonal mood disorders.” Applicants woud be sent questionnaires, from which participants would be selected.
One could question the timing of casting such a net in the long days of June — when the sun was at its highest points in the sky.
What followed was a dam burst. Thousands upon thousands requested the surveys. Even more than the volume, Rosenthal was astonished at the uniformity of the answers.
Such as, I slow down when October comes. … I sleep too much. … I eat more than usual, especially sweets and starches. .. I gain weight. … I can’t concentrate. … I become depressed because I fail at various things. .. I withdraw from friends and family.
“Again and again and again, Rosenthal said, “I heard these things, and I thought: ‘Wow, we’ve got a syndrome over here.’
“As I read the questionnaires, it seemed as though Bridget had been cloned.”
Rosenthal was the lead author of the 1984 paper in which the term Seasonal Affective Disorder, with the almost too–perfect acronym SAD, first appeared.
SAD is a form of depression, prevalent mostly in the light–challenged cool seasons.
The milder form of seasonal disorder is called “winter blues.” In fact, Rosenthal’s popular treatise on the subject bears the title Winter Blues; however, the onset of the symptoms typically occurs in fall as the light dwindles rapidly.
Case estimates vary, but Rosenthal says as many as 13 million Americans suffer from SAD–related depression, whose symptoms can persist as long as five months. Up to 30 million may be afflicted with the tamer version.
SAD “is considered a serious mental health problem” in the psychiatric community
Underscoring that the loss of light is a prime factor, SAD is seven times more prevalent in Washington State than in Florida. Women patients outnumber men by a 4:1 ratio.
And clinical diagnoses aside, indisputably the fading of the light and the onset of colder weather in the populous midlatitudes have profound mental and physical effects, despite the technological advances that have insulated us from the harshest impacts of the elements.
“Light is a very powerful drug,” says Dr. Phyllis C. Zee, a professor of neurology and chief of the Center for Circadian and Sleep Medicine at Northwestern Medicine, in often light–deprived Chicago.
“We don’t think of ourselves as being seasonal creatures, but we are. There are changes that occur in our metabolism. There are changes that occur in our immune system over the course of the seasons.”
As Rosenthal pointed out, “to a greater or lesser degree, a great majority of the population experiences some changes in seasonal well–being and behavior.”