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Seasonal Affective Disorders: Seasonal Energy Syndrome?-Reply

Norman E. Rosenthal, MD
Arch Gen Psychiatry. 1986;43(2):188-189. doi:10.1001/archpsyc.1986.01800020098014.
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In Reply.—  The letter written by Drs Mueller and Davies raises several interesting points.1. I agree with them that seasonal affective disorder is not purely a fallwinter phenomenon and therefore prefer to use the term seasonal affective disorder rather than winter depression, which does not reflect the spring and summer aspects of the syndrome. The epidemiologic literature on seasonal incidence of mania is in agreement with their observations of manic symptoms in the summer months.1 However, of the 156 patients we have studied to date, most (83%) have met criteria for bipolar II disorder (major depression with a history of hypomania) and relatively few (7%) have met criteria for bipolar I disorder (major depression with a history of mania). One possible reason for this distribution is that most patients with a history of disruptive manic episodes have had their symptoms vigorously medicated and are not allowed to


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