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.

I have had occasional success in my patients who insist on avoiding traditional antidepressants when using nontraditional treatments, including S-adenosyl methionine (SAM-e) — a supplement that has pretty good evidence and doesn’t cause psychoactive effects.

DEAR DR. ROACH: I am a 72-year-old male in good health, and I have routinely donated blood five to six times a year. I am not on any prescription medications. I have not seen a definitive study as to whether I should continue to donate. Will my immune system be compromised? Is there an upside or a downside to donating blood? — K.K.

ANSWER: Thank you for being a blood donor. The major upside is that you are helping people in your community. There is still no substitute for donated blood. The need increases as people live longer with serious illnesses and as we continue to have treatments that keep a person from being able to make their own blood (in addition to the loss of blood during surgery).

The risk to you as a blood donor is very small. The major risk is fainting. Donating too often can cause a person to develop anemia, which is why blood banks check your blood first before allowing you to donate.

Although you do lose some white blood cells when you donate, the body quickly makes these up. In studies that focus on long-term, frequent blood donors like yourself, there is no difference in the amount of white blood cells.

Please keep donating as long as you want, while recognizing that it’s very safe.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2026 North America Syndicate Inc. All Rights Reserved