Seasonal Depression as an Expat in Spain: Treatment Options
If your mood drops every autumn or winter and lifts in spring, you may be dealing with seasonal depression, also called seasonal affective disorder (SAD). It is treatable. The main options are light therapy, psychotherapy, medication, or a combination, and an expat in Spain can reach all of them in English, in person or online. Being far from home often makes the winter harder, so the best plan treats both the season and the expat experience.
TL;DR
Seasonal depression is a recurring pattern: depressive episodes in the same season, for at least two years in a row, that fully lift when the season ends.
Evidence-based treatments include bright-light therapy, psychotherapy such as CBT, antidepressants, and vitamin D, used alone or together.
Light boxes are safe for most people, but eye conditions and photosensitizing medications call for a doctor’s guidance first.
Expats often carry extra weight in winter: distance from family, language strain, and a missing support network. Therapy in your own language helps with that.
If you have thoughts of harming yourself, call 024 or 112 in Spain right away.
Table of Contents
What seasonal depression looks like
Seasonal depression is a type of depression with a recurring seasonal pattern. According to the National Institute of Mental Health, symptoms last about four to five months of the year. Most people feel it from late autumn into winter, though a smaller group has a summer pattern.
Common signs include:
Persistent sadness or a low, empty mood
Hopelessness or feeling worthless
Fatigue and low energy, even after sleep
Loss of interest in things you normally enjoy
The two patterns look different. Winter-pattern SAD often brings oversleeping and carbohydrate cravings. Summer-pattern SAD tends to bring insomnia and weight loss, as the same NIMH guidance explains.
How to tell if your pattern is seasonal
A bad few weeks in January does not make a diagnosis. A clinical review for primary care physicians describes the pattern as mood episodes in the same season for at least two consecutive years, with full remission when that season ends.
A simple way to check is to look back. Ask yourself:
When did my mood and energy last drop, and what month was it?
Did the same thing happen the year before?
Did I feel like myself again by spring or early summer?
Was there another explanation, such as a move, a breakup, or a job change?
That last question matters for expats. A first winter in a new country can bring low mood for reasons that have nothing to do with light. Only a professional assessment can sort out which is which, and the answer shapes the treatment.
Why expats can feel the winter harder
I see this often in my practice in Madrid. Many internationals arrive from northern Europe, North America, or Asia and assume Spain’s sunny reputation will protect them. Then autumn comes, and the sun is not the only thing that changed.
Several things stack up:
Distance. Holidays come around and your family is a flight away.
Thin support. Your closest friends are in another time zone, and local friendships take time.
Language strain. Doing daily life in a second language is tiring, and fatigue feeds low mood.
Work pressure. Burnout and seasonal dips often feed each other.
Culture shock. The adjustment curve does not end after the first few months. Our guide to culture shock triggers expats face in Spain covers what to expect.
None of this means the seasonal pattern is “just” circumstances. It means the treatment plan should look at your whole situation, not only the calendar.
Treatment options that have evidence behind them
The NIMH lists light therapy, psychotherapy, antidepressants, and vitamin D as treatments, used alone or in combination. The best fit depends on how severe your symptoms are, your history, and what you can sustain through a working week.
If you are in the Spanish public system, it is worth knowing that Spain’s Ministry of Health has said that newer therapies and drugs do not currently change first-line psychological or pharmacological recommendations. In practice, the established options below remain the core.
Option | What it involves | Who it often suits |
Bright-light therapy | A 10,000-lux light box, about 30 to 45 minutes each morning | Mild to moderate winter-pattern symptoms |
Psychotherapy (CBT and related) | Regular sessions that work on thought and behavior patterns | Anyone, especially when stress, isolation, or burnout are part of the picture |
Antidepressants | Prescribed and monitored by a doctor | More severe symptoms, or when other approaches are not enough |
Vitamin D | Discussed with a doctor | Used alongside other treatments |
Bright-light therapy
Light therapy means sitting in front of a 10,000-lux light box each day, usually first thing in the morning, for about 30 to 45 minutes, per the NIMH. Most people tolerate it well.
Two groups should talk to a doctor first: people with certain eye diseases, and people taking medications that increase sensitivity to sunlight. They may need an alternative or medical supervision. Do not buy a lamp online and start without checking, especially if you take any prescription medication.
A few practical tips:
Use the box at the same time each morning, ideally while you have breakfast or answer email.
Choose a device designed for SAD, not a decorative lamp.
Keep a mood and sleep diary for two to three weeks so you can see whether it helps.
Psychotherapy and CBT
Cognitive behavioral therapy (CBT) is a structured form of talk therapy. For SAD, it helps you notice the thoughts and habits that deepen winter lows, such as withdrawing from plans, and replace them with more helpful ones. It is one of the options the NIMH names for treating the condition.
For expats, therapy has a second job. It gives you a space to say what you cannot easily say at work or to a friend still learning your story. A therapist who understands life abroad can also help you separate what is seasonal from what is adjustment, grief, or burnout.
At Heske Therapy, I combine approaches depending on what you need: CBT, counseling, EMDR for unresolved stress or trauma that surfaces in the dark months, and clinical hypnotherapy. I also work with Rapid Transformational Therapy (RTT), which many of my clients choose when they want a focused, time-limited process.
Medication and supplements
Antidepressants can help people with SAD, especially when symptoms are severe. The Mayo Clinic notes that extended-release bupropion may help prevent episodes, and that treatment may begin before symptoms usually start. Only a physician can decide this.
If you already take an antidepressant and want to stop, do it with your doctor. Spain’s Ministry of Health recommends very gradual discontinuation over at least four weeks to avoid discontinuation syndrome.
People often ask what they should “take” for seasonal depression. Supplements are tempting, and some ingredients are under study, for example saffron and mood research. Still, the Mayo Clinic advises discussing any supplement with a healthcare provider, because supplements can interact with prescription medicines. Check with your doctor or pharmacist before adding anything.
Daily habits that support treatment
Habits do not replace treatment, but they make it work better. The NHS guidance on SAD suggests getting as much natural daylight as you can, exercising regularly, keeping consistent sleep times, and staying connected with friends and family.
Here is how that can look in Madrid:
Walk in daylight. Even on a working day, a 20-minute walk before or around lunch counts. Schedule it like a meeting.
Sit by a window. Move your desk, or take calls outside when you can.
Protect your sleep. Go to bed and wake up at similar times, including weekends.
Move your body. A class, a run in a park, or a regular football game with colleagues gives you structure and company.
Schedule people. Plan one recurring social commitment each week, so connection does not depend on how you feel that day. Language exchanges and expat meetups are an easy start.
Call home on a schedule. A fixed weekly video call is easier to keep than good intentions.
The NHS advises seeing a GP if you think you may have SAD, or if treatment is not helping. In Spain, that means your médico de cabecera in the public system, or a doctor in your private insurance network.
When to seek professional help
Do not wait for spring if any of these apply:
Your low mood has lasted more than two weeks and affects work, sleep, or relationships.
You have noticed the same pattern for more than one winter.
You are relying on alcohol, or withdrawing from people, to cope.
Light and routine changes have not helped.
If you have thoughts of suicide or harming yourself, contact help now. Spain’s Ministry of Health runs the 024 line for suicidal behavior, which offers emotional support and can refer you to health services or to 112 in an emergency. In an emergency, call 112. If you do not speak Spanish, say “English, please” calmly when the call connects.
Finding English-speaking support in Spain
The good news is that you do not need to wait until your Spanish is fluent to get care. You have three main routes:
Public health system. Start with your GP for assessment and, where appropriate, medication. Therapy access can involve waiting times, and sessions are usually in Spanish.
Private practice in your language. Many expats choose a private therapist because they can express emotions more precisely in their native language.
Online therapy. If you live outside Madrid, or travel often, video sessions give you the same continuity. Our guide to choosing online therapy from abroad explains what to look for.
For a fuller overview, see our pages on therapy in English in Spain, how to choose a therapist in Spain, and finding English therapy in Madrid.
When you compare therapists, ask:
Are they a licensed professional, and what is their training?
Which methods do they use, and for which problems?
How many sessions do they expect, and what does it cost in total?
Do they offer a first conversation so you can judge the fit?
Cost and coverage matter too. Some private insurers reimburse psychotherapy, with limits. Read our notes on health insurance reimbursement for psychotherapy in Spain and on session limits in therapy insurance before you commit.
Our perspective
Seasonal depression is rarely only about light. In our work with expats in Madrid, we see the winter dip land on top of homesickness, language fatigue, and work pressure. Treating the season alone often leaves the rest untouched. That is why we build a personalized plan. We combine clinical psychology with integrative methods: CBT and counseling to change the patterns that deepen low mood, EMDR when past stress or trauma is part of the picture, and RTT and clinical hypnotherapy for people who want a focused, structured process. Our approach is designed to be time-limited, so you know where you are heading and what each stage is for. We also believe you should not have to translate your inner life. Sessions are available in English, Spanish, and Dutch, in our Madrid office or online. If you are on medication or considering a light box, we encourage you to coordinate with your physician, and we work alongside that care rather than instead of it. Starting before the darkest months gives you the most room. Many people tell us the relief begins with the first honest conversation. Heske
How working with us looks
If you want to start, the first step is a free discovery call. We talk about your symptoms, your history, and what you want to change. I then suggest a plan that fits.
Our main options, as published on our site:
Create a Breakthrough in 3 Months: a three-month program at €600 per month for people who want sustained, structured work.
The Classic RTT all-in Package: €750 one-off, also available as an online package.
21-day just RTT Package: €550 one-off, also available online.
Pack of 4 Counseling Sessions: €375 one-off, held in our Madrid office.
If you are not sure which format suits you, apply for a discovery call and we will work it out together. There is no judgment, and no pressure to decide on the call.
Related struggles that often travel with the winter blues
Seasonal depression rarely arrives alone. Three companions come up most often in my sessions with expats.
Anxiety about language and belonging. When every errand takes extra effort, anxiety grows in the quiet months. Our guide to language anxiety and six exposure steps is a practical start.
Culture shock that lingers. If your low mood began with the move, see how psychoeducation can reduce culture shock anxiety over three months.
Impostor feelings at work. Low energy can make you doubt your place in a new workplace. Read about impostor syndrome as an expat in Spain, including signs and treatment.
Naming these themes early helps you and your therapist decide what to work on first.
A simple plan for the next four weeks
If you recognize yourself in this article, here is a realistic sequence:
Week 1. Write down when your mood dropped in past years. Book a GP visit or a discovery call.
Week 2. Start a morning routine with daylight, and ask your doctor whether a light box is safe for you.
Week 3. Begin therapy, so you have a weekly space to work through what the season brings up.
Week 4. Review your sleep, energy, and mood notes with your clinician and adjust.
Small, steady changes matter more than a perfect plan. Seasonal depression follows a pattern, and a pattern is something you can prepare for.
FAQ
What is the best treatment for seasonal depression?
There is no single best option. The NIMH lists light therapy, psychotherapy, antidepressants, and vitamin D, alone or combined. The right mix depends on your symptoms and history, so start with an assessment by a doctor or licensed therapist.
Is seasonal depression more common for expats?
We cannot point to a figure for that. What we see in practice is that distance from family, language fatigue, and a thin support network can make winter feel heavier. Therapy that addresses both the season and the expat experience tends to fit best.
Can I get therapy for seasonal depression in English in Madrid?
Yes. Heske Therapy offers sessions in English, Spanish, and Dutch, in our Madrid office or online. You can start with a free discovery call to see whether the approach suits you.
When should I start treatment?
Ideally before your symptoms usually begin. The Mayo Clinic notes that treatment may start before the season when symptoms typically appear. If you are already low, do not wait: contact a doctor or therapist now.
Sources
Recommended
Comments