A Case Report of Summer Seasonal Affective Disorder: An Underrecognized Condition in Tropical Regions

This case report presents a 35-year-old male patient from Lahore, Pakistan, who experienced recurring seasonal depressive symptoms from May to September for seven years. The patient exhibited symptoms including feelings of worthlessness, low mood, loss of appetite, decreased energy, anhedonia, and psychomotor retardation during the summer months, with a return to normal functioning outside of these months. The patient remained undiagnosed throughout this time. After multiple unsuccessful treatments from various facilities, he presented to our outpatient clinic for evaluation. Subsequently, he was admitted to the inpatient unit, where regular assessments diagnosed him with summer seasonal affective disorder (SAD), a rare and less-recognized form of SAD. After further evaluation, a treatment plan was devised that included slowly tapering off previous medications and initiating bupropion (a United States Food and Drug Administration [FDA]-approved medication for SAD) along with cognitive behavioral therapy. The patient subsequently fully recovered on bupropion and returned to normal functioning. The case highlights the challenges in diagnosing and treating summer SAD, particularly in tropical climates, where it is less recognized than winter SAD due to the scarcity of literature and awareness regarding it. Additionally, the positive response to bupropion suggests its potential efficacy for summer SAD. This report emphasizes the importance of considering regional and seasonal factors in psychiatric diagnoses and calls for increased awareness of and research on summer SAD, especially in countries such as Pakistan. The authors note this as potentially the first reported case of summer SAD in Pakistan, the sixth-most populous country globally. This highlights the need for a better understanding and management of seasonal disorders in diverse geographical contexts.