Are you feeling SAD?
Tamberly Mott
winter months, many people experience low emotions and a sense of
energy loss. If you feel anxious and socially withdrawn, crave extra
sleep and carbohydrate-rich "comfort" foods, you may be experiencing
Seasonal Affective Disorder (SAD). It's estimated that more than 20%
of Americans suffer from either SAD or its milder cousin, Subsyndromal
Seasonal Affective Disorder (SSAD).
Factors Influencing Severity
S.A.D. can be experienced as an isolated disorder or may be
experienced in conjunction with an existing mood disorder or chronic
illness. The tendency toward S.A.D. or severity of the symptoms can be
influenced by many factors, such as living in a northern latitude,
recent cloudy weather patterns, family history of S.A.D., working in a
windowless office, recent illness, or general life stresses.
Causes of SAD
Change in sunlight exposure is the key. The amount of day light
exposure one receives and the changes in sunrise/sunset reducing the
daylight hours in the fall and winter can affect suffers of S.A.D. The
most commonly believed hypothesis follows: although the body has
natural daily rhythms, they are not fully precise and rely on the
intensity of sunlight to provide adjusting cues. These cues originate
in the retina at the back of the eye, creating signals which pass
through the optic nerve to the mid brain, setting in motion a number
of chemical changes. These changes include:
Increase in the neurotransmitter serotonin, necessary for a sense of
well being.
Regulation and suppression of the hormone melatonin, which is a factor
in normal sleep patterns and may influence the recuperative benefits
of sleep. The short days of winter may cause an increase in melatonin
production — and therefore feelings of sleepiness and energy loss.
Melatonin is a hormone produced by the pineal gland, and it helps
regulate your sleep cycle. Since your body produces more melatonin in
the absence of bright light, dark winter days may cause an excess in
your system, leading you to feel listless and sleepy.
The most common pattern is the onset of major depression in September
through January, and abating of the symptoms in late winter to early
spring -March through May. There are other people who experience
periods of abnormally high or euphoric mood between major depressive
episodes. About 3/4 of S.A.D. sufferers are women, but S.A.D. affects
men and children as well. The most typical age of onset is in the
twenties, but other onsets are common such as during puberty, middle
age, and old age. After women pass through menopause the numbers in
men and women become equal. Susceptibility for S.A.D appears to be
inherited. Fifty percent of fibromyalgia patients see a seasonal
worsening of their symptoms.
A major depression, seasonal or otherwise, is characterized by a
series of symptoms:
Symptoms of S.A.D. may include the following:
Change in appetite or weight, Sleep problems, Lack of energy,
Diminishing sex drive, Body aches or pains, Memory loss, Inability to
make decisions, Problems concentrating, Low self-esteem (feelings of
worthlessness or guilt), Lack of interest in or enjoyment of
activities, and Suicidal thoughts
SAD Treatment
Treatment options for SAD range from cognitive behavioral therapy,
nature therapy, and antidepressants to light therapy and melatonin
supplementation. Light boxes, for example, supply a higher number of
lumens than regular incandescent lamps, providing a powerful light
source which may help control melatonin production without exposing
the user to harmful UV rays.
In many ways, the treatment of SAD is similar to that of other major
depressive episodes, utilizing psychotherapy, antidepressant or mood
stabilizing medication. In addition, the exposure to bright light has
been found to be an effective means of treating seasonal affective
disorder. The individual sits in front of a bright light unit, a
specialized, portable box which houses balanced spectrum fluorescent
tubes. An individual's needs for light therapy specifies the duration
of exposure and the optimal time of day. An individual should meet
periodically with their health care professional and the dose of light
therapy can be adjusted as needed.
How the light box works
The light box provides a measured amount of balanced spectrum light
equivalent to standing outdoors on a clear spring day. This has been
shown to help regulate the body clock. Photobiologists point out that
the light is registered by the eyes through the retina, which then
transfers impulses to the hypothalamus in the brain to normalize the
body clock function. The light from the box will help synchronize
sleep/wake patterns with ones work and life style.
Melatonin Supplementation
Although it seems counter-intuitive, carefully timed melatonin
supplementation may also help. By taking Melatonin at the right time,
you can help yourself become tired at night, when it's time to sleep.
By getting the proper rest overnight, you may end up feeling more
refreshed during daytime hours. Researchers in the Department of
Neurology at Northwestern University found that, when taken a few
hours before bed in accordance with phase response curves, Melatonin
helped advance the body's internal clock and promote earlier wake
times.
Seeking Treatment
Given the effectiveness of treatments for S.A.D. it would be a shame
for anyone not to seek help. It is true that S.A.D. is often correctly
self-diagnosed and anyone can purchase light devices, but other
illness factors may be at play, and seeking the guidance of a
qualified medical practitioner in both the diagnosis and treatment of
S.A.D. is the wisest thing to do. (Usage patterns outlined herein
represent those most typically given by current clinical practices.
They are not intended to encourage self-prescription or to contradict
an individual's prescribed therapy.) Seeking the guidance of a
qualified medical practitioner in both the diagnosis and treatment of
S.A.D. is the wisest thing to do. For more information, give me a
call 415 657-9858