Wednesday 30 May 2012

SAD: THE WINTER BLUES


“I had the blues because I had no shoes until upon the street, I met a man who had no feet.” - Denis Waitley

I came home rather late this evening and as I start very early in the morning it made for a very long workday. As we progress into Winter, with the days shortening, it is very much a case of leaving home in the dark and returning home in the dark. Unless I pop out at lunchtime, all the daylight I see is through my office windows, but I guess I am lucky in that respect as I realise that many workers work in buildings or offices that don’t have access to external views or natural light. Fortunately I’m not prone to SAD…

SAD or Seasonal Affective Disorder is now a well-described psycho-medical entity, although it first appeared in the literature only in 1985. SAD is a depressive illness that has a seasonal pattern. It’s characterised by mood disturbances that begin in winter and usually subside when the season ends. It’s typically diagnosed after the person has had the same symptoms during Winter for a couple of years. SAD is about four times more common in women than men, and the average age of people when they first develop this illness is 23 years of age, however, people of all ages can develop seasonal affective disorder.

While most people experience mood swings and some disturbance to their normal daily and life patterns with the onset of Winter, SAD is a great deal more serious and can involve the following symptoms: Craving a lot more sleep than usual; overeating, especially carbohydrates, which leads to weight gain; having less energy; and, becoming more solitary, not wishing to spend time with others. The SAD symptoms make the sufferer look like they are going into “hibernation”. The disorder is now recognised as a form of depressive illness.

It is believed by researchers that the cause of the disorder is a lack of exposure to light. There is a much higher prevalence of SAD in countries with shorter days and longer periods of darkness such as Finland, Alaska and northern parts of Russia (although interestingly, SAD is less prevalent where there is a great deal of snow cover). The pineal gland, located in the depths of the brain responds to darkness stimuli picked up by the eyes, by secreting melatonin, a hormone that regulates daily biorhythms including the sleep/wake cycle. It’s believed that when melatonin secretion is out of balance, SAD can occur. Some people are more prone to melatonin imbalance than others and these persons would be the worse affected.

One the best ways to regulate your normal biorhythm is to expose yourself to morning sunlight and have a good daily exercise plan. An early morning sunrise walk or aerobics session would be ideal! Phototherapy (treatment by exposure to light) is commercially available in the form of light boxes, which are used for approximately 30 minutes daily. The light required (fluorescent tube light is fine) must be of sufficient brightness, approximately 25 times as bright as a normal living room light. Contrary to prior theories, the light does not need to be actual daylight from the sun. It seems that it is quantity, not necessarily quality of light that matters in the light therapy of SAD.

Drug therapy may be required in some severe cases of SAD, which extend beyond Winter and in patients who may be prone to suicidal behaviour. Antidepressant medications, particularly those from the serotonin selective reuptake inhibitor family (SSRI) family, have been found effective treatment for SAD. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa). Acupuncture may be an alternative treatment to antidepressant medications, particularly in pregnant women, for whom medications may be contraindicated.

Active changes to behaviour can also help people deal with the “Winter Blues” as SAD is sometimes called. Taking up a new hobby, meeting new people, joining special interest groups engaged in activities one is interested may help. Regular exercise, especially so in a well-lit room in the morning or evening is also beneficial.

3 comments:

  1. my mother is affected by SAD
    she lives in Qld to help her cope better

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  2. Excellent informative post Nicholas.

    Anna :o]

    ReplyDelete
  3. A few years ago, I was in the centre of Copenhagen in June when the temperature reached 22c. Not boiling hot, but very pleasant. All of a sudden, the locals tore their clothes off and stuck silver foil dishes under their chins. The excitement of summer was amazing.

    I don't like cold weather or grey skies either, to be honest.

    ReplyDelete