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Seasonal affective disorder (SAD)
Link...SAD (Seasonal Affective Disorder) is a type of winter depression which affects millions of people every winter between September and April, in particular during December, January and February. SAD is caused by a biochemical imbalance in the hypothalamus due to the shortening of daylight hours and the lack of sunlight in winter. For many people SAD is a seriously disabling illness, preventing them from functioning normally without continuous medical treatment. For others, it is a milder condition, causing discomfort, referred to as sub-syndromal SAD or winter blues. There is also a rare reverse form of SAD, known as summer SAD, where symptoms occur each summer and remit in winter.
Symptoms:
- a desire to oversleep and difficulty staying awake, but in some cases, disturbed sleep and early morning wakening;
- feeling fatigue and an inability to carry out normal routine;
- a craving for carbohydrates and sweet foods, usually resulting in weight gain;
- feelings of misery, guilt and loss of self-esteem, sometimes hopelessness and despair, sometimes apathy and loss of feelings;
- an irritability and desire to avoid social contact;
- a tension and inability to tolerate stress;
- a decreased interest in sex and physical contact
- and in some sufferers, extremes of mood and short periods of hypomania (overactivity) in spring and autumn.
SAD symptoms usually reoccur regularly each winter, starting between September and November and continuing until March or April; a diagnosis can be made after 2 or more consecutive winters of symptoms. In sub-syndromal SAD, symptoms such as tiredness, lethargy, sleep and eating problems occur, but depression and anxiety are absent or mild.
SAD symptoms disappear in spring, either suddenly with a few weeks of hypomania/hyperactivity, or gradually, depending on the intensity of sunlight in the spring/early summer. In summer SAD, symptoms may be related to excessive heat rather than light and may include irritability and lethargy rather than oversleeping and overeating.
SAD may begin at any age, but the main age of onset is 18-30. It occurs throughout the northern and southern hemispheres but is rare in those living within 30 degrees of the Equator, where daylight hours are long, constant and extremely bright.
Treatments:
Light therapy has been proven effective in over 80% of diagnosed cases, with exposure from 30 minutes to several hours per day to very bright light, at least 10 times the intensity of ordinary domestic lighting. Ordinary light bulbs and fittings are not strong enough. Whereas the average home or office lighting deliver an intensity of 200-500 lux, the minimum dose necessary to treat SAD is 2500 lux. Some light units deliver up to 10,000 lux, which can shorten treatment time.
Light treatment should be used daily in winter, starting in early autumn when the first symptoms appear. It consists of sitting 2-3 feet away from a specially designed light box, wearing a Light Visor, or waking up to dawn simulator. Allow the light to shine on the eyes. While getting your light treatment carry out normal duties; eating, writing, reading, etc. It is not necessary to stare at the light during the session, but keep in mind that the more photons that reach the retina, the faster the session will be.
Treatment is usually effective within 3-4 days and the effect continues provided it is used every day. Sun glasses, tinted lenses, or any device which blocks the light to the Retina of the eye, should not be worn. Daily exposure to as much natural daylight as possible can be of help.
When it comes time to shop for a light unit, be a smart consumer and shop around. Weigh the pros and cons of the different products and different companies. Product economy is one factor, but product quality and company service are even more important. All reputable companies will offer a return system if the light doesn't work for you.
Traditional antidepressant drugs such as tricyclics are not usually helpful for SAD as they may exacerbate sleepiness and lethargy. The non-sedative SSRI drugs such as paroxetine (Seroxat), sertraline(Lustral) and fluoxetine (Prozac) are effective in helping the depressive symptoms of SAD and combine well with light therapy. Other psychotropic drugs (i.e. lithium, benzodiazepines) have not proven very useful in the treatment of SAD.
Psychotherapy, counseling or any similar therapy which helps the person with SAD to relax, accept their illness and cope with its limitations can be useful.
Link...Incidence:
Nordic countries
Winter depression is a common slump in the mood of some inhabitants of most of the Nordic countries. It was first described by the 6th century Goth scholar Jordanes in his Getica wherein he described the inhabitants of Scandza (Scandinavia). Iceland, however, seems to be an exception. A study of more than 2000 people there found the prevalence of seasonal affective disorder and seasonal changes in anxiety and depression to be unexpectedly low in both sexes. The study's authors suggested that propensity for SAD may differ due to some genetic factor within the Icelandic population. A study of Canadians of wholly Icelandic descent also showed low levels of SAD. It has more recently been suggested that this may be attributed to the large amount of fish traditionally eaten by Icelandic people, 225 lb per person per year as opposed to about 50 lb in the US and Canada, rather than to genetics. Fish is high in vitamin D. Fish also contains docosahexaenoic acid (DHA), which has been shown to help with a variety of neurological dysfunction.
Other countries
In the United States, a diagnosis of seasonal affective disorder was first proposed by Norman E. Rosenthal, MD in 1984. Rosenthal wondered why he became sluggish during the winter after moving from sunny South Africa to New York. He started experimenting increasing exposure to artificial light, and found this made a difference. In Alaska it has been established that there is a SAD rate of 8.9%, and an even greater rate of 24.9% for subsyndromal SAD.
Around 20% of Irish people are affected by SAD, according to a survey conducted in 2007. The survey also shows women are more likely to be affected by SAD than men. An estimated 10% of the population in the Netherlands suffer from SAD.
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I generally feel more depressed in summer time.
Originally Posted by Loki
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