Seasonal Affective Disorder, despite the godawful cutsey acronym (GCA), really is sad. It is classified as a mood disorder that is biochemical in nature. SAD is thought to be caused by the the body's reaction to decreased sunlight, specifically in a decrease in serotonin production, although no reproducible clinical evidence has been able to satisfactorily pinpoint the cause of the disorder. Symptoms include hypersomnia (sleeping a lot), hyperphagia (eating a lot), and weight gain; given the similar symptoms, it is easy to see why the disorder can be misdiagnosed as depression.
Treatment typically involves daily application of full-spectrum light. This comes in the form of light boxes (overhead lights that are installed on a wall), desk lamps (well, really big desk lamps), or visors that are worn just above the eyes. The exact treatment varies from patient to patient, but generally involves twenty-minute applications of about 10,000 Lux of light (Lux is used as a measurement of intensity; indoor lighting ranges from about 200 to about 700 Lux, a sunny spring day is about 10,000 Lux, a cloudless summer day is about 50,000 Lux), although treatments of only 60 Lux have been effective when used in visors. Ultra-violet light has been shown to have no effect on the SAD patient, and most full-spectrum light sources include a UV filter of some sort.
That's all the clinical stuff. Here's the bit about what it's like.
Imagine your energy draining away, day by day, so slowly that you can't even tell it's disappearing. Every now and again, you begin to feel that something is wrong, that you're in trouble for something, that there is a terrible doom of some sort that is about to happen. You start to have unreasonable, irrational, paranoid thoughts that your friends are excluding you, or that your co-workers don't respect you. Eventually, you stop caring about things, you don't want to do anything but stay in bed and kill time.
This is the worst case, of course. It begins subtly a week or so after the autumnal equinox. It gets worse and worse, and hits bottom about three or four weeks after the winter solstice. It's a devious thing, and most SAD sufferers don't even realize what's happening. The depression gnaws away at the personality, reducing a person to an obnoxious, disturbed, and unpleasant individual.
I didn't know what was going on until I was 22 (or 23, I'm not certain; ironically, my birthday is about three or four weeks after the winter solstice), when I consciously noticed my mood problems and decided to go for help. As a child, my parents had sent me to therapy, but usually in the late Spring, when I was getting better anyway, so it looked like the therapy worked and I didn't need to be there any more. The therapist I went to listened to my story, and suggested that SAD may be at the root of my problem. I agreed, but then she said that a diagnosis couldn't be made unless there was four consecutive years of evidence. I was terrified that I was stuck for four years, but before total desperation settled in I remembered that my grades throughout my primary education tended to form an upside-down bell curve when taken as a function of time over the course of the school year; this saved my proverbial emotional butt.
I was loaned a light box. It was an obnoxious size, too big for one person but too small for two to carry comfortably. A roommate helped me get it home and I plopped down in front of it for twenty minutes. I didn't notice any effect, but my excitement about getting treatment was enough to carry me for the day. A few days later, I did notice an effect: I was starting to be me again. No angst, no depression, energy up, no disgust with myself or the world. It was my electric teddy bear, my happy light.
Nowadays, I have a desk-lamp version, which pokes up over my computer and keeps me company during the morning email. Now that I know what to look for, I can notice when my mood starts shifting, and start the therapy then. During the longest nights of the year, I usually have to do another twenty-minute session in the evening, just to keep me from going to bed around six in the evening. On advice from a doctor, I've also tried St. John's wort, and found it to be a mildly effective stop-gap for when I'm away from my light, although not a good alternative.
SAD is a weird thing, although I'm sure that the cause and cure will someday be figured out by people that know a lot more about this thing than me. It's kinda spooky to know that something in your body can subvert your mind and personality, your soul, if you prefer. But at least I get a bright morning every day, well, for twenty minutes, at least.
Pike's writeup above is a vivid account of what I, and other SAD sufferers, go through every winter. Here is a list of ways to cope.
By the way, watch out for spring. Some SAD sufferers go hypomanic when it gets lighter.
SAD has been described eloquently by Pike; it's a good read. Why, however, did the winter time blues become a psychiatric disorder?
As more and more of us become naturalized citizens of Prozac nation, a few of us cranky souls remain prescription-drug1 free, titrating the available OTC medicines with caffeine, alcohol, and herbs, surviving yet another winter.
What wintertime symptoms make the diagnosis of SAD?
(1) increased rather than decreased sleep; (2) increased rather than decreased appetite and food intake with carbohydrate craving; (3) marked increase in weight; (4) irritability; (5) interpersonal difficulties (especially rejection sensitivity), and (6) leaden paralysis (a heavy, leaden feeling in the arms or legs). Surveys estimate that 4 to 6 percent of the general population experience winter depression, and another 10 to 20 percent have subsyndromal features.2
To summarize, about a quarter of otherwise normal human beings sleep more, eat more, gain weight, and get irritable in the winter, just like any other self-respecting mammal that wanders too far from the Equator.
For those of you here not so addled as to have lost functional use of their God-given senses, and who still can latch on to the tit of reality (in a strange culture that worships cow's milk but finds human milk obscene 3), let me review the annual cataclysmic events that should shake anybody's sense of complacency in this wonderful and truly terrifying world of ours:
1) Every winter, most plants either die (annuals) or go into suspended animation. The vast majority of our crops in this part of the world die. In my garden, half ripe eggplants hang like shriveled ecchymotic scrotums in the dying light of December. My tomato vines are black, gnarled skeletons. The basil plants are but a memory. It is impossible to get a decent tasting strawberry this time of year, reason enough to want to slink down into the bowels of the Earth and sleep until the vernal equinox.
If the crops fail in the spring, we could starve. Instead of worrying all winter about this, I choose to stuff my belly as full as I can with last year's surplus, then sleep.
2) The air becomes so dry that mild patches of eczema and psoriasis turn into vast swaths of gilafied reptilian skin, repulsing friends and family, who are all just as irritable as you. Now I'm flaky, fat, and fearful, living under forced solitude--feeling happy just upsets the natural order of things.
3) In New Jersey, the sun rose at 5:25 AM on June 22, 2002, and set at 8:31 P.M., over 15 hours of sweet, summer rays. On December 22, the sun goes up at 7:16, barely peeks over the horizon, and plunges back down at 4:31 P.M., 9 hours, 15 minutes of dull winter light. That depresses me. If you are paying any attention, it ought to depress you, too.
4) Look at those bills! Paying for the carcass juice of long dead thunder lizards to keep my home heated condemns me to long hours at work. I know air-conditioning is expensive, too, but AC is a luxury. Heat keeps you alive. You have no choice. Sleeping late under a cozy comforter lets me keep the heat turned down longer, and saves money.
5) The local roads freeze, and the December demolition derby begins; debt-ridden SUV owners try to justify their monstrous credit-eating oversized sedans by driving like crazed maniacs in icy conditions. (I can hardly blame them--if I plunked 25 grand after watching commercials in which the SUV climbed perpendicular up a snow-covered mountain, I'd expect my car to handle a level road. They do go nicely perpendicular into ditches, though.)
What is a rational person to do? Seems like crawling into the bed under a comforter with a huge bag of Doritos while others careen to work on icy highways makes perfect sense. Feeling down? Little wonder. I just don't think that it is a disorder. Nor do I think my spring fever is a problem. Watching the Earth spring back to life deserves some manic dancing. Come April, I'll review this node, and make it shine! Until then, I am going to bed.
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