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Beating Seasonal Affective Disorder

By Darren Buford

Originally published in Body Sense magazine, Autumn/ Winter 2003.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.


As the days become shorter and the sun shines less frequently, many of us are temporarily affected by winter's "blues." Lumbering around inside a cozy house, exercising less, and eating and sleeping seem more appropriate than in the spring and summer months.

For millions of Americans, however, November to March doesn't bring a period of welcomed hibernation but the return of considerable stress. Seasonal affective disorder, better known as SAD, is a form of clinical depression resulting in apathy, lethargy, loss of libido, a change in eating and sleeping habits, and sometimes even harbored thoughts of death or suicide.1

The mood disorder is brought on by the change in the quantity of light the body receives during the winter months, affecting the amount of melatonin released and thus the body's natural rhythms. The more light we get, the more successfully melatonin is suppressed and the more normal our sleep patterns are.

"Historically, we can look back to the beginning of time to see why this occurs," says Kathy HoganBruen, Ph.D., senior director of prevention at The National Mental Health Association. "In a time when, during the winter, you wanted to stay in your cave, hibernate and store up energy, there were reasons for this bodily function. Today in our modern society, however, it translates to people having a tough time getting out of bed in the morning or getting motivated to do what they need to do around the house or at work."

For some, this equates to winter doldrums; for others, it is more extreme and results in depression. "There's a difference between feeling down and being depressed," HoganBruen admonishes. "Being clinically depressed means you have more than just a couple of symptoms and they've lasted for more than a couple of days. Before someone receives a diagnosis of SAD, they must experience this consecutively for two years. It's not just 'I feel bad one winter, therefore I must have SAD.' There has to be a history there."

SAD generally affects women in far greater numbers than men,2 though, according to HoganBruen, it's not clear why. "There's been some research done, but it's not definitive. Some say it's because women are more likely to report depression -- they are more likely to seek help because women seem to be more relationship-focused than men. It's not clear, though, whether it's just social factors or whether there's biology involved."

SAD, like common depression, also affects people of any age, but more commonly onset occurs in those 18-30. As much as 5 percent of the U.S. population is affected by SAD, and 10-20 percent may endure milder symptoms.3


Let There Be Light
According to the Seasonal Affective Disorder Association (SADA), treat lack of light with light. To stimulate the appropriate amount of light needed by the body, healthcare specialists are turning to artificial sources to help accommodate for what nature sometimes lacks. Light therapy from a light box has proven effective in up to 85 percent of diagnosed cases.4

This device yields up to 2,500 to 10,000 lux (measurement for light intensity). By comparison, a cloudy-to-sunny day, depending on longitude and latitude, yields often more than 10,000 lux. SADA recommends daily use of light boxes during the winter, and results may manifest in as little as four days to two weeks. The positive effects of light box therapy should continue as long as a daily schedule of 30 minutes to one hour of exposure is followed during the more intense months.

Treatment involves sitting approximately three feet from the light box, usually in the morning, and may be done while reading, watching television, working, eating or during any other stationary activity. Best results occur when light is allowed to shine directly through the eyes. Tinted lenses or light-deflecting sunglasses should not be worn because they restrict the amount of light reaching the retina. Typically, fluorescent tubes are used inside the light boxes because they give a more consistent distribution of light and operate under cooler temperatures. A recent treatment development for those who find it difficult remaining stationary for this period of time each day includes wearing a light visor, which can be donned on the head like a cap.

Side effects of light therapy are rare, but may include headache, insomnia, irritability, fatigue and eyestrain. It is also recommended that people with manic depressive disorders and skin and eye sensitivity contact a physician before proceeding. Remember: Tanning beds are never an alternative to light box treatment because they do not provide the proper lighting required and may damage your skin and eyes in the process.5

Overall, the best treatment is simply to get outdoors whenever possible, even if it's cloudy. HoganBruen says, "Even if it's cold, get outside and get exposure to direct sunlight, which is ultimately more effective. Encouraging those with SAD to get outside and to take a brisk walk benefits those who are depressed. Plus, they get the combined effects of exercise and sunlight at the same time." One study found that one hour of walking outdoors was equivalent to two and one-half hours in front of a light box.

Finally, mentalhealth.com recommends against self-diagnosis and self-treatment of SAD without first contacting a physician because the disorder is often confused with other depressive symptoms.6

Darren Buford is managing editor Body Sense magazine.

References
1 Specific to SAD are increases in the number of hours spent sleeping per day and an increase in diet, particularly craving carbohydrate-rich foods, thus setting it apart from common depression, which often results in loss of appetite and an increase in insomnia.
2 As much as five women to each man.
3 http://familydoctor.org/handouts/267.html.
4 www.sada.org.uk/treatment.htm.
5 http://familydoctor.org/handouts/267.html.
6 Lam, Raymond, "Seasonal Affective Disorder," www.mentalhealth.com/book/p40-sad.html.




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