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Seasonal Affective Disorder (SAD)

Continued from: Seasonal Affective Disorder: Introduction

Syndromes of SAD

"I should have been a bear.
Bears are allowed to hibernate;
humans are not."

A SAD patient

To a casual acquaintance a person with SAD may not appear to have obvious difficulties. In reality, those who have the condition can suffer very severely. They are likely to have no energy and great difficulty listening attentively, thinking, and concentrating, as if they had the flu. (Hyman 1990, 95)

People vary in the degree to which they experience the seasonal changes. At one end of the spectrum are those who have few, if any symptoms. Then, there are those who experience mild ones that can easily be accommodated in the course of their everyday lives. A third group finds them a nuisance - not worth taking to the physician, but troublesome, nonetheless. This group may be suffering from what is commonly known as the "winter blues" or "February blahs." At the far end of the spectrum are patients with SAD, whose changes in mood and behaviour are so powerful that they produce significant problems in their lives. (Rosenthal 1989, 16)

The timing of the problem varies as well. For example, one person may begin to feel SAD symptoms in September, whereas another will feel well till after Christmas. (Rosenthal 1989, 18)

Most people enjoy sunny days and dislike gray, cloudy days; most prefer dry to humid weather. The difference between seasonal types is primarily in the degree to which they dislike certain types of weather or climate. Winter types strongly prefer long, sunny days and loathe short, dark ones. Summer types, on the other hand, strongly dislike the heat, and greatly prefer cool weather.

Everybody can remember a time when they were not thinking properly - for example, when feeling very tired. That is how people with SAD often feel during the winter months. They tend to have problems thinking clearly and quickly. "It is very difficult, if not impossible, for them to summon up the information and knowledge needed for their work - or even casual conversation. They are not able to keep up with what is going on around them or what needs to be done." (Rosenthal 1989, 57) This is the best description (and the worst problem) of SAD condition.

Light-sensitive people develop an almost constant feeling of fatigue and drowsiness and tend to sleep much more than usual during the winter months, as long as 10 to 12 hours, or even 13 to 14 hours on weekends. (Hyman 1990, 93)

Many business executives and professionals with SAD complain that during the winter they are unable to take the necessary steps to handle the tasks they are responsible for. Instead they hide behind their office doors, shuffling papers around on their desks, i.e., creating the appearance of getting work done. Those not fortunate enough to have offices in which to hide, often call in sick and say they have the flu, a more acceptable excuse than depression. (Rosenthal 1989, 58)

"It is typical for a depressed person to withdraw - to have neither the desire nor the energy to interact with others." (Rosenthal 1989, 8) They may feel that this is an impossible task, and so they just want to be left alone.

Patients with SAD usually report an increase in their craving for heavy foods, such as pasta, macaroni, cheese, rice, bread, candy, etc. Two research groups have actually tried to record the eating habits of people with SAD at different times of year. Dr. Judith Wurtman at MIT and Dr. Anna Wirz-Justice in Basel, Switzerland have confirmed that the increase in carbohydrate consumption reported by so many patients does, in fact, occur. One study performed in the cafeteria of the National Institutes of Health found that people eat more carbohydrates in winter and more salads in summer. (Rosenthal 1989, 53)

I got to the point that I was into binge-eating so much that I joined an eating-disorder group. When I was extremely anxious my automatic response was to look for those high-calorie foods, and I would eat them and eat them and eat them. I feel very successful this year because for the first time I have not gotten into the Halloween candy. There was one year - and of course it would be the end of October - where I went through a hundred little bars of candy before Halloween ever came, and I had to go out and buy a whole new bag of it.
41-year-old woman
(Hyman 1990, 95)

Surprisingly, people with SAD report that eating carbohydrates seems to give them more energy, while research with people who do not have SAD shows just the opposite. In a study performed by Dr. Rosenthal, the people with SAD and non-seasonal people were given high-carbohydrate meals (six big cookies) and high-protein meals (a plate of turkey salad). The study showed that the high-carbohydrate meal did indeed make the SAD group feel more energetic, whereas the non-seasonal group felt more fatigued. As a result, it was suggested that there is a basic difference in the brain chemistry of seasonal and non-seasonal individuals, and, therefore, there is this difference in response to carbohydrates.

Considering the change in diet and the low level of activity that occur in the winter in SAD, it is not surprizing that patients tend to gain weight, often very dramatically. (Rosenthal 1989, 54) Unfortunately, some people do not lose all the weight gained during the winter, and become steadily heavier from year to year. Their functioning becomes impaired to a significant degree. They may develop problems at work, including difficulty completing tasks that they were previously able to manage, difficulty getting to work on time on a regular basis, marked reduction in their ability to think and concentrate.

Continued here: Seasonal Affective Disorder: Syndromes (2)