Free Essays

Seasonal Affective Disorder (SAD)

Continued from: Seasonal Affective Disorder: Syndromes (1)

Syndromes of SAD (2)

SAD patients experience significant feelings of depression, including regularly feeling sad or having crying spells, feeling that life is not worthwhile, or wishing that they would not wake up in the morning; thinking negative thoughts about themselves - being incompetent, unreliable, an impostor - which would not really apply to them at other times of the year; feeling pessimistic about the future; feeling guilty much of the time.

One's physical functions are markedly disturbed during the winter. Good examples are, requiring several more hours of sleep per day, or having great difficulty waking up in the morning, wishing to lie about for much of the day, feeling that one has no control over one's eating and weight. (Rosenthal 1989, 43)

People with SAD complain as much about changes in their sleep patterns as they do about their eating. Common problems are difficulty getting up in the morning, making it to work/school on time, and getting the children off on time. They generally sleep more but do not feel refreshed on waking. Sleep is often interrupted and "low quality." (Rosenthal 1989, 54)

In most people with SAD, sex drive decreases markedly during the winter. Many people report not wanting to be touched, but rather to curl up and be left alone. Often, people with seasonal affective disorder become highly interesting in sex in the spring, and sometimes this increase in libido can exceed the bounds of good judgment. (Peters 1994, 43)

Dr. Cook also provided us with a description of seasonal rhythms of sexual drive among the Eskimos:

"The passions of these people are periodical, and their courtship is usually carried on soon after return of the sun; in fact, at this time, they almost tremble from the intensity of their passions and for several weeks most of their time is taken up in gratifying them."
(Rosenthal 1989, 179)

The more severely affected person might only emerge from the winter slump in April, whereas a mildly affected one may feel better by mid-March. Many people can predict almost to the week when they will begin to experience their winter difficulties and when they will begin to feel better in spring, almost as one can predict when different flowers will begin to bloom" The timing of the appearance of symptoms also depends on where the person lives. (Rosenthal 1989, 18)

The three months during which most patients with SAD would like to be a mouse or a bear and sleep are December, January, and February. These months could well be called the SAD months. (Rosenthal 1989, 20) People, in different ways, start emerging from their low winter state during the coming of the warmth of March, April, and May. Some have a bumpy course over the spring, especially in places where it is dark, stormy, and unpredictable. Others emerge into an exuberant state where they may be excessively energetic, needing little sleep, and feeling "wired" or "high". At times this state of excessive energy, known clinically as hypomania, can constitute a problem in its own right. A final group of people with SAD never quite emerge completely from their winter depression and remain somewhat down all year round, though less so in the summer. (Rosenthal 1989, 20)

People, who feel worst in December, January, or February, have a winter seasonal pattern. In July or August, have summer seasonal pattern. At both of the above times, have a summer-winter pattern. If there is no time of year when you generally feel best or worst, you have a non-seasonal pattern.

Certain events can trigger the feelings of depression during winter in people who have previously experienced only mild decrease in energy and productivity. For example, a sudden weakening of one's eyesight can "precipitate" the person into the depths of depression (Rosenthal 1989, 51).

Virtually all studies of the prevalence of SAD report that women are more likely to suffer from SAD. In some studies the female to male ratio is close to 4 to 1, but the average ratio across all studies is approximately 1.6 to 1 (Canadian Consensus Guidelines 1999, 39). People in their twenties through forties appear to be most vulnerable to it, but SAD occurs in all age groups.

Light deprivation is a major problem in the northernmost countries, although these have been surprisingly slow to recognize SAD as a clinical problem. Nonetheless, there are local names for the condition. For example, in Iceland, skamdegisfunglindi, or short-day depression, was described in medieval epics. In Tromsö, a Norwegian city 125 miles north of the Arctic Circle, all manner of ills are blamed on the mφrketiden, or murky days - those forty-nine days of total darkness around the winter solstice (Rosenthal 1989, 50).

Continued here: Seasonal Affective Disorder: A Case Study