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Sunday, November 16, 2014

Struggling With Seasonal Affective Disorder

"If you suspect that you have SAD (Seasonal Affective Disorder), please seek help. Depression is a terrible thing to live with -- especially in this day and age, when there are so many treatments available. Just like you would get treatment if you broke a bone or came down with a high fever, get help if you suspect you have SAD."
Dr. Robert Levitan, professor of psychiatry and physiology, Cameron Wilson Chair in Depression Studies, University of Toronto Faculty of Medicine

Prevention is the key to so many troubling medical conditions, physical as well as psychological. Who isn't affected when the weather isn't pleasant, after all? Another reality is that Canada is a northern country hemispherically, our winters tend to be severe, all the more so the more northerly we live in North America. For some Canadians winter offers the opportunity to engage in winter sports, recreational opportunities not as readily available to people living in southern hemispheres.

We needn't travel anywhere to ski, snowshoe, toboggan, ice skate, romp about on a skidoo or snowboarding, much less throw snowballs in an excess of gleeful celebration at the first notable snowfall presenting a fairyland scene of a pristine white comforter settling over the sere, dried-up landscape that late fall leaves in its wake. That's the good news, and then there's traffic snarl-ups in icy driving conditions, incessant colds and flu season, and ice-slipping threats to the elderly.

Some people find it amenable to their expectations that the seasons will inevitably follow one upon the other while we learn to live with those seasons, making the most of opportunities presented, and trying to diminish the detriments that accompany them. And then there is a relatively limited number of people living in northern climes for whom shorter days with fewer sunlit hours present as an insurmountable block to comfort and happiness.

Those people, like many others tend to sleep more than they would at any other season, they consume fuller mealtime proportions, they gain weight and tend to withdraw from social gatherings. Dr. Robert Levitan, clinician-scientist at the Centre for Addiction and Mental Heath considers these hibernation-like symptoms to represent a holdover from a much earlier prehistory age when energy conservation during the winter days of food shortages was a matter of survival.

A snowball fight marks the 2010 winter solstice at Stonehenge on Salisbury plain in southern England December 22, 2010
Kieran Doherty / Reuters   A snowball fight marks the 2010 winter solstice at Stonehenge on Salisbury plain in southern England December 22, 2010

The phenomenon of modern-day SAD typically begins when the clocks have changed, jarring our internal clock mechanisms as days become shorter. Dr. Levitan holds, from his experience, that the winter holidays with their additional stress arriving shortly after the shortest day of the year -- December 21 -- heightens anxiety leading people to complain of weight gain, isolation and depression.

Three of four SAD sufferers are female. People born as spring babies appear to be more vulnerable to SAD, particularly those with a particular genetic background. January and February represent the pinnacle of Seasonal Affective Disorder, whose symptoms gradually ease when the clock is turned toward the "spring forward" position with oncoming spring and the days noticeably lengthen in duration and sunlight hours increase.

The condition causes interpersonal relations to become strained when people are irritable and depressed. People find themselves unable to cope with normal daytime routines, and getting through each day appears more and more of a struggle with themselves. Most family practitioners are capable of diagnosing and treating SAD and may refer their patients to specialized light therapy clinics that have proven to be useful.

Treatment usually works to turn SAD sufferers' symptoms around to make them feel less hopeless about their psychological hormone-deficient disequilibrium. Light therapy involves exposure to specific types of light, sufficiently effective in outcome so that two-thirds of patients realize considerable relief from their symptoms. Those individuals given to over-eating during these critical months appear to find the most relief.

The syndrome can also be treated successfully with a supplement called tryptophan, a prescription drug that can be used on its own or in combination with light therapy. Tryptophan is an amino acid boosting serotonin naturally; important since evidence exists in abundance that serotonin deficiency is the main cause of SAD.

As for prevention: maintaining an active schedule and avoiding long periods of remaining indoors, isolated and inactive is an excellent way to help stave off SAD. Just as we need a sufficient amount of sleep nightly to be healthy, over-sleeping can have deleterious effects to health, potentially promoting depression. Exposure to natural light for as long as possible is critical, but during Canadian winters can present as a challenge.

Avoidance of simple sugars found in junk food also helps. What people often think of as 'comfort food' in the throes of depression promotes sluggishness, weight gain and moodiness. Replacing empty carbohydrates with protein can help. Snacking moderately on seeds or nuts represents a useful alternative to muffins and doughnuts.

Above all, get out in the cold but refreshing clean air even if just to walk around the block. Daily bits of exercise help enormously.

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