With the passing of the autumnal equinox and fall’s beginning Sept. 22, seasonal affective disorder also will arrive.
SAD is a form of depression that an estimated 5 percent of the U.S. population will experience, typically with a female-to-male ratio of 4-to-1. For women, its occurrence also is higher during their childbearing years. Gender differences decline and disappear in advancing years, and older people become less susceptible. Unquestionably, SAD is more common in northern latitudes and, therefore, more common in Canada than the United States. SAD often lasts four to five months.
Therein is its definition: It must resolve completely, and seasonally, to distinguish it from garden-variety depression. Depression and other psychiatric disorders, as well as chronic-fatigue syndrome, decreased thyroid activity or drug or alcohol abuse, must be excluded to properly diagnose SAD. However, these conditions are not likely to be seasonal and relapse annually.
Straight from a National Alliance for Mental Illness fact sheet come some of the common symptoms: oversleeping, daytime fatigue, craving for carbohydrates and weight gain. Other symptoms, which are also seen in depression, are the “vegetative symptoms”: diminished libido, lethargy, hopelessness, suicidal thoughts and a decrease in usual activities and socialization. SAD also has been termed “winter or seasonal depression” and “winter blues.” In northern New England, it was known as “cabin fever,” suggesting winter confinement as a factor.
Much more significant than confinement is the diminution of light brought by winter and northern latitudes. In some societies, China for one, interfering with a neighbor’s light – by raising one’s roof, placing a sign board, etc. – will make an enemy and result in trouble. Light is the most important factor in SAD and in its treatment.
Because recognition of SAD as an actual disorder has been recent, research about its cause and treatment also has been recent. In addition to light, research has focused on the effects of neurotransmitters, circadian rhythm and even genetics.
Light therapy is now recommended, viewing (but not directly into) a white, fluorescent light from a distance of 12 to 18 inches for 30 minutes daily in early morning. Improvement usually occurs in one to two weeks, but the subject may relapse if treatment is discontinued prematurely – before the time of usual spontaneous remission. Blue or ultraviolet lamps may cause retinal damage and should not be used.
Light therapy lamps are available for several hundred dollars. Equally effective are anti-depressant drugs, such as Prozac, and also second generation anti-depressants. The possibility of undesirable side-effects suggests that anti-depressants should be reserved or used in addition to light therapy.
Ten years of commuting to San Juan Regional Hospital in Farmington half-convinced me that deer get SAD – or SADD, Seasonal Affective Deer Disorder. From a bunch winter-grazing on a highway shoulder, one, which can’t take another winter, runs, walks, leaps or steps into the oncoming headlights – and into my freezer. Will residents in the winter shadow of the proposed project on East Second Avenue experience a SAD epidemic? Will there be a light kiosk and a Prozac dispensary in the complex?
www.alanfraserhouston.com. Dr. Fraser Houston is a retired emergency-room physician who worked at area hospitals after moving to Southwest Colorado from New Hampshire in 1990.