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For around
one million people a winter depression known as SAD (Seasonal Affective
Disorder) can become a disabling illness which in the most extreme
cases can lead to thoughts of suicide.
As many as 10 million of us suffer from milder but still debilitating
symptoms, known as the winter blues. If from September you begin to
have sleep problems - usually too much sleep - feelings of fatigue
and an inability to carry out your normal routine, combined with cravings
for sweet foods and carbohydrates, and feelings of depression you
may be suffering from SAD, doctors say.
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| Do
you suffer when the nights draw in and the light diminishes? |
Symptoms
can last until March or April, and also include irritability and a
desire to avoid social contact, anxiety, loss of libido, mood changes
and a weakened immune system.
SAD has been a medically recognised condition since 1984 and scientists
say it is caused by a biochemical imbalance in the hypothalamus, a
small part of the brain that rules our body's main functions:
sleep, appetite, sex
drive, temperature, mood and activity.
If insufficient light passes through the eye to stimulate these functions,
they slow down and gradually stop. Dr Cosmo Hallstrom, Consultant
Psychiatrist and Medical Director at the Florence Nightingale Clinic,
describes SAD as "a variation of depression where there are regular
dips in relation to the seasons".
He says that SAD occurs in both the northern and southern hemisphere
but increases with distance from the equator. More women than men
suffer from it. According to Dr Hallstrom, if you think you may be
suffering from SAD, it is important to have a proper consultation
with your GP or a specialist to make sure that there is not some other
cause underlying the depression.
"We have to work out if it is an abnormal reaction or a normal and
understandable one. You have to look at the long term patterns and
think back and see if there is a reasonable explanation."Myra Graham,
from the Laurencekirk SAD Support Group, agrees that a correct diagnosis
is vital."
"You may have other problems that can be causing this depression
such as a change in your lifestyle in winter," she says. Graham,
a sufferer of SAD for 13 years, says that you can recognise the first
symptoms in the autumn "like a twinge with feelings of panic and confusion".
The good news for SAD sufferers she says is that it is easily treatable
either with light therapy, which boosts the supply of bright light
by using a light box, anti-depressants, counselling or a combination
of all three. SAD can be diagnosed by a GP after three successive
winters of symptoms and sufferers can then be referred to a mood disorder
clinic, although as Dr Hallstrom says there are not that many in the
UK and some patients treat themselves.
As SAD is caused by a lack of light getting more light is the solution.
Moving to sunnier climes will make SAD symptoms disappear.
"If you are retired you could go Florida or Spain for the winter,"
says Dr Hallstrom. He believes that medication can be just as effective
as light therapy in certain cases.
"If you know you are going into a depressive blip there is a strong
reason for using anti-depressants," he says. Graham says that
anti-depressants didn't work for her, as they made her lethargic,
but they can work for others. "Some people need a combination of
anti-depressants and the light box or even St John's Wort. People
have to find what works for them through experimentation. "
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| Some
people benefit from artificial light to relieve their symptoms |
She is
a strong advocate of the light box which was 100% effective in her
case. She started to use one last year after a particularly bad winter
had made her suicidal.
"I began to think about how to stage an accident that wouldn't look
like suicide. Life became so difficult that I couldn't carry on and
that scared me."
Using the lightbox made her feel better in just a few days and now
she says: "If I am not using my light box I am a bear to live with."
Light boxes are not available on the NHS so it is up to the sufferer
to purchase their own. Reputable companies offer light devices on
a trial basis so if it doesn't work it can be returned straight away.
Experts say they help relieve symptoms in 85-90% of cases. The brighter
the light the shorter the time spent using it. The recommended level
is 10,000 lux, which is the same as a bright spring morning, for one
to two hours a day.
Graham set up the Laurencekirk SAD support group in 2001 to offer
a listening ear and send out information to sufferers. She wants to
get people away from the stigma that SAD is a mental illness. "I
find it confusing to use the word depression with SAD. It is a depression
but the cause is physiological. On a bright sunny day you can feel
quite good whereas with depression this will not affect you."
She recommends trying a light box before anti-depressants. And with
any illness knowing that you are not alone can be half the battle.
"Sometimes people need to talk to somebody who understands and isn't
a family member," she says. "It is comforting to know that you
are not alone. It can be very lonely to think that you are going crazy."
For more help and information related to SAD, please click on the
internet links above.
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