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comfortzone

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Sad Season: If Your Gloomy Mood Matches the Wintry Skies
January 06, 2006
Knight Ridder/Tribune News Service

A little grouchy, aren't we?

Perhaps you feel sluggish, less creative or withdrawn. Maybe you're eating more than usual.

Join the club, the one with 14 million Americans who live with Seasonal Affective Disorder, or SAD.

A type of depression, SAD and its milder form, the winter blues, are caused by shortened exposure to daylight. Symptoms begin in the fall, as daylight hours dwindle. Five or six months later, the blues are gone with the snow, only to return the next fall.

Sorry to report, folks, but SAD's peak season starts in five days and runs through all of February, according to the American Psychiatric Association.

You've got enough to grouse about. We want to help you understand the problem and remedy it, on your own or with professional help.

The problem

Some 6 percent of the U.S. population has SAD, and another 14 percent cope with winter blues, says Dr. Norman Rosenthal, the nation's leading SAD expert and author of the newly revised "Winter Blues" (Guilford, $15.95). What causes it?

Our bodies have internal cycles and clocks. Come fall, our brains and our behavior change with shorter days and less exposure to daylight. We produce more melatonin, a hormone that is made almost exclusively at night. Some call it the hormone of darkness, Rosenthal said.

People with SAD are more susceptible to the extra melatonin, which affects their mood.

Sometimes, a move from a southern climate to a colder, northern one with fewer daylight hours may bring on symptoms. For reasons that aren't clear, women outrank men 3-to-1 with the problem.

SAD can sneak up on you, Rosenthal, a Georgetown University psychiatrist, said in a telephone interview. "It starts with feeling sluggish. You start sleeping in. You aren't as pumped up as usual."

Jennetta Helton of Michigan started noticing the problem shortly before she was diagnosed seven years ago.

"I start feeling down; I just don't want to do anything," says Helton, 37, a homemaker with a 12-year-old son. "I could sit around, pretty much all day." Today, she uses both antidepressant medicines and light therapy to help reduce the symptoms.

Each morning, after her son leaves for school, she turns on her phototherapy unit and watches television. "It seems to give me the kick I need to keep going," she says. She also tries to exercise more and spend time outside when it's sunny. "I'm doing pretty well," she says.

There are three known therapies: anti-depressant medicines, light or phototherapy and a type of counseling known as cognitive behavioral therapy, or CBT.

CBT helps people take negative thoughts and turn them into realistic ones, says Dr. Jed Magen, chairman of the Michigan State University Department of Psychiatry. "People who are depressed have lots of negative thoughts," he says. "Everything seems worse than it is. You ask people, `What's a more realistic thought?' You give them homework."

An example: A student worries about flunking a test. A more realistic thought: you are doing well in school.

Anti-depressants like Prozac work in 50 percent to 60 percent of people, and light therapy is effective in as many as 70 percent of patients, says Dr. Alireza Amirsadri, a psychiatrist and SAD specialist at Wayne State University School of Medicine and Detroit Receiving Hospital.

Drugs are the main choice for people who want a quick, convenient option and whose insurance does not pay for light units or counseling, he and others say. In the long run, a light unit that costs $200-$300 is significantly cheaper if a person has no insurance drug coverage.

Dr. Neel Jolepalem, a child and adult psychiatrist at St. Joseph Mercy Hospital in Pontiac, Mich., said he finds his patients opt for the drugs because they are not willing to take the time necessary to sit in front of a light box. Some hospitals have the Cadillac of treatment settings for SAD: a room brightly lit with overhead fluorescent lights. Some patients even sleep there, oblivious to the bright lights.

For some, there's the option of escaping someplace with more winter sunshine. For the rest of us, try an outdoor sport like skiing on sunny winter days. Cultivate indoor plants in a sunroom.
 
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