Wednesday, 31 January 2018

3 Pervasive, Persistent Myths about Seasonal Affective Disorder

Our society tends to dismiss seasonal affective disorder (SAD). We minimize it. We misunderstand it.

Oh, you just don’t like winter. And who could blame you? Winter is tough on everyone.

Oh, SAD is like the winter blues, right? You get grumpy or moody because you hate the freezing cold.

You’re just in a funk. It happens to a lot of people. It’s totally normal.

How can you feel depressed when the air is so crisp and it’s a winter wonderland out there?

We incorporate SAD into our vocabulary, flippantly using it in conversation. “Similar to someone saying “I can’t make up my mind, it’s like I’m schizophrenic,” or “Costco was out of those socks I love, I’m so depressed,” it’s tempting to trivialize the reality of SAD,” said Stephanie Smith, PsyD, a psychologist in practice in Erie, Colo., who specializes in working with individuals with depression.

“Instead of appreciating it for the real mental illness it is, it becomes ‘Ugh, I hate driving in the snow and ice; it’s like I have SAD.”

In reality, SAD can be devastating. Smith’s clients have described their experience as falling off a cliff. Melanie Greenberg’s clients experience a deep dread as winter approaches. Some feel fatigued and lethargic and have a really hard time getting out of bed and on with their day. “Others describe an emotional heaviness.”

Dr. William Marchand’s clients have described SAD as being kicked in the stomach or having a lead weight inside their stomach. Others have described “a sense that life has lost meaning and there is no joy or pleasure.”

Obviously, there is nothing minor or trivial about that. Below, these depression experts share the specifics behind the most persistent myths about SAD.

Myth: Seasonal affective disorder is disliking the cold, dark days of winter.

“I myself am not a huge fan of winter, but that’s quite different than SAD, which is an actual clinical syndrome made up of several symptoms,” Smith said. These symptoms may include: depression for most of the day every day; lack of pleasure in things previously enjoyed; sleep problems, such as excessive sleep or sleep deprivation; poor concentration; low energy, which makes it hard to get things done; and suicidal thoughts and actions.

SAD can look different in different people. For instance, in this piece on The Mighty, Salaam Green describes how SAD affects her: “My body feels heavy, bloated, and I lose all feeling in my hands and legs throughout the day. My feet hurt and are frozen most days. I pile my body inside comforters, blankets and soft pillows for relief. Most days, I sleep until noon, making it impossible to be productive on my full-time job. I crave sunlight; however, I am much too tired and sick to go for my usual walk and when I do, I am unable to walk very far. My mood with SAD leaves me in a perpetual fog. It’s akin to having a heavy, dim cloud follow you around every day, weighing on your back…”

Other individuals with SAD have described it as everything from a battery that’s slowly draining to a faucet that leaks heavy, thick gasoline to losing a significant other in a car crash.

As Smith reiterated, SAD is, “the real deal in terms of mental illness—not just a pining for flip flops and lemonade.” It’s not a preference. It’s an illness.

Myth: Seasonal affective disorder only happens in the winter.

About 10 percent of people with SAD get sick in the summer. Instead of feeling depressed and drained, they tend to feel more agitated, irritable and restless. They have a hard time concentrating, and struggle with insomnia. Their appetite decreases and they might lose weight. They might appear as though they’re totally fine, experiencing a kind of “smiling depression,” where they’re literally smiling but struggling and crumbling inside, as psychologist Dean Parker noted in this piece.

Summertime SAD is especially frustrating because everyone is expected to feel happy and relaxed as temperatures warm up and the sun comes out. Which only makes people with SAD feel lonelier and more misunderstood.

However, one theory is that it’s precisely too much sunlight that’s to blame. That is, excess sunlight may affect melatonin production,” said Greenberg, Ph.D, a clinical psychologist in Marin county, Calif., and author of The Stress-Proof Brain: Master Your Emotional Response to Stress Using Mindfulness and Neuroplasticity. Melatonin is a hormone that regulates sleep. “Another idea is that people stay up later in the summer, which affects circadian rhythms.”

Because summertime SAD is associated more with feeling manic (versus wintertime SAD), it’s possible there are biological differences between suffers with different onsets, Greenberg said.

Myth: You should be able to pull yourself out of seasonal affective disorder.

“Though there are certainly self-help and self-care strategies that may be beneficial, it is not possible to will the blues away,” said Marchand, M.D., a psychiatrist, clinical associate professor of psychiatry at the University of Utah School of Medicine and author of the book Depression and Bipolar Disorder: Your Guide to Recovery. “Like any other medical condition, SAD requires professional treatment.”

The first line of treatment for wintertime SAD is light therapy or phototherapy. According to the National Institute of Mental Health, “The idea behind light therapy is to replace the diminished sunshine of the fall and winter months using daily exposure to bright, artificial light.” For instance, individuals might sit in front of a light box every morning. In this piece, Therese Borchard outlines six types of light therapy, including light boxes and dawn simulators.

Other effective treatments for both wintertime and summertime SAD include psychotherapy, such as cognitive-behavioral therapy, and antidepressants (such as selective serotonin reuptake inhibitors).

To manage summertime depression, try a day/sleep light; exercise indoors; avoid exposure to sunlight in the afternoons and evenings; and use darkening shades in your home. (Learn more in this article.)

Again, if you think you’re struggling with seasonal affective disorder, the key is to get professional help—and to be kind to yourself. You are struggling with a real, serious condition, which about 14 million Americans struggle with, too. And thankfully, it’s one that can be effectively treated.

And if you don’t have SAD, be kind to those who might, and don’t perpetuate the misconceptions—or the destructive stigma that makes being sick even more devastating and distressing for people with the illness.



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