Seasonal Affective Disorder: It's That Time Of The Year Again
When I was younger my Aunt Maggie would randomly get really depressed and irritable. I never understood why, but my mom always told me to just ignore it. As I grew older I started to notice that these ‘episodes’ would only occur around certain months of the year, particularly in the winter. I then observed some more unusual characteristics: she quickly gained a lot of weight, most of her free time was spent sleeping, and she became less involved in our family affairs. When she did get involved it was only to start unnecessary and petty fights. I couldn’t comprehend why she was acting so distant towards her own family. It was a known fact that she hated the winter along with the snow so when I was thirteen-years-old she moved from Newtown, Pennsylvania to West Palm Beach, Florida. After a year or so she was back in shape and her attitude was nothing but friendly. She no longer slept her days away, and even though she lived twenty-four hours away she still remained really close to us. I now know that what my Aunt Maggie was suffering from was seasonal affective disorder, but in order for me to fully understand what she was going through I must first understand the disorder itself. It is for this reason that I will be looking at the symptoms and causes in particular that are related to this disorder.
What is seasonal affective disorder and who suffers from it?
Seasonal affective disorder (SAD) is characterized as a mood disorder that occurs during certain months of the year and is marked by periods of major depression (3). The most common type is known as the winter blues. This disorder typically starts around the late fall or early winter and continues until the spring (3). Another type, recognized as the summer depression, is more uncommon and begins in the late spring or the early summer and usually ends in the winter. Seasonal affective disorder is a subtype of the bipolar disorder, which is described by a disorder marked by periods of depression and mania.
Fifteen studies have been performed to measure the prevalence of seasonal affective disorder in different populations using surveys distributed throughout the communities. It was found that 0.8% - 9.7% of North Americans, 1.3% - 3% of Europeans and 0% - 0.9% of Asians suffer from SAD (8). However, I am a little skeptical of the accuracy of these surveys. Can we really rely on surveys to correctly diagnose patients with this disorder, and if so can we then use them to consistently categorize different populations?
What are the symptoms?
Seasonal affective disorder is commonly undiagnosed in about one half of all patients by primary physicians because it is often confused with another form of depression (1). Not everyone with SAD has the same symptoms. However many experience a significant amount of weight increase, irritability, a tendency to avoid social gatherings, a heavy sensation in the legs and arms, a sense of fatigue, lack of energy, difference in appetite, and an increase in sleep (9). People who have summer depression usually experience insomnia, weight loss, and a loss of appetite (9).
What are the causes and theories?
There is no direct cause to SAD, but it is believed to be related to the insufficient production of bright light during the winter months (7). This theory involves the idea that the quantity of light that enters the eye somehow stimulates the nerve centers in our brain and acts on their ability to control our circadian rhythms and moods (2). The pineal glad, one of the brain’s small endocrine glands, secretes the hormone, melatonin which then gives off a feeling of sleepiness at night (2). The bright light that characterizes morning causes the pineal gland to stop generating melatonin. However, in the winter time there is often an insufficient amount of light to stop the production and initiate the switch between the stages of sleep and awake (2). It is doubtful that melatonin directly causes SAD because “studies have not shown consistent changes in melatonin levels and melatonin suppression is not always required for the antidepressant effect of light” (8). If this theory were true then it would be consistent with studies that found SAD to be more prevalent in northern regions.
One theory concludes that the neurotransmitter, serotonin, is directly related to depression. It is hypothesized that serotonin is triggered by sunlight (4). There is then a connection that is made by some scientists that serotonin is the only neurotransmitter to have seasonal pattern in the human metabolism (8). Studies have been performed which state that during the winter and fall, humans generally have low levels of metabolism and in the summer and spring, our metabolism increases (8). This evidence is consistent with the idea that seasonal affective disorder causes many people to gain weight, however I wonder if these studies accurately portray the levels of metabolism within different patients and whether or not there is a direct correlation between the time of year and the different rates of metabolism. Nonetheless, correlation does not necessarily mean causation therefore I would caution many of the scientists to wait until there is hard evidence to prove these claims before asserting their knowledge as the truth.
Another theory known as the “Holiday Blues”, states that the causes of SAD is linked to the media’s portrayal of the feeling of warmth and comfort around the holidays and the desire to spend it with family. Depression is then felt among people who are unable to go home for the holidays and thus experience a feeling of extreme sadness (5). If this theory were true, then how would we account for the many people who, in fact, are able to go home during the winter time? This theory also believes that this disorder stems from psychosocial factors that act on our mind relating to the idea that one must feel ‘good’ during the holidays, family obligations, or possibly the idea that one might have unresolved childhood issues about Christmas time (6). This part of the theory is highly probable, yet there is no evidence to prove its validity.
My Aunt Maggie refused to acknowledge her problems and instead of seeing a physician and getting properly diagnosed, she could have been treated in a different manner. However, she chose to deal with it on her own by running away from the problem. Although she was not diagnosed, she was still able to resolve the problem by moving to Florida where the winters are not marked by insufficient light, coldness and a general sense of despair associated with some of the northern regions. Many of her symptoms were consistent with those related to SAD, and once she moved they all magically disappeared. I know the theory about the “Holiday Blues” would not be accurate to categorize my aunt because she was already home so it wasn’t as if she was missing anything. Although this aspect is inconsistent, my aunt might have unresolved issues from her childhood that I am unaware of. On the other hand, my aunt normally was unable to wake up in the mornings. This might be attributed to the idea that her pineal gland was unable to stop the production of melatonin because of the lack of lack entering her eyes. I can also tie her weight fluctuations to the affects of serotonin on metabolism, even though this theory lacks real evidence. Many people are suffering from this disorder, yet the direct cause is undetermined. We must perform more studies in order to learn the inner workings of the mind’s depressive state. Until then, people are just going to have to continue to suffer this depressing disorder, without a true and complete understanding of one question: why is this happening to me?
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