Wallowing in Winter SAD-ness
Wallowing in Winter SAD-ness
It’s been overcast for weeks. There have been unrelenting snowstorms. You’re tired. You lose all motivation. You can’t remember the catalyst responsible for this change – you can’t even remember if there is an actual catalyst at all. There seems to be no rational explanation – you’re just sad. Seasonal Affective Disorder (SAD) is a cyclic condition that triggers recurring episodes of depression with respect to seasonality. In this web paper, I will explore only the psychological condition of winter SAD (henceforth, any reference to SAD should be understood as winter SAD and not summer SAD) and its relevance to neurobiology, behavior, and environment.
SAD affects roughly 6 percent of the general population, with affected women outnumbering men four to one and with the risk of SAD decreasing with age.[i] In northern regions where winters are harsher and longer, more cases of SAD have been recorded. The generally accepted cause of SAD is the decrease in exposure to sunlight that occurs in the colder seasons. Symptoms of SAD include episodic depression, hypersomnia, loss of energy (despite the hypersomnia), diminished interest in previously-enjoyable activities, rejection sensitivity, social withdrawal, and difficulties with concentration and focus. Interestingly enough, SAD differs from other types of major depressive disorder in that it is cyclic in nature: symptoms occur accordingly (time of year, type of weather: generally colder, sunless weather can stimulate the same symptoms).
Biologically, the lack of sunlight does affect the body. Reduced sunlight disrupts the body’s 24-hour internal clock, or the circadian rhythm, which assists in communicating to the body when to sleep and rest and when to wake and be active. The decreased exposure may confuse and interrupt the rhythm leading to symptoms of hypersomnia (excessive sleeping) and restlessness. The shift in sun exposure also disturbs melatonin levels, which regulate sleep pattern and mood; during the winters, SAD patients secrete more melatonin than they do during the summer[ii]. Thus, a fluctuation in melatonin levels affects the regulation of sleep pattern, which in turn, can worsen circadian misalignment. According to the research of AJ Lewy, et al, the severity of SAD is interconnected to the degree of circadian misalignment because phase relationship to day/night cycle becomes skewed, altering both mood and behavior.[iii] In addition, reduced sun exposure is believed to affect levels of seratonin, a neurotransmitter responsible for regulation of mood, appetite, muscle and cognitive functions. One study explored the promoter region of the serotonin transporter gene (5-HTTLPR) and it’s relation to seasonality.[iv] It was determined that duration of exposure to daylight correlated negatively to 5-HHT binding; thus, serotonin undergoes dynamic changes when exposed to “stressful environmental stimuli.” Therefore, exposure to sunlight is connected with mood and behavior. In terms of SAD, the lack of sunlight propels a symptomatic pattern according to nature’s pattern: weather and somewhat predictable seasons.
Cold weather and longer winters typically are more common in northern regions, and accordingly, studies have shown a prevalence of SAD cases in northern latitudes.[v] Interpretations of this conclusion can result in generalization: people who live in the north are more depressed and/or have a higher potential to succumbing to seasonal depression and conversely, people who live in sunnier areas are less likely to experience winter SAD and therefore must be happier. Taking sweeping generalizations aside, this interpretation suggests that behavior – or at least some part of behavior – falls into a model where seasonal affective behavior is an inescapable effect of nature (weather), which then is the cause. Therefore, nature, and the location of the natural effects – one’s physical environment and location – are critical in regulating behavior and mood.
Imagine a region far up north: the farther up the location is, the higher SAD’s ability to affect behavior becomes. Suppose the region becomes so cold that so many people display SAD (or a milder case of winter blues) that the weather becomes responsible for generating a collective behavior. Does the idea of collective behavior help shape regional culture and stereotypes? For example, the easygoing, relaxed, content Californian versus the busy, serious, independent, and cold New Yorker? To what extent can SAD connect something so inherently scientific and natural to something inherently humanistic and produced?
Location is inherently interconnected to regional culture and community. Culture and community can be thought of as social constructs. Social constructivism is a widely-held sociological theory of knowledge that states that all things (i.e. gender, familial units, government, and corresponding behaviors) exist as social constructs; things exist because there is a social and societal need for their existence. Therefore a constructed culture of a specific location should yield specific reactions and responses; in saying this, I mean to stress that it is widely believed by many social constructivists that human-made constructs decidedly regulate outcomes, responses, trends, behaviors, etc. However, we have seen that exposure to nature (sunlight) – something that is out of human and societal control (i.e. not a social construct) – prompts SAD and can alter behavior. It is natural science that monitors the relevance of location, which then controls behavior and mood.
To conclude, SAD is triggered by a reduction in sun exposure and those suffering from SAD cannot actively do anything to change that fact – it’s all up to Mother Nature. Therefore, rational control over behavior is not always the case. Does this mean that SAD patients have no free will when regulating their own behavior? Free will is inherently humanistic: it is what makes us different from the simple beast. The idea that certain disorders can take away a fundamental characteristic of our humanity is altogether frightening. If free will makes us human, and if science regulates free will, then perhaps science makes us human. Conversely, isn’t science a social construct? Ultimately, what does it mean to be human? Is it rational control or is it the acceptance that maybe we’ll never understand these complex intricacies of life and humanity? In any case, that is rather SAD news, after all.
[i] Targum, SD, and Norman Rosenthal. "Seasonal Affective Disorder." Psychiatry 5.4 (2008). PubMed Central. Web. 2 Apr. 2010. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686645/?tool=pubmed#B1>
[ii] See i.
[iii] Lewy, AJ. Emens, JS. Songer, JB. Sims, N. Laurie, AL. Fiala, SC. Buti, AL. "Winter Depression: Integrating Mood, Circadian Rhythms, and the Sleep/wake and Light/dark Cycles into a Bio-psycho-social-environmental Model." Sleep Medicine Clinics 4.2 (2009). PubMed. Web. 31 Mar. 2010. <http://www.ncbi.nlm.nih.gov/pubmed/20160896>.
[iv] Kalbitzer, J. Erritzoe, D. Holst, KK. Nielsen, FA. Marner, Lisbeth. Lehel, S. Arentzen, T. Jernigan, TL, Knudsen, GM. “Seasonal Changes in Brain Serotonin Transporter Binding in Short Serotonin Transporter Linked Polymorphic Region-Allele Carriers but Not in Long-Allele Homozygotes” Biological Psychiatry 10. (2009). ScienceDirect. Web. 28 Mar. 2010 <http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T4S-4Y8357M-2&_user=400777&_coverDate=01%2F27%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000018819&_version=1&_urlVersion=0&_userid=400777&md5=7fb5fd562ebec75423d9f181a5787372>
[v] Winkler, D. Willeit, M. Praschak-Rieder, N. Lucht, MJ. Hilger, E. Konstantinidis, A. Stastny, J. Thierry, N. Pjrek, E. Neumeister, A. Möller , HJ, Kasper, S. “Changes of clinical pattern in seasonal affective disorder (SAD) over time in a German-speaking sample” European Archives of Psychiatry and Clinical Neuroscience 252.2 (2002).
Other References and Sources
Saeed, SA, and TJ Bruce. "Seasonal Affective Disorders - March 15, 1998 - American Academy of Family Physicians." Home Page -- American Academy of Family Physicians. Web. 02 Apr. 2010. <http://www.aafp.org/afp/980315ap/saeed.html>.
"Seasonal Affective Disorder (SAD): Symptoms - MayoClinic.com." Mayo Clinic Medical Information and Tools for Healthy Living - MayoClinic.com. Web. 03 Apr. 2010. <http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195/DSECTION=symptoms>.