Current Issues in Mental Health

‘Tis the Season…

… to be jolly, -- or not to be.
If you are relaxing during this post-holiday lull, curled up by the fire and feeling content, you may want to stop reading now.

But if the shorter days and overcast skies of winter find you asking Hamlet-like questions such as ‘to be, or not to be’… then perhaps reading this article can help turn the tide. Some persons are particularly vulnerable to the change in seasons. Seasonal Affective Disorder or Winter Depression is the same as Major Depression, but has the added characteristic of being precipitated by decreased exposure to sunlight. This sunlight deficit occurs generally between September and April when days are shorter, but can occur any time of year for those who work where there are no windows. The more the decrease in daylight, the more common or severe the symptoms may be. In Easton, daylight decreases from 15 hours in June to only 9-1/2 hours by Christmas. Because seasonal depression is worse with less sunlight, someone traveling north may become more irritable and emotional (during winter vacations).

Major depression is the #1 leading cause of disability worldwide. That means of all the diseases and illnesses in the world, this one is the most likely to interfere with your personal and professional life. It is so common, that within a one year period, more than 6% (1 of every 20 persons) will have an episode of depression severe enough to warrant treatment.

Not everyone has the same symptoms. Common symptoms include:

• Decreased energy.
• More easily irritated, grouchy, emotional, stressed out, angry.
• Sleeping more (some have insomnia).
• Decreased concentration or focus, such as with reading.
• Less desire to socialize or leave the house.
• More sensitivity to feeling hurt or rejected.
• Less enjoyment of activities or less able to laugh and play.
• Physical problems: headaches, backaches, tension, worse PMS, aches and pains.
• More pessimistic or hopeless.
• Increased drinking (which may increase symptoms in the long run).
• Less motivated – having to make yourself go to work or do chores.
• Weight gain in the winter, with cravings for sweets and starchy foods especially later in the day (and often loosing weight again in the summer).

Most people do not realize how serious untreated depression can be.

• Depression and anger cause decreased immune response.
• Depression increases the risk for developing heart disease to the same degree as smoking does.
• Persons who have a heart attack are 6 times more likely to die if they also have depression.
• Depression effects blood clotting factors, increasing the risk of thrombus formation and thus strokes.
• Depression also causes an increased risk of death following cardiac bypass surgery.

Feeling down sometimes is normal, but having some of the above symptoms to the point that it decreases your level of functioning is not normal, and may be caused by a decrease in the level of certain neurotransmitters, precipitated by lack of exposure to sunlight. It is wise to consult a physician rather than self-diagnose because these same symptoms may be caused by a medical illness, or by another mood disorder which requires a very different type of treatment. Increased outdoor activity or exercise particularly on sunny days may lessen the symptoms. Light therapy with special 10,000 lux light bulbs is also effective and safe (www.sunboxco.com). Antidepressants also are effective as treatments, and psychotherapy plus medication works better than either alone.

So if you’re not certain if your blues have reached the point of interfering with your personal relationships or your performance at school or work, check with your doctor. Depression is probably the most under-diagnosed and the most under-treated cause of decreased quality of life. Additional information can be found on antidepressant medication websites where pharmaceutical companies are required to post accurate information about depression.

Examples: Prozac.com, Zoloft.com, Cymbalta.com, Effexor.com.

Written by Brenda C. Scribner, MD, a private practice psychiatrist in Easton. She specializes in individual and couples therapy, personal growth therapy and in adult mood and anxiety disorders.

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