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Are you SAD in the festive season?

By on December 29, 2009

Photo © Elena Derevstova

 

One sometimes wonders if they think of the acronym first, then make up a disease name to fit. SAD means ‘seasonal affective disorder’, more simply known as winter depression or ‘winter blues’. It comes from the ‘Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition’ (DSM-IV), of the American Psychiatric Association, sometimes called the psychiatrist’s ‘Bible’, which refers to it as a ‘specifier for major depression’, whatever that is supposed to mean.

 

That said, some people do seem to suffer from a disorder which recurs every year in the late autumn (fall) or winter, and recovers as the days get longer in the spring and summer.

 

The features include depression, loss of energy, excessive sleeping, overeating and weight gain, and a desire for sweet or starchy food. 

 

Various theories have been put forward to account for this problem. Is it a vestige of an earlier evolutionary stage in which some animals prepare to hibernate, by  eating a lot, getting fatter, then curling up and sleeping through the cold winter months when food is scarce? Or is it a disorder of excessive production of melatonin – the hormone secreted by the pineal gland in the brain during the hours of darkness? Changes in the body’s circadian rhythm (or ‘biological clock’) due to reduced sunlight in winter may also be involved in the cause, but nobody knows for sure.  

 

Nonetheless, one empirical treatment which may be effective is exposure to artificial bright light, or phototherapy, especially if given in the mornings. This is thought to reduce the levels of melatonin, and some sufferers find it effective. Psychotherapy (counselling) is often of value, and antidepressant medication may be used as well.

 

Whether, or to what extent, recurring seasonal depression is disorder of brain chemistry or how much it is due personal or environmental factors is unknown. Of course, if someone is seriously affected by depression, they should consult a doctor. In any case, to assist in keeping one’s spirits up during the cold dark winter months, the following simple measures should be helpful: Take regular moderate exercise, such as walking, especially in the mornings when the sky is bright, and avoid excessive alcohol and overeating.

 

Dr Gabriel Symonds is a British general practitioner who has been serving the expatriate community of Tokyo since 1984. He is the director of the Tokyo British Clinic which offers comprehensive medical services including psychotherapy for depression and other mental health problems. www.tokyobritishclinic.com 

Tel: (03) 5458-6099. 

About Dr. Gabriel Symonds

Dr. Gabriel Symonds was the director of the Tokyo British Clinic. The clinic closed down in May 2014 after serving the expatriate community for 20+ years. Dr. Symonds has retired and the Tokyo British Clinic is now closed. Dr Symonds will continue to live in Tokyo and may be contacted by e-mail over any questions concerning medical records or related matters: symonds@tokyobritishclinic.com He will be available from another address for: smoking cessation psychotherapy/counselling circumcision information Tel: (03) 5458-6099 www.tokyobritishclinic.com