Emerging from the winter doldrums

March 25, 2003|by KEVIN CLAPP

Forget the holidays. For some, this is the most wonderful time of the year.

Icy temperatures melt away. Flowers eager for sunlight muscle their way through soil. Days last longer, and venturing outdoors for a little exercise is no longer a pipe dream.

Spring, as they say, has sprung.

Just as animals rouse their weary bones from a long winter's nap, some men and women are awakening from their own fog, brought on by short days and long nights.

Called Seasonal Affective Disorder (SAD), it is an annual rite that crops up in sufferers during their 20s. For individuals with the disorder, the winter blahs are just the tip of the iceberg.


"Think of hibernation, like with animals," says Dr. Jim Childerston, a psychologist with Childerston and Associates in Hagerstown. "Everything slows down; slow, sluggish, lethargic movement."

SAD is simple enough to detect, marked by irritability, poor sleep patterns, a decreased interest in work or social activities, excessive appetite, weight gain, a detachment from friends and family.

As autumn days shrink leading to the end of daylight-saving time in October, symptoms increase. They wax and wane throughout the winter, usually for five months. Childerston says they grow most intense during January and February.

"And then spring comes," says Hagerstown psychiatrist Dr. Jude Boyer-Patrick, "and you bloom again."

Activity levels increase. Feelings of fatigue subside. Irritability dissipates.

Reasonably enough, Childerston says, incidence of SAD increases the farther from the equator people live. In Florida, for example, 1 percent to 2 percent of people are affected. In Maryland, the rate jumps to 5 percent. Live in New Hampshire, Childerston says, and there is at least a 10 percent chance of having the depression.

Seasonal Affective Disorder, he says, has to do with an increase in the levels of melatonin, a sleep-related hormone generated by the body, and a decrease in production of seratonin, a brain chemical that helps moderate moods.

Though Boyer-Patrick says the disorder has less to do with the weather than with shrinking daylight, Childerston saw an upswing in cases this winter.

"We're not used to having a winter with snow on the ground for as long, or it being as cold as it's continued," he says. "Even though we don't have the winters like Minnesota or New Hampshire, it has been a long winter relative to us."

Bitter cold and a thick blanket of snow conspired to obscure the sun and limit activity under natural light.

To combat the condition, Boyer-Patrick says, anti-depressants can be prescribed, or light therapy employed, for which people sit in close proximity to a light source for extended periods of time.

Better yet, try to take a walk outside. Childerston says one hour of walking in winter sunlight provides the same boost as two and a half hours under bright, artificial light.

Regardless, since SAD tends to be a recurrent condition, early treatment can stunt the severity of symptoms throughout the season.

The simple passage of time may wash these blues away, but it doesn't mean there aren't steps to hasten the progress.

Margaret Kitchens, a licensed certified social worker - clinical with Behavioral Health Services at Washington County Hospital, advocates grabbing life by the horns:

n If winter weather has derailed regular exercise, start taking walks at lunch, using the sojourn as an opportunity to soak up some sun.

n Eat better, and try to shed any winter weight lingering around the midsection.

n If part of the ennui has included a distancing from friends and relatives, Childerston says to reconnect and become more social.

And the difference in demeanor can be dramatic.

"What you'll find is people with SAD, as the mood lifts, it's more intense than people who are enjoying the spring," Kitchens says. "It's almost exaggerated, the lifting of the mood."

Boyer-Patrick and Childerston caution that since Seasonal Affective Disorder symptoms should dissipate as weather improves, more permanent symptoms may signal a deeper problem.

Too often, Boyer-Patrick says, men and women are reluctant to seek help, due to cultural bias about mental disease. Or, they revert to their upbringing, where depression wasn't discussed.

Instead of seeing a doctor, they turn to self-diagnosis and treatment.

"It's such a social taboo," she says. Unlike seeing a doctor for a physical, people seem to be hesitant to admit there might be problems with their minds.

Balance, Childerston says, should be put at a premium. Having seen the highs and lows patients traverse, Childerston urges patients to find a common ground.

"When we live life at the extremes," he says, "we're asking for trouble."

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