In the dark days of SAD's winter doldrums

December 23, 1997|By Darryl Campagna | Darryl Campagna,ALBANY TIMES UNION

ALBANY, N.Y. -- In "Troilus and Cressida," Shakespeare wrote: "Alas the day, how loath you are to offend daylight!"

Shakespeare wasn't writing about seasonal affective disorder when he penned that line for his character Pandarus, but his words have a contemporary resonance for the millions of people who struggle through the winter doldrums.

Sometimes scoffingly dismissed by the uninformed as a made-up disease, a real case of seasonal affective disorder (SAD) is no laughing matter, said Dr. Robin Tassinari, a professor of and clinical medicine at Albany Medical College.

People suffering from SAD may find it difficult to perform well at their jobs as they contend with fatigue and irritability. Their craving for sweets or carbohydrates can add unwanted winter pounds.

"We should take it seriously," Tassinari said. "The symptoms are different from major depression, but certainly it is a form of depression."

The cause of SAD is unknown, but may have its origins in ancient instincts that drove humans into a near-hibernation state in the winter so they'd be warm and safe, Tassinari said.

If you do have a diagnosed case of SAD, take heart; you've technically gotten through the darkest part of the season. The winter solstice, which occurred at 3: 05 p.m. Sunday, was the shortest day of the year.

Still, people suffering from seasonal affective disorder probably won't gain any real benefit from additional afternoon daylight until at least March or April, Tassinari said. To cope until then:

Speak to your doctor about light therapy, or ask for a referral to a mental health professional familiar with light therapy. SAD is diagnosed through a standard questionnaire that evaluates a recognized set of symptoms. People with true SAD do benefit from exposure to intense levels of light under controlled conditions. A clinician familiar with SAD must prescribe the light therapy the amount of exposure and number of times per day vary with individuals.

The specially designed lights cost anywhere from $200 to $500, and are rarely covered by insurance, but they work so well they're worth the investment, Tassinari said.

If you suspect you have SAD but your doctor seems unsure of how to diagnose it, ask for a referral to a psychiatrist, psychologist or social worker trained in the recognition and diagnosis of SAD.

Follow your doctor's prescription for light therapy, and don't stop using the lights when you start feeling better. Most patients gain a noticeable benefit from light therapy within two weeks, but their SAD symptoms quickly return if they stop light therapy, Tassinari said.

In addition to light therapy, try a 45-minute walk before going to work.

"Even a modest increment of natural light exposure can be helpful," said Michael Terman, a physiological psychologist at New York State Psychiatric Institute. "Even on an overcast day, you're going to get a lot more light outside than inside."

Intense aerobic exercise has helped some people with SAD, Terman said.

If you crave carbohydrates or sweets, work them into a balanced diet. Researchers believe the craving for carbohydrates or sweets is triggered because carbohydrates produce a neurochemical process in the body similar to that produced by certain antidepressant medications.

Pub Date: 12/23/97

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