Seasonal Affective Disorder (SAD) – more than just ‘the rhythm and blues’Posted on: 30 January 2013 by Fiona Flaherty
The amended Health and Social Care Act arrives in April and changes the way care is delivered - some of it for the better!
The Government is preparing to implement the Health and Social Care Act 2012 in April 2013. Changes to the way care is delivered will affect all of us – some of it for the better.
General Practitioners (GP’s) will be the gatekeepers of the ‘new’ service and hold the purse strings. Government pledges have been made to uphold the slogan “ No health without Mental Health”- with huge financial investment into the services. But, and it is a very small but, getting the service, treatment and advise may well be more difficult than it first seems. As with all good things, it is about first steps – and recognising that you (or someone you know) needs to access help in the first place. Coupled with the billions of proposed savings across the NHS – it may be that pre-armed is pre-warned. As with any service provision it may not be universally accessible across the whole UK health arena. Mental health is a real health – and need not be shrouded in mystique and stigma and confined to the annals of healthcare.
So what can we do if we think we have SAD?
Seasonal affective disorder (SADS) was first reported in 1984 and its’ cause still remains largely misunderstood. It falls into a group of conditions that affects our mental (and subsequent) physical health. It is both an annual (late autumn and winter time) and cyclical condition (every year) that affects both genders, predominately between the ages of 18-30 years; but it can affect older adults. It is more prevalent in the northern hemisphere affecting 12 million people in northern Europe, as it is thought to be related to the amount of daylight hours that we receive. It currently affects 2 million people in the United Kingdom (UK), which equates to 1:50 people. It is not to be confused with ‘Winter Blues’, which is a milder form (subtype) affecting 1:8 adults predominately women and does not necessarily reoccur year on year.
SAD diagnosis is confirmed if the presence of clinical depression and other symptoms have reoccurred in the last two consecutive years. Mental Health issues are known to affect 1:4 adults in their lifetime. Not all are pathogenic and many of the disorders are treatable or if not, certainly manageable.
Recognising and managing your own self-care may be the most important factor in symptom control. It is all about balance - chemicals in our brain, chemicals in our food and boosting our immune systems. SAD sufferers are prone to poor quality restless over-sleeping (hypersomnia). Quality sleep preferably when it is dark (of no more than eight hours) will boost the melatonin levels in the brain and promote a ‘feel good’ factor. These affect our circadian rhythms – controlling our patterns of sleep, appetite and activity. These can very quickly get out of line, which will lead the body to produce excessive cortisol the ‘stress’ hormone which is detrimental and potentially damaging to our normal body functions.
The optimal temperature of between 36-37 degrees centigrade is essential for our body to function efficiently. If we get cold, muscles become less pliable and restrict activity, social interactions and can conversely make us more tired and sleepy. This cycle then becomes more difficult to break.
SAD can sabotage any diet – as it creates abnormal cravings for increased carbohydrate in the form of starches and sugars, both in quantity and ‘readily available convenience’ foods. This coupled with inactivity may lead to the inevitable weight gain. ‘Feel good’ micronutrients are found in foods that are fresh and as unadulterated as possible. A mix of the food groups, protein, good fats, complex carbohydrates, fibre in the form of colourful vegetables and fruit and adequate water at every meal and snack will ensure that the correct energy level can be used when it is needed. A general tip is that preparation and cooking should be in your own hands; and not already, prepared, coated, treated, fried or salted to ensure the maximum micronutrient content.
Sunlight, even when the sun is covered by cloud is essential to our wellbeing. Adequate levels will increase our serotonin levels and keep our moods elevated. Exposure needs to be through our eyes and on our skin (face and hands) for at least an hour a day for maximum effect and preferably when the sun is highest in the sky. This will also help us manufacture adequate daily levels of vitamin D, which is needed in the manufacturing process for optimum calcium levels for healthy bones and teeth. This can also be supplemented daily in our diet by including fish, eggs and fortified rich foods. This is not a replacement.
Our ‘mood’ is how we function and present ourselves to the world. SAD can give rise to acute episodes of anxiety, concentration lapses, melancholy and despair. Upon diagnosis, current symptom control may be managed by a single treatment or combined therapies. These may include talking therapies known as Cognitive Behavioural Therapies (CBT), prescribed anti-depressants (known as SSRI’s) and light box therapies. Your General Practitioner (GP) can assist with prescribing CBT and medication if considered appropriate.
Artificial light (Lux) may offer individuals some relief from the symptoms, but there is little research to support this as yet. A standard domestic light bulb Lux is between 200-500L. Light boxes in a range of sizes are available through retailers, offers ultraviolet free (non harmful) Lux up to 3000L. These can be used for up to an hour a day (as per manufacturers recommendation) preferably before daylight. Some light boxes have the facility to operate before dawn (and waking) to maximise the effect.
Keeping a ‘mood’ diary may also help in keeping track of the symptoms. As a recognised mental health issue – SAD is important and not a trivial inconvenience that can be ignored. So what are you waiting for?
I'm a creative, enthusiastic independent lecturer, nurse and midwife. A public health advocate who continually motivates individuals to manage their personal change, through health education and screening. I am a regular contributor to 50connect and co own Meducate Limited.
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