"Winter is a disease," declared French poet and playwright Alfred De Moussett. Many can identify with this statement, but others find winter a delight. Why? Perhaps you are affected by "cabin fever" or worse "Seasonal Affective Disorder."
Mental health experts agree that recognizing symptoms of winter depression called cabin fever and then seeking professional help is the first stop in conquering depression, overeating, anti-social behavior and boredom. "Over 25 percent of the population in mid to higher latitudes suffer from what is called Seasonal Affective Disorder or SAD," said Dr. Michael Terman, Ph.D. of the Now York State Psychiatric Institute and Department of Psychiatry at Columbia University, "In fact one in every five persons who lives in Alaska may be affected by SAD." Ternian, a leading expert on tic diagnosis and treatment of SAD says that the only major population at northern latitudes that is not affected by SAD are Icelanders.
What is the difference between cabin fever the winter blues and SAD?
Any depression due to winter that creates inactivity, weight gain, social withdrawal and sleep disturbance can be diagnosed as the winter blues, and in fact cabin fever and SAD uc more severe forms of the winter depression. Cabin fever can be brought on by factors like severe storms and confined spaces, and can manifest itself as boredom, irritability and sleep loss. Cabin fever strikes most often during our long, often severe winters, but it can affect a person anytime of year, say research experts.
"Cabin fever is closely related to relationships," said Paul Rosenblatt, a family social scientist at the University of Nbnnesota. Rosenblatt's research has foun that people who are home, caring for children or the infirm are most likely candidates for this malady.
One of the biggest hurdles of Arctic exploration in the 19th century was inactivity. According to Peter Suedfeld and Phyliss Johnson, a professor in the School of Family and Nutritional Science at the Lniversity of British Columbia, who researched how sailors in the Arctic adapted to voyages that kept them from their families for a year or more.
Suedfold said that long periods of unstructured time with nothing to do and no definite end in sight is a tough mcutal challenge. "Boredom was the fate of most crew hands an Arctic whaling and exploration trips from faraway places, such as England and Canada. Things grew even more monotonous when a ship became locked in sea ice, sometimes for more than one winter. Ship's officers, such as WHO?? deBrey, wanted to 'prevent the men from stagnating in deadly inactivity.' Crows of Canadian and American whaling ships frozen into the ice next to one another in the winter of 1903-04 held foot races and played soccer. On board the Canadian officers held lectures, The Arctic sailors also celebrated traditional holidays together."
More severe, and clinically known as Seasonal Affective Disorder, SAD affects million of Americans and 20 percent of the Alaska population according to the Alaska Mental Health Association. The American Medical Association and the American Psychiatric Association characterize these symptoms of SAD triggered by fall or winter onset with several of the following:
What causes SAD? Experts agree that there is a link between decreasing sunlight during the fall and winter months and a chemical imbalance in the brain. In 1980 researchers at the National Institutes of Mental Health demonstrated that high-intensity light affects the natural release of metatonin by the pineal gland in the brain. This determined that human physiology is influenced by light.
During the. fall and winter seasons, and exacerbated by higher latitudes, where daylight is short or nonexistent, less light passes through the eyes, which inhibits the release of an important brain chemical serotonin. When serotonin is not released in sufficient quantity, depressive symptoms begin to occur. Melatanin , another important brain chemical, also is affected by insufficient light. The brain releases too much of this chemical (melatonin is the same hormone that causes bears to hibernate,), at the wrong time, also contributing to depressive symptoms resulting in fatigue and a desire to sleep.
Younger people, ages 20-35, seem to be at a higher risk for the disorder, and, according to the Center for Environmental Therapeutics in Upper Montclair, N.J., there is some suggestion that more women than men are afflicted. According to studies done in Alaska, 75 percent of those affected by SAD are women. SAD is not related to seasonal factors such as unemployment, the start of school, or unhappiness about the weather.
How do you treat SAD? Serotonin levels can be elevated by increased exposure to light, according to Greg Danzig, president of lonair Co. "Light and antidepressants like Prozac help. But researchers say negative ions may also increase brain levels of scrotonin."
Scientists at Columbia University's Presbyterian Medical Center conducted a placebo-controllcd study testing high-density negative ion generators for the treatment of winter depression. Researchers found that 58 percent of patients treated with high-density negative ions had significant relief of their symptoms - almost identical to the number who improved with drugs but without drug side-effects, Dr. Norman E. Rosenthal, M.D. outlines the effects, problems, and treatment of SAD in his book "Winter Blues," Rosenthal discusses the use of St. John's wort and a helpful nutritional regimen. In his book Rosenthal also discusses the use of light therapy in treating problems, by those whose symptoms mirror those of SAD. These include jet lag, sleep disorders, premenstrual syndrome, and the effects of shift work.
Experts around the world agree that light therapy in sufficient intensity and time is an important component in the successful treatment of SAD. Exposure to intense artificial light suppresses the secretion of the night time hormone metatonin and may enhance the effectiveness of serotonin and other nourotransmitters.
"We recommend that every person seek help from their family doctor if they are depressed," said Jan McGillivary who is CEO of the Alaska Mental Health Association. "In fact we emphatically recommend your family doctor, but if a person can't afford health care we automatically screen patients with a questionnaire."
According to McGillivary the screening process helps determine if there is a pre-existing problem from drugs or pre-diabetic condition or chronic depression, which manifest similar symptoms to SAD and the winter blues. After this screening process they suggest light therapy or counseling or both.
"You don't have to have a prescription for light therapy. We have gobs of information on it for free, but if you want to get reimbursed for a portion of your expense, most insurance companies require a prescription from your doctor. "
McGillivary added that full spectrum florescent lights in the home can help but, professional sources maintain that at least 2,500 lux of light within throe feet of an individual for at least 30 minutes daily is the minimum requirement to change sarotonin levels. (100 lux is the amount of light entering your eyes from a 100 watt bulb five feet away.)
Several companies sell portable personal-uso light units for $300 to $550, though the federal Food and Drug Administration has not, as yet deemed phototherapy devices as safe and effective. Safety concerns have focused on exposure to ultraviolet light, which can ultimately cause sunburn, eye damage and skin cancer. Fortunately, recent studies have shown that UV rays are not an essential component of light therapy, according to Consumer Reports and Health magazine.
The state of Alaska and Alaska Mental Health Association teamed up recently to create legislation that allows Medicaid recipients who are in treatment for SAD by a doctor or psychiatrist benefits that will allow reimbursement for light box units.
Another effective means of treating SAD and winter depression is one that is gaining popularity by those who are against drugs or feel stigmatized by using them.
"I used St. John's wort last winter, and sailed right through in good spirits," McGilliyary added. Also spiriting the movement along in favor of St, John's wort is the price.
According to McGillivuy, patients who were used to spending from $100 to $130 dollars a month for drug treatment and have switched to St. John's wort are now spending $15 dollars a month for similar relief.
St John's wort is a derivative from daisy flower family and is a mood altering (several days) to (two weeks) treatment. However the use of this herb is limited, Doctors have found that some individuals are allergic to the compound. St. John's wort and drugs like Prozac can have serious side effects, according to doctors and pharmacists.
"Research among those of us as hypnotists supports the theory that an individual's personal belief system is imaged from the root of their childhood," said Daze(Daze ?First name?), a local hypnotist. "I think people need to change the picture of what winter is to their belief system. This is something that may have been suggested early in their life. You can train your subconscious mind to change those beliefs, and make a change in your mind's image of how you feel in the winter."
Daze, of The Feel Good Place, which offers hypnosis and body massage, is a proponent of another technique called self-imaging, which can also be done with hypnosis. Daze is currently coaching several individuals with wintertime blues using this technique.
"The light box is the only effective means of shifting citcadian rhythms, or the body's internal time clock," said Neil Wagner of Alaska Northern Lights. Alaska Northern Lights, located in Homer, sells a box designed by Wagner who has the boxes manufactured in New Jersey. "The extra light is really nice, its like getting extra sun in the winter," Wagner said. "I have friends that reasoned that they probably needed more sunlight to make them feel better, not more Prozac, and low and behold they save the price of one light box in a month's time. After dropping the drug use."
Wagner, who sells between 1,500 and 2,000 of his 10,000-lux light boxes internationally a year, says that there are more than eight locations that sell his lightboxes in Anchorage and any Alaska pharmacy can find his box. Wagner said he recently sold several light boxes to Bruce Packard, an ARCO Alaska Inc. employee who works in Prudhoe Bay, for use in offices during the winter months.
In Barrow far above the Arctic Circle, where from Nov. 18 to Jan. 23, the sun never reaches above the southern horizon, the light boxes have also gained notoriety and use, among non-Native school teachers and counselors working through the winters in Alaska's northern most community.
"We decided to take a proactive approach to winter," said Joanne Hall who is experiencing her first winter in Barrow as a counselor for the Ipalook Elementary School. "So we decided to hold an in-service gathering to discuss the darkness and effects of winter, We called it; 'Cookies and the Blues.' " According to Hall, 25 people attended the meeting where Larry Moen from the North Slope Borough Community Counseling Center made a presentation about winter blues and SAD. "I do not feel like I am effected by SAD," Moen said. "But after using the light therapy for a couple of weeks, was like waking up on a spring morning, totally energized." Moen also uses a dawn simulator to regulate circadian rhythms in conjunction with irregular use of the light box to elevate his energy levels.
"When I first moved here I thought my depression was a result of being awa from my family at the holidays. Little by little, and year by year, I realized something else was going on," said Jill Emerson a teacher at Ipalook, and resident of Barrow for 21 years. "I stay active to counter act the dark, which was, I finally realized, the factor in my depression. Now when I got home I turn on all the lights and leave them on until late, and then turn them off one by one before bedtime."
The Barrow in-service meeting resulted in an order of six of the light boxes from Alaska Northern Lights in Homer. Two of the boxes are for use at the school, and the other four boxes were purchased by individuals to counteract the lack of sun for 66 days this winter.
Dawn simulators work either as a light that gradually increases in brightness or timed to turn on in the early morning hours.
Dr. Michael Terman demonstrated a travel version of a dawn simulator at the University of Fairbanks recently that worked from the keyboard of a lap-top computer. Dawn simulators are effective. in curbing late waking and hard-to-wake habits as a result of extended sleep due to SAD or an increase in melatonin, according to Terman.
Doctors, counselors, and experts agree that more than just light is needed to keep depression from knocking at the door of winter enthusiasm. Diet, exercise and a regimen of regular goal oriented activity will drive away the winter blues.
Food for the mood is the rule, eat more fruits and vegetables and less fat and sweets to stabilize moodiness, according to Delicious On-line, an Internet magazine. Magnesium, vitamin B6, Vitamin C, and folic acid are additives you may also want to consider . Excessive intake of alcohol, caffeine and nicotine and added stress, are also discouraged if you are affected by the wintertime depression. Daily walks or exercise routines are encouraged.
So take advantage of one of dozens of Alaska outdoors adventures, snowmachine, ski, snowboard, winter bike, fly an ultralight, or go snowshoeing, whatever it takes to keep the winter blues away.
reprinted with permission of the author and the Alaska Journal of Commerce, where this article originally appeared.
<http://www.alaskanorthernlights.com> The Home Page of A local SAD light manufacturer/distributor.