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Many suffer down mood in winter.

Byline: Joanna Hoskins For The Register-Guard

Modern life is not good for humans or other living things.

Before the invention of the electric light, people went to sleep when it was dark and got up when the feathered alarm went off in the barn. So did most of the creatures around them.

Nature programmed our brains to produce a natural sleeping agent called melatonin that increases in darkness and is suppressed in light. It's a neat and effective system.

Now we have the halogen marquee, which is modern life. Swing shifts, night shifts, kids' soccer games and homework. Demands have lengthened, but our age-old brains still crank out the melatonin when the seasons darken.

Response to the seasonal shift can be severely disruptive for about 6 percent of people - and about 20 percent more people experience some disruption. Sufferers feel lousy, but the demands of their lives don't let up.

They may be experiencing SAD: seasonal affective disorder.

SAD is a mood disorder. Some symptoms are depression, lethargy, fatigue, craving for sweets and starches and social withdrawal. Other symptoms may include increased sleep and sleepiness; difficulty concentrating and processing information, especially in the afternoon; irritability; and perhaps headaches or worsening of headaches.

For people with winter SAD, it's as if their brains treat a year as if it were one very long 24-hour day, with the light months as uptime and the darker months as downtime. And the downtime can be a real struggle.

No one knows what actually causes SAD - why some people have this condition and others don't. It is probably a combination of brain chemistry reactivity (which is usually genetic) and where the person lives.

The farther a person lives from the equator (either north or south), the greater the incidence of SAD in the population.

The research of Dr. Alfred Lewy of the Oregon Health and Sciences University in Portland suggests that SAD is caused by a disruption of the brain's internal clock.

For SAD sufferers, as daylight shortens and darkness lengthens, the brain produces more melatonin (which can make a person sleepy) and less serotonin (which may lead to depressed feelings).

There are three approaches to treating SAD:

Light therapy. The standard treatment for SAD is 10,000-lux of diffused, white fluorescent light, early in the morning.

This treatment, which can be augmented by a dawning light, adjusts the brain's light-dark cycle so the person awakens in the early morning, aligning with the brain's natural pattern. Treatment continues through the vulnerable winter months.

This isn't a cure: SAD comes back each season like grass allergy. But Lewy's research shows that light therapy is equally effective each time. With light-therapy treatment, about half of SAD sufferers regain the energy and positive moods they experience during long summer days.

"Remission rates climb to 80 percent if light therapy is tailored to a person's individual sleep-wake cycles," says Michael Terman, a psychology professor at Columbia University Medical Center. "(Results) are quite conclusive: Bright light therapy, administered at the right time and in the right dose, is the most efficient, tested and safe method of treating SAD."

Cognitive behavioral therapy. Although SAD has a biological basis, researchers have identified a pattern of personal reaction that can make episodes of SAD worse for some than for others. People who take situations that occur personally (believing that, "What is happening is about me. Everyone thinks I'm a loser, and they're probably right.") and who dwell on their symptoms, tend to have earlier and more severe bouts of winter SAD.

This type of therapy teaches people to shift their focus from suffering more to problem-solving and action-oriented thinking.

It also encourages people to increase their healthy lifestyle actions, including low-fat and low-sugar food choices, aerobic exercise, getting outside (the morning sky, even when overcast, emits the same light as a light box) and doing enjoyable, social things.

Medication. Some early studies suggest that buproprion (Wellbutrin and Wellbutrin XL) can be helpful to the mood shifts in SAD, but the research on this is in the early stages.

If you think you could use help with SAD, seek help from your physician, psychologist or employee assistance program if:

You have the symptoms of seasonal affective disorder, especially the down mood, loss of purpose, sleep interruptions and marked changes in appetite pattern.

You feel blue for days at a time, especially if you have thoughts of harming yourself or someone else.

Joanna Hoskins, Ph.D., is a psychologist with Cascade Health Solutions and Direction for Employee Assistance.
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Title Annotation:Springfield Extra
Publication:The Register-Guard (Eugene, OR)
Date:Jan 17, 2008
Words:753
Previous Article:SPRINGFIELD POLICE BLOTTER, JAN. 4-10.
Next Article:Several sharing load for Springfield this season.


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