Plumbing the dark depths of depression
Long nights and overcast mornings that take hours to brighten can make this season of the year depressing. Indeed, a formula devised by a researcher at Cardiff University suggests that misery reaches its peak each year on 24 January as foul weather, debt, fading Christmas memories, failed new year resolutions and a lack of motivation conspire to depress.
Soon, it is true, there will be a sense that another springtide is on its way,
but not just yet. Our enthusiasm for living and activity is damped down by that
curious phenomenon known as seasonal affective disorder — appropriately
SAD for short — which is commonly encountered in our temperate latitudes.
The dominant symptoms of SAD include moody depression, lack of energy and enterprise,
irritability, anxiety, inability to concentrate on an immediate task, reduced
libido and a tendency to shirk social encounters. In contrast to most depressions
of a non-seasonal type, SAD tends to induce sleepiness, which may prove troublesome
during the day, combined with an urge to consume rich foods such as chocolate
and other products with a high fat or carbohydrate content.
Estimates by psychiatrists have suggested that some 3 per cent of the UK population
show a clinically significant winter depression. Treatment with one of the specific
serotonin-reuptake inhibitors, such as fluoxetine, paroxetine, citalopram or
sertraline, may relieve the symptoms, but not always.
Light therapy has been widely advocated, although this may have conflicting results.
Exposure to light intensity of 2,500 lux or more, particularly in the morning,
which is calculated to advance the onset of melatonin secretion, has been practised.
A procedure known as “dawn stimulation” has also been used. One such
regime involves applying white light of slowly increasing intensity from about
4.30am during sleep, peaking at 250 lux after 90 minutes. A US study showed that
this was more efficacious than a 30-minute exposure to 10,000 lux (roughly the
outdoor light intensity half an hour after dawn) starting at 6am. The object
of treatment is to advance the phase of the circadian rhythm.
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