In addition to my other jolly diagnoses (hypothyroidism, PTSD), I definitely have SAD. I've found Vitamin D to be even more helpful than the light box, although the light therapy definitely helps. To be fair to my trusty light box, sitting in front of it happens to replicate some of my childhood abuse so it's hard for me to do. The flashbacks sort of take the edge off the benefit.

I started taking Vitamin D last winter and was astonished at the difference. Then I remembered that I'd had rickets as a kid. Obviously there's some sort of Vitamin D issue with me.

I can really tell the difference between my SAD and the other stuff going on with me. For starters, it's clearly seasonal. The NH winters push me over the edge every year. At this point I'm waiting for my sweetie to retire so we can get the hell out of here in winter. I bloom in the sunshine.

I suspect some of the lack of "popularity" in the medical field about SAD is the inability to medicate it. Also, it does get back to something SteveBMD said yesterday--people do want pills a lot of the time. Pills are now part of our culture. I was evaluated by a nice young man in our local mental health clinic. I ran into him a few years later and he was surprised I was still using my light box. He said I had one of the worst cases he'd ever seen (most of my worst abuse happened in fall and winter so I suspect there's an overlay of PTSD). Most of his clients used the light box for a winter or two, then dropped it. It sounds silly, but once you feel better you get frustrated sitting there. You want to be "oot and aboot," as the Canadians say.

I think that splitting up affective disorders by etiology will be of great use for both research and treatment. We currently have a list of symptoms that we call depression that are clearly caused by different mechanisms but we talk about and treat them like they are all the same. And maybe it won't turn out to be that useful, but I think it is at least worth investigation.

It is ridiculous that in a place like seatle that is known for it's overcast days that light therapy isn't the #1 treatment tried before turning to meds. It's also ridiculous it's not tried with people with mild to moderate bipolar symptoms considering that Lithium, still the gold standard despite it's loss of market share recently, works exaclt by messing with the "clock genes" that regulate a persions circadian rythme. (as does the amount of light and darkness one is exposed to over a 24 hour period - And there are studies PROVING that dark therapy will get rid of mania, if only temporarily, and sleep deprivation (and therefor more exposure to light over the 24 hr period) completely gets rid of depressive symptoms, again, if only temporarily - it still shows us that BP can be a circadian rythm problem in many people)

Here is a GREAT! Link you should check out philip, and if you haven't already linked to this guys site you definately should because the information he gives is unbiased, and a lot of it has nothing to do with meds, and he explains it all very very well.

http://www.psycheducation.org/

And HERE is the link explaining how Lithium works -The ONLY medication that the actual mode of action is understood:

http://www.psycheducation.org/mechanism/Clock.htm

Here's the link desribing dark therapy:

http://www.psycheducation.org/depression/darkrx.htm

Here's the link describing how the biological clock works and why it;s relevnat to BPD:

http://www.psycheducation.org/BipolarMechanism/3ClockRole.htm

He also explains over and over that exercise is EXTREEMLY improtant, AND as effective as many medications, more effective than many antidepressants in fact.

I think you'll like his site if you haven't visited yet, and if you do already link to his site here on your blog, could I make a request? Could you make the link bold, or move it up higher on the list as a source of information for your readers with BPD? Because it is invaluable info. It has helped me a lot and it gives people ideas of what they can try other than just meds while also explaining in detail and very clearly WHY these things are worth trying.

Thanks Philip
-KT

I actually suffer from reverse SAD-The winter is the best time for me an summer is next to impossible.

Agreeing with you, it's not going to affect that much, but I think if they mention SAD they should mention reverse SAD.

susan,
SAD is merely Seasonal Affective Disorder. It can happen in any season and summer onset is well documented.

Didn't realize summer is your hard time. Maybe we could do some sort of swap...
Sherry

I would love that Sherry. Throw in your ducks and you got yourself a deal!

You asked for our thoughts and here are mine.

I used to suffer from SAD and for me it had nothing to do with the lack of sunlight (I enjoy prowling at night and sleeping during the daylight) but everything to do with the cold in the winter. I absolutely hate the cold. During the winter a person can take all necessary precautions and still find himself in a situation where he's going to die.

To me, SAD is your body telling you go hibernate. I mean, pretty much everything shuts down in the winter. A lot of animals hibernate. Bugs die and exist only as larvae. Plants die or go dormant. And SAD is something left over from our ancestors who had to conserve food and energy during the winter and so they shut down as many activities as possible and slept. If you think about it, we're not very many generations removed from such people.

For me, I no longer look at it as a disorder, but as a cyclical, regenerative process. I expect it to happen, make plans for it and embrace it. I keep as warm as possible, eat less and sleep. I follow the Belt of Orion in the night sky and have been known to drop to my knees and weep in joy as I see it appearing in the far western sky immediately after sunset-- it is now spring.

It is so sad that modern man has lost all sense of the seasons and their purpose. I somehow think that if we're going to survive as a species, we have to refocus on these cycles and not look at everything as an inconvenience that needs to be destroyed or artificially manipulated.

i haven,t felt like myself all summer.I think i need about two weeks of complete sunshine to get out of this rut.I guess i should start using my sad light also since it is the end of august.fun ,wow!

the post by Marlboro makes some good points about the evolutionary psychology of SAD. The unfortunate thing is that we do live in a world where even the seasons are seen as hassel sometimes and not fully embraced... and our cultures are geared to go go go at full steam no matter what the season, thanks to technology, while for many of us there are still active genes that try to slow us down in one season or another (think about someone who is prone to overheating, they may be geneticaly programmed with a gene (or genes) paired with those same ones that lead them to be heat sensitive, to also cause behaviors an psychological states that would lead to their being less active durring the hotter seasons (and for people with "reverse" SAD it is the temperature NOT the increased daylight hours that causes the mood fluctuation).

I wonder when the genetic studies of both summer and winter SAD will be done and what results they will show. My guess would be that people with more genetic ancestry from nearer the equator are more likely to get SAD in the summer/hottest months (temperature dependant SAD), and those with more genetic ancestry from peoples living farther towards the poles would be more likely to get winter SAD (light dependant SAD). ... That is if there is any genetic component to it at all.

I'd love to see more work on the evolutionary psychology of mental illnesses. In fact I'm going to look into it today.

@ its me. Uh, yah. I also forgot to say I've had a problem with obesity all my life and store fat easily. I'm also a hairy critter. Both of these mechanisms were highly adaptive for survival at one time. Now, not so much. Just think of me as your friendly neighborhod troglodyte :-)

Interesting. Although it seems as if we're undergoing a veritable explosion of new diagnostic categories, since SAD is something I experience myself I tend to be more understanding of the motivation.

I also found Marlboro's comments interesting, and I think he/she is on to something. I tend to gain weight in the winter and have often thought that it may be something evolutionary going on. The cold tells the body to gain weight - store fat to fend off winter's dangers and potential deprivations, I guess. Makes perfect sense if we were all hunter-gatherers.

There's something about barometric pressure that seems to be related to SAD. I notice that periods in which barometric pressure is fluctuating quickly can really affect my symptoms. But so far, the only research that's been done appears to find links only to migraine headaches, MS, and epilepsy (all neurological conditions). No link that I've found ties barometric pressure to SAD or to depression/anxiety in general.

I don't have a light box and would like to work with a doctor to use one rather than going it on my own. Can you Philip, or any other reader, recommend a good doc who treats SAD? (Preferably someone in private practice.) Thanks.

BTW, I happened to run across an article that suggests that there is a summer variant of SAD, but related to heat: http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s230.htm

Hi - I included your post in a round up on SAD on my blog. There's an article I cited from a chronobiologist on circadian rhythms that's very interesting.