Tuesday, April 26, 2016

Overcoming Seasonal Affective Disorder

            When falls turns into winter and the skies become grey, do you lack energy and motivation? Do you find it hard to find your get-up-and-go when there are several cloudy days in a row? Do you feel more alive on a bright, sunny day? You might be struggling with Seasonal Affective Disorder. If so, I’ll share what I’ve found that helps. I’m not a doctor, so you’d be wise to talk to a medical professional.


            Your eyes have special cells that detect light called light sensitive ganglia. They are separate from your rods and cones. The rods and cones help you see. The light sensitive ganglia help to establish your body’s rhythm. They help to flip the switch in your brain—the switch between a sleepy, hibernating state; and an alert, fully-awake state.
            Your brain has a “day brain” and a “night brain”. Or, you might think of these as an “awake brain” and a “sleepy brain”. The chemistry in your brain is different in these two states. Throughout the course of 24-hours, your brain transitions between these two states.
            It’s the light sensitive ganglia that help flip the switch between these two different brain states. When the ganglia don’t receive enough light or the right kind of light, which happens in winter, the brain doesn’t fully wake up. This can also happen to someone who works inside too much—without access to proper lights or windows. While it’s normal and healthy to have a sleepy brain during the night, when one needs to sleep, when the brain is in sleepy-mode too often, you begin to feel sluggish, anxious, and antisocial. You may lack drive. You may also have food cravings, put on weight easily, and find it hard to find the energy to exercise.
            Too much of this sleepy brain is hard on the body. It’s a stress that impacts the adrenal systems in your body. During stressful times, the adrenal glands kick in to give you a boost of energy. That’s fine short-term, but long-term they can become stressed, leading to a further lack of energy, weight gain, anxiety, and a general decline in health. If you live in a particularly dreary climate (or don’t receive adequate light a good percent of the time), you may find SAD impacts you year round—even though it’s worse during certain times of the year.


            In general, SAD has a yearly pattern. The most common pattern is that during the sunnier months of late spring to early fall, you’ll feel better—sometimes significantly more balanced and energetic. During late fall to early spring, you’ll feel down—probably feeling the worst during the dark days of December and/or January. You may also notice that even during the summer, you just don’t have the same energy when there are several cloudy days in a row.
            Some people with SAD experience an opposite pattern. They feel best during the darker months, and worse during the summer. During the summer, they may experience anxiety and deep depressions. It’s my belief this is because the adrenal glands are working hard during those dark months to give the person energy. Some people like the feeling of running on adrenaline. But, after a while, the adrenal glands run out of juice, and during the summer the person feels down, because the adrenal glands are in a depleted state.


            A common treatment for SAD is light therapy. Since the main cause is a lack of proper light, a key solution is light. There are several factors that impact light therapy including: intensity of light, wavelength or light, length of treatment, and timing of light. There are several devices that can help provide the light your body is lacking, including: dawn simulators, light boxes, and light visors.
            Light intensity is the first factor to consider. Offices, homes, and factories often contain insufficient light to provide the stimulus to the light sensitive ganglia to wake the brain up. Light intensity is measured in lux. The standard for treatment is 10,000 lux (although full sunlight can be more than 10 times that amount). When you choose a device to help with SAD, you need to consider that the light intensity decreases as the distance from the light source increases. A device that produces 10,000 lux at 8 or 16 inches isn’t going to be as effective (or may have no effect) at greater distances.
            When choosing a light therapy product, be sure it is UV free. Also, be sure it produces enough lux at the distance you’ll be using it.
            The most common device to help with SAD is called a light box. It’s exactly what it sounds like—a device that produces a high intensity light. Some of these look more like a desk or floor lamp. Some look like a box that is meant to placed on a table or desk near the person. You don’t stare into the light box. You place the light box to your side (or with some devices overhead) where the light is indirectly reaching the eyes. One that I’ve found to be effective is called the Aurora LightPad Mini made by Alaska Northern Lights. This can be purchased for about $200 on Amazon.com. It’s about the size of an iPad Mini, and produces 10,000 lux at 25 inches. The amount of light it produces for its size is phenomenal.
            The only downfall of 10,000 lux is that it’s quite bright. You might find it hard on your eyes. If that’s the case, there is another solution. Several light therapy devices produce blue spectrum light—similar to the color of a clear, blue sky in the middle of day. The light sensitive ganglia are more sensitive to this wavelength of light, so the theory is that it requires less intensity to have the same effect. Philips makes a device called the GoLITE BLU Energy Light. The rechargeable version costs about $130, and the plug-in around $100 on Amazon.com. I have the rechargeable version, and find the blue light it produces does give a boost in energy.
            Another device that I’ve found helpful is called the Feel Bright Light Portable Light Therapy Device. It’s a rechargeable device that connects to the visor of a ball cap. It shines blue-spectrum light into the eyes. The biggest advantage is it allows the user to receive light therapy while moving around. There are two main disadvantages. It is quite bright, so it tends to wash out other light sources. If the surroundings aren’t well lit, it can be somewhat difficult to see. The other downfall is that it looks goofy. If you wear it in public, people are going to wonder why you have beams of blue light glimmering down on your eyes. This product can be found for around $150 on Amazon.com.
            The three devices I’ve mentioned are all highly rated. They are also small enough to use while traveling. Some of the light therapy devices are quite large.
            Besides intensity and wavelength, the other factors for treatment are the length of time, and the timing of treatment. You’ll find the various treatments often advertise short lengths of time—15, 30, or 60 minutes. While I have found short treatments useful, I find I do best when I have light during most of the day—whether that comes from a device or natural sunshine.
            For me light therapy works best when I’m on some sort of consistent schedule—generally waking up and going to bed at the same time, and starting and stopping light between the same general time frame every day. You don’t want to use light therapy before a normal waking hour. You might find it causes insomnia. You may also need to be careful not to use any kind of light therapy within several hours of bedtime. During the night hours, you want things to be dark. You may find it helpful to avoid reading lamps, bright lights, or watching a TV or monitor too late at night. You’ll have to experiment a little and find out what works best for you—but in general, you’ll want things bright during the day and dark during the night.
            For some people, light therapy can aggravate other conditions—such as bipolar disorder. You may find too much may make you jittery. Each person is a little different, so you’ll have to find out what works for you.


            A dawn simulator is an alarm clock that simulates the light of early morning. Over a period of time, it gently increases light intensity. I have found it wakes me up much more gently than a blaring alarm. It seems to help establish a more natural body rhythm, which is healthy for the body. The one I use is made by Philips and can be purchased on Amazon.com for around $120.


            You body produces vitamin D when sunlight hits your skin. During the winter months, vitamin D levels can plummet. This may also be true for people who spend quite a bit of time inside. I find that a vitamin D supplement does help some.


            You’ll need to be careful with herbal supplements, because they can interact with prescribed medications. So, talk with your doctor. The prime herbal supplement to help with SAD is St. John’s Wart. It helps elevate mood. Some people also mention SAM-E.


            Negative ion generators give air molecules a negative charge. These negative ions are found in nature in abundance near the ocean or near waterfalls. There has been some research that suggest they are helpful to treating SAD, although I haven’t found a good explanation why. Some people have concerns with negative ion generators that produce ozone, so if you want to purchase one, I’d suggest doing your research first. They do give the air a fresh scent. I purchased one called the Sani-Mate Plug-In Ionic Air Purifier for about $35. I do think it is mildly helpful, but it wouldn’t be my first line of defense for fighting off SAD.


            One option in treating SAD is moving to a sunnier climate. I didn’t even realize I suffered from SAD until after I lived a few years in Pensacola, Florida. I’ve lived most of my life in Northeast, Ohio. When I was in Florida, I became a different person. I was more energetic. My thinking was clearer. My body went through huge, positive changes. Before that time, I never knew someone could feel that healthy.
            After moving back to Ohio, I was fine for several years. Then, I began to return to my old self. I started to fatten up and get sluggish. It took a while for me to put the pieces together and realize the problem. I can see that I’m two very different people. When my SAD is under control, I’m more energetic, have more physical stamina, think clearer, have more drive, and am generally a happier person. When my SAD is dragging me down, I’m sluggish, anxious, have periods of depression, and just have a hard time getting myself going.


            Just as with any other physical malady, moderate exercise and a sensible diet should be part of the treatment regimen. I’ve found that as I’m discovering how to get my SAD under control, I’m gaining more willpower to eat right. SAD does produce food cravings. I’m also finding I have more energy to workout.


            Counselling and medicine (sometimes separately or in conjunction) are also common treatments for SAD. I’ve never tried those therapies, since I prefer more natural routes.


            From my experience, my first line of defense against SAD would be moving to a sunny climate. I haven’t found anything that replaces natural sunlight. My second line of defense would be light therapy and a dawn simulator. Those two treatments in combination provide considerable relief. If they don’t work, you’re probably either not getting enough intensity of light, or you’re not getting enough time of regular treatment. I don’t find the times recommended (usually 15-60 minutes) enough to alleviate the problem. Those amounts of time do seem to help, but for me more light is better. I would consider vitamin D therapy, diet, and exercise as the third line of defense. Certainly, diet and exercise would be the first line of defense for general health, but for treating SAD, at least in my case, it doesn’t seem as effective as getting adequate light. I would place herbal supplements and negative ion generators as a fourth line of defense. I do think they help a little, but not near as much as other treatments. I would consider counseling and medicine as the last line of defense (at least for me). SAD does cause huge changes in brain chemistry, so for some people those treatments might be essential.

            I hope what I’ve shared can help. Those people that suffer from SAD know how miserable it can be. For some people, it can be debilitating. For other people, a dreary climate or the darker days of winter have little impact. I hope this short blog can help ease the suffering of someone impacted by SAD.

Tuesday, April 19, 2016

The Diagnosis

            He rocks back and forth. His pinpoint pupils stare out, but it isn’t quite certain their point of focus. He runs his fingers through his disheveled hair and mumbles. “Why? Why? Why can’t it do what I want?” He grabs the orderly by the collar.
            “Take it easy, friend. What seems to be the problem?”
            “Why! Why can’t it do the simplest of things? I don’t ask much. I only want it to obey. Obedience is all I ask.” His pupils focus in a penetrating stare that startles the orderly. “Why won’t it obey?”
            “Why won’t what obey?”
            “It! Why won’t it obey?”
            The orderly shakes himself loose from the disfigured fingers grasping his collar.
            “Obey! It’s all I ask!”
            The orderly sees the therapist in the hallway. He saunters over. “What do you think is wrong with our friend there?”
            “I’m not sure, but he’s in a bad way.”
            “Yeah, he’s been sitting on that cold, tile floor for the last six hours. He keeps mumbling about it needing to obey.”
            A lady in a lab coat hands the therapist a report. “Here’s another piece of the puzzle.”
            The therapist shakes his head. “Carpal tunnel syndrome and arthritic fingers.”
            The orderly tilts his head to the left. “That can’t be right. He can’t be a day over thirty. Wait a second, . . . you don’t think?”
            “Think what?”
            “Cubicle psychosis? We’ve had that a lot since that telemarketing company opened up down the street.”
            The therapist shakes his head. “No, no. It can’t be that.”
            “How do you know?”
            “He’s been here six hours, and he hasn’t tried to kill anyone yet.”
            “Is it Multiple Avatar Disorder?”
            “No, no. We ran a complete Facebook Addiction Panel. He only scored a 13.”
            “Thirteen, hmm? That’s lower than most of the people working on this floor.”
            “Yeah. I scored an 88, and I’m supposed to be a therapist.”
            “That’s pretty high.”
            “Yeah, and it’s over 90 when I drink too much coffee.”
            “Did you try a Rorschach Test?”
            “He scored a 100%.”
            “I thought there were no right answers.”
            “Sure, sure there are.”
            “What are they?”
            “Bat, monks, bag pipe players, Darth Vader, moth, cosmic string, lovers, kidneys, pelvic bone, and Schrodinger’s cats.”
            “So, what could be bothering our friend over there?”
            “Why you asking me? You’re the therapist.”
            The therapist flags down a nurse. “Could you hook our friend over there up to an EEG?”
            “We ran an EEG when he came in.”
            “Well, why wasn’t I notified?”
            “We attached it to his chart, Sherlock!”
            “Okay, you don’t have to get lippy. Get me his chart.”
            Meanwhile, he continues to rock back and forth. Aside from the mumbling, he’s nearly catatonic.
            “Okay, Sherlock, here’s the chart.”
            “Let’s see here. Hmm, that’s interesting.”
            The orderly leans in. “What’s interesting?”
            “He seems to have little brain activity.”
            “You don’t think?”
            “We’ve seen this before. Let’s go talk to him.”
            He stares deeply into the therapist’s eyes. “Why won’t it obey! Why? I just want it to do what it’s told.”
            The orderly chuckles. “What do you want it to do? Put the lotion on the skin?”
            The therapist cringes. “That’s not funny.”
            “It puts the lotion on the skin.”
            He runs his fingers through his hair. “Why? Why won’t it obey.”
            The therapist grabs and shakes him. He looks the therapist in the eye. The therapist boldly proclaims, “Ariel.”
            “Ariel. No, no no!”
            “No, no! I just want italics. Why won’t it obey!”
            “Did you create a chart?”
            “You’re holding his chart,” says the orderly.
            “I’m not talking to you. I’m talking to him.” The therapist stares him in the eyes. “Did you try to create a chart?”
            “Yes, yes. No, no. NO!”
            “Oh, please, make it stop! Why won’t it obey!”
            The therapist turns to the orderly. “I think I know what we’re dealing with here.”
            “What? What is it?”
            “This isn’t good. He’ll need treatment, rehab, and at least several years of outpatient counselling.”
            “What? What is it?”
            “He has, . . . Microsoft Mania!”