During the early 1980s, a man called Herb Kern, began to believe that his seasonal cycle of fatigue and depression may be caused by the shorter and duller daylight hours of winter. Herb approached the National Institute for Mental Health (USA) with his observations. There, doctors proposed a treatment whereby Herb was exposed to bright light, equivalent to summer sunlight. By the fourth day of light exposure his symptoms had virtually disappeared (Lewy et al 1982). This was the start of our acknowledging the condition that has come to be known as Seasonal Affective Disorder (SAD) or the Winter Blues.
In all mammals, the desire to sleep is brought on by the secretion of a hormone called melatonin. In the evening the pineal gland reacts to the diminishing levels of daylight and begins producing melatonin. Melatonin is then released into the blood and flows through the body making us drowsy. Its secretion peaks in the middle of the night during our heaviest hours of sleep. In the morning, bright light shining into the eye reaches the pineal gland, which reacts by switching off the production of melatonin, thus removing the desire to sleep.
Seasonal affective disorder can be characterised by four main symptoms:
* extreme fatigue
* lack of energy
* a greater need for sleep
* changes in appetite, especially cravings for carbohydrates and sweets, which can often lead to weight gain and depression
Further symptoms may include; anxiety, loss of libido, menstrual difficulties and an increased sensitivity to pain - headaches, muscle and joint pain.
Light therapy is now regarded as a first-line treatment for SAD
Since the 1980's, most of the interest in SAD has been stimulated by its treatment response to bright artificial light. Clinical consensus guidelines are now recommending light therapy as 'a first-line treatment for SAD' (Lam & Levitt, 1999). Indeed, the treatment of SAD is almost exclusively associated with light therapy.
Surprisingly, research has consistently found that the general prevalence of severe SAD accounts for 5-10% of any population, who live 30 degrees north or south of the equator. Further, it has been found that approximately 25% of these populations suffer with sub-syndromal SAD or S-SAD, which is a milder, yet still problematic form of SAD. Therefore, it can be concluded that 30-35% of the UK population are suffering (to varying degrees) with seasonal effects during the dark winter months.
Taking all this information into account, it would be easy to think that the awareness of SAD would be quite high, yet this is not the case. One reason for this is that the Committee of Advertising Practices (CAP), who enforce advertising codes within the UK, have deemed SAD to be 'all in the mind'. However, this judgement is only based on 'their views' of SAD and not on relevant research or knowledge. Indeed, the CAP have put a stop to any mention of SAD, as it is 'in the best interest of the public'. Put in plain English, the CAP believe that the public are not ready for such information, that the lay person may be influenced into believing that they are suffering with SAD. Indeed, the public cannot be trusted with such information and therefore, ignorance is bliss!
It should be stated that it is not the intention of this article to pass judgement on the CAP, as they are only trying to do their job. The CAP have to monitor all media for advertisement infringements, inform advertisers of the relevant codes of practices and maintain high ethical standards within all advertising drenched media's, and all this is achieved by only ten, over stretched, CAP employees…
However, extensive research, which has been conducted over the last twenty years, has concluded that SAD is a biological fact and irrefutably linked to our highly complicated hormonal systems. It is not a psychosocial phenomena which is all in the mind of the neurotic or hypochondriac.
The problem that is inherent with labelling a disorder as 'all in the mind' is that the sufferer will not be able to receive the correct information, diagnosis or treatment for their symptoms. Indeed, it is an unfortunately reality that academic studies and the results are 'traditionally' slow to filter down to the medical community. This is especially true of disorders which can only be diagnosed on perceived symptoms such as SAD or indeed ME (CFS).
The effect of this can be extremely detrimental to the health of SAD sufferers. For example, in a recent study, it was found that General practitioners consultation time is mainly taken up by SAD sufferers during the Autumn and Winter (Kendrick, 2002). However, it has been found that only one out of 25 cases of SAD are actually diagnosed and 50% of SAD sufferers are being miss-diagnosed with clinical depression and needlessly prescribed antidepressants (Michalak et al, 2001). Clearly, as light therapy is the only effective treatment for SAD symptoms, then these individuals are not receiving the best advice from their health services let alone the correct diagnosis and treatment for their condition.
SAD is a reality and a consequence of living outside our natural habitat. Indeed, working within socially constructed environments such as offices without natural light are compounding SAD symptoms and we cannot biologically evolve fast enough to adapt to our 'light deficient' society. With up to 35% of the UK population suffering seasonal symptoms it is clear that we need to raise peoples awareness of this endemic disorder and thus replace miss-diagnosis and stigma with recognition, acceptance and effective treatment.
Mark Golding is the Managing Director of Goldstaff Ltd and a SAD sufferer. He started to manufacture light boxes after using one and discovering the benefits of light therapy. Goldstaff now manufactures the BriteBox, which is an optimum, 10,000Lux (daylight) SAD light therapy unit used for the treatment of Seasonal Affective Disorder (SAD), depression, severe PMS, winter weight gain and other hormonal dispositions. For more information about BriteBox and Seasonal Affective Disorder, +44 (0)800 1388567 or visit http://www.BriteBox.co.uk.
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