At the onset of winters, people of Kashmir usually become lethargic, lose interest in work and often tend to sleep for longer periods than is necessary. As BILAL HANDOO reports, these are symptoms of Seasonal Affective Disorder which must be treated with utmost care.
Rubeena, 17, a resident of Bohri Kadal in old city Srinagar often complained of depression at the onset of winter in Kashmir over the last three years. She also suffered from the loss of appetite, social withdrawal, marathon sleep and hopelessness. When she consulted a doctor, she was diagnosed with Seasonal Affective Disorder (SAD).
SAD is a state of depression which occurs usually at the onset of winter. The disorder may begin during teenages or in adulthood. Like other forms of depression, it occurs four times more often in women than in men and the average age of people when they first develop this disorder is 23 year but anyone can be affected by SAD. The term first appeared in print in 1985. It is also known as winter depression, winter blues or hibernation reaction.
“People who live in places with long winter nights like Kashmir are at greater risk of SAD,” said a physician, Dr Abdul Hameed Khan. He said the symptoms of SAD usually build up slowly in the late autumn and initial months of winter. SAD has not been recognized as an official diagnosis.
Although there is no specific diagnostic test for this illness, it is understood that symptoms of SAD are the same as with other forms of depression. “Healthcare provider can make a diagnosis by asking about patient’s history of symptoms and by performing a physical exam and blood tests to rule out other disorders that are similar to SAD. As with other types of depression, antidepressant medications and talk therapy can be effective,” Dr Gulzar Ganai, a physician, said.
“Hopelessness, increased appetite with weight gain, increased sleep, less energy and less ability to concentrate, loss of interest in work or other activities, sluggish movements, social withdrawal, unhappiness and irritability are its prime symptoms. SAD can sometimes take the form of long-term depression,” said Dr Ganai.
Bipolar disorder or thoughts of suicide are also possible with SAD. Manzoor Ahmad, 38, a resident of Buchpora in Srinagar lost his mother who committed suicide during winters seven years ago due to seasonal depression. “She would lose her mental abilities and often remain depressed in winters,” he said, “One day she left home in wee hours and later we fished out her body from Jhelum.”
Getting enough sleep, eating a healthy diet, taking medicines the right way are some of the common remedies to keep this seasonal nuisance at bay. Besides, medical practitioners suggest that the victim should look out for activities that make one happy, do exercises and take proper rest which acts as a resistance against SAD. However, doctors caution that taking alcohol and banned drugs can worsen the state of a victim of seasonal depression and also affect the victim’s judgment about ending his or her life.
“SAD seems to develop from inadequate bright light during winter months,” said Dr Khan. Researchers have found that bright light changes the chemicals in the brain. “Exactly how this occurs and the details of its effects are being studied. While those specific mechanisms remain undetermined, factors like low vitamin D levels in the blood are found to be associated with a higher occurrence of seasonal affective disorder and some other depressive disorders.”
Light therapy using a special lamp with a very bright light (10,000 lux) that mimics light from the sun may also be helpful, according to physicians. “The treatment should be started during the fall or early winters before the symptoms of SAD begin to show up. A common practice is to sit a couple of feet away from the light box for about 30 minutes every day. This is usually done in the early morning to mimic sunrise. The outcome is usually good with treatment and recovery. But some people are victims of SAD throughout their lives. However, light therapy comes with side effects that include eye strain, headache and mania. People who take drugs that make them more sensitive to light such as certain psoriasis drugs, antibiotics or antipsychotics should avoid light therapy.
Antidepressant medications have been found effective for seasonal affective disorder that occurs during summer as well as at the onset of winters. The most common side effects of this class of medications include insomnia, nausea, diarrhea, and decreased libido. Most health care providers believe that in individuals who are vulnerable to the development of bipolar disorder, either light therapy or antidepressant medication can cause a manic episode as a side effect.