It's NOT just the winter blues

Recent IU graduate Amy Gibbs could study for six hours at a time without so much as a coffee break. So in early October when she began to lose her concentration after hitting the books for less than two hours, she suspected something was wrong. Headaches kept her from focusing on her studies and sleep consumed 14 hours of every day. \nAfter enduring two weeks of frustration and confusion, Gibbs went to her local emergency room hysterical. Little did she know that something as natural as the coming of winter was responsible for disrupting her life.\nThe mind of a college student swirls with thoughts of exams, grades, internships and interviews, leaving little room for other worries. But when winter rolls in, some students battle with an added burden. \nAccording to the Mayo Foundation for Medical Education and Research, Seasonal Affective Disorder (SAD) plagues an estimated 10 to 20 million people nationwide. A disorder that hinders a person's ability to concentrate, increases tendencies to oversleep and is categorized as a form of depression, SAD is particularly difficult for college students. Although the biological reality of the disorder is still being debated, physicians and psychiatrists across the country are dedicated to the diagnosis, treatment and prevention of SAD.\nDimensions of the disorder\nDescriptions of SAD have existed for centuries, but the first formal identification of the disorder came a little more than 20 years ago.\nThe American Academy of Family Physicians estimates that four to six out of every 100 people have some degree of SAD, and it is four times more common in women. College students are especially at risk because the disorder usually only affects those 20 years and older, but decreases with age. Although SAD is more likely to affect those who live farther north, cases have been reported in every area of the country.\nDespite these estimated statistics, debate still exists among the medical community about the scientific credibility of the disorder and its treatments.\n"I think there really is no scientific basis for it," said Dr. Michael Werle, director of a psychiatric rehabilitation center in Rhode Island. "I take more of the common sense approach to it. In the end, depression is depression."\nThe difficulty physicians have in diagnosing SAD also increases questions of its credibility. For a SAD sufferer, seeking medical attention is the first step toward diagnosis, but many are so confused by their symptoms that they are unaware of how to go about it. \n"The hardest thing about experiencing the first signs of SAD is that I had no idea what was going on," Gibbs said. "Being a college student, I had no time to be unmotivated and tired. Not knowing what was causing it was very frustrating." \nBecause it shares symptoms with numerous other disorders, diagnosis of SAD is a challenge for physicians. In order to be diagnosed, a patient must have no other explanations for their symptoms and must experience them at least two consecutive winters. Whether or not a person has SAD cannot be determined by a blood test, and not all symptoms are present in every case.\n"SAD is diagnosed by symptoms, and also by ruling out other things," said Dr. Gila Lindsley, a practicing psychologist in LaMora, Penn. "I am always careful to determine that a person has SAD because it has often turned out that they are affected by something as different as mold allergies." \nBut, a group of common SAD symptoms has been identified, and any person who experiences them during the winter months should at least seek medical attention. \nDr. Lindsley says a craving of carbohydrates is a factor in determining the disorder. Also, a SAD sufferer tends to oversleep as opposed to someone who is experiencing depression and who sleeps poorly. \nSeeking a cure\nEven if a person learns of SAD identifies their symptoms and seeks medical attention, the elusiveness of the disorder can still impede proper diagnosis and treatment.\n"When I finally went to the hospital, they wanted me to see a psychologist, so I signed a form to be transferred to the psychiatric department," Gibbs said. "But it was a Sunday and none of the doctors who knew anything about SAD were in, so they assumed I needed to stay overnight and be under suicide watch! I spent the night with people who were suffering from severe depression and hallucinations."\nWhile not every case is extreme, Dr. Sheila Jowsey, a psychiatrist at the Mayo Clinic recommended that people seek professional help if they experience seasonal depression. \n"If you feel down for days at a time and life seems to be losing its pleasure, see your doctor," she said. "This is particularly important if you notice that your sleep and appetite are affected, and especially if you think about suicide." \nOnce a patient has been diagnosed with SAD, a physician may prescribe several treatment options. Anti-depressant drugs are available, but the option most commonly associated with SAD is the unique theory of light therapy.\nLooking to the brighter side\nAlthough studies thus far have been inconclusive, it is believed that a lack of sunlight disrupts the body's natural circadian rhythm, or daily biological clock, which is controlled by the amount of the hormone melatonin produced. When the days grow shorter in the autumn months, the decrease in sunlight has adverse effects on some people, causing SAD symptoms to develop. \nIn order to replenish the light that the body needs to stay on track, a competitive market for alternative light sources has developed. \n"Light therapy is pretty much what works," Lindsley said. "I have seen it to be more effective than any other treatment." \nSupporters of light therapy believe that exposure to an alternative light source for 20 to 30 minutes a day during the winter months has proven to be the most effective tool in battling SAD.\nWhile light boxes may cost up to $200, costs can often be covered by health insurance. \n"Light products are available without a prescription, and therefore are not considered medical devices," said Neil Wagner, president of Alaska Northern Lights, a company that sells light boxes. \n"However, if a patient does receive a prescription from a doctor, they can receive about 80 percent coverage from insurance companies."\nLight therapy has its supporters, but also detractors. \n"Light therapy may have a placebo effect on someone suffering from SAD," Werle said. "If a company insists that their product will create a significant improvement, people are likely to buy into that confidence. However, a vacation in Florida would likely have the same result."\nAnti-depressant drugs are also prescribed to deal with the mood aspects of the disorder, but patients who suffer from other SAD symptoms typically find little relief in this form of treatment.\nTo those skeptical of the medical basis of SAD, simple lifestyle changes may be enough to decrease or prevent the effects of the changing seasons. \nFor sufferers like Amy Gibbs and millions of others, the frustration of winter blues is becoming less common, while successful treatment and prevention continues to increase.