Today, Christmas Eve, we hear the inspired 8th Century BCE prophet Isaiah fore-telling the birth of Christ when he said: "The people who walked in darkness have seen a great light; upon those who dwelt in the land of gloom a light has shone" His visual description of the impact of the Incarnation in Biblical terms can serve today as a quasi-definition of a classically described modern medical condition called Seasonal Affective Disorder or SAD.
Isaiah, like the Egyptians and other "ancient peoples," reflected in their writings the early ideas of the fear of darkness or the unknown. Astronomers and other "Wise Men" felt that the position of lights (stars) and the movement of lights (planets) in the sky and other changes in natural light such as the winter solstice and eclipses predicted or reflected significant events.
Modern thoughts about darkness are seen in the contemporary terms "the power of darkness" or "the dark side." Films of the 1930s used light and darkness as instruments to enhance dramatic scenes. Arthur Koestler's classical novel "Darkness at Noon" exemplifies the concept of imprisonment and torture as a metaphor for the absence of light (freedom) or darkness.
The winter season with its initially decreasing and subsequent slowly increasing daylight hours in the midst of long hours of darkness at times can be a catalyst for the onset of SAD, the other neuropsychiatric affective disorder similar to the situational depression or "Holiday Blues" which we discussed in our recent column.
This present winter season certainly gives us pause when considering the possibility of the light- related illness. The mid-December Winter Solstice celebrations throughout history and cultures emphasize the concern of these cultures about the "setting" of the sun and its effect of the loss of the daylight hours so vital to their existence. Thus, the possibility of a seasonal light-related illness as a result of these beliefs must be considered even in our contemporary society.
SAD is one of the illnesses which physicians call affective or mood disorders, characterized by a disturbance in the regulation of mood, behavior, or affect. Depression is the archetypical affective disorder, and we all experience it in our lives in the "ups and downs," and the "exhilaration and the blahs" which comprise our reactive euphoric and depressive episodes. Usually these moments or periods are relatively short, tolerable, and pass uneventfully; however, some of these trials which we experience can lead to significant depression and changes in our lives. We need to recognize the presence of significant depression and act to receive help from our families, friends, and often professionals to facilitate treatment and recovery.
Mayo Clinic physicians describe SAD as: "Winter's short days and long nights may induce feelings of depression, lethargy, fatigue, cravings for food (sweets), headaches, and sleep problems. Exactly how many people have SAD isn't well known, but estimates range from 2 to 10 percent of Americans What causes SAD is unclear, but it may have to do with the amount of sunlight you receive; it becomes more common the farther north or south you live from the equator." However, in any location, we all realize that some of us are "morning people" and others "night owls." The amount of light in our lives is unlikely the cause of all of our ills!
Dr. Norman Rosenthal, when describing the syndrome of Seasonal Affective Disorder in 1984, recognized the therapeutic value of light. Unfortunately, your "make-up mirror light " won't do it! Studies have shown that a prescribed light box or other source of light producing 20 times the usual room light used for a short time each morning may be valuable in treatment. They even make an "alarm clock" which awakens patients with SAD by gradually increasing the light in the sleeping room.
The use of the psychotrophic rugs of the SSRI class (Prozac, Paxil, Zoloft, Effexor, Wellbutrin, and others) may assist those patients who cannot tolerate the usual light sources. You should consult your primary care physician who can help you to evaluate your specific situation and recommend/prescribe some of the treatments described above.
More importantly, as in virtually all illness and conditions, especially those related to anxiety and depression, developing a positive attitude and lifestyle, comfortable personal relationships, a trusted companion/family, regular exercise, and a healthy and reasonable diet may be effective and valuable tools for both prevention and recovery from affective disorders.
May all of your enjoy a peaceful and purposeful New Year!