Seasonal Affective Disorder
Descriptions, definitions, synonyms, organizer terms, types of
Seasonal Affective Disorder (SAD), is a mood disorder that is associated with episodes of depression. It is thought to be related to seasonal light variations (www.nmha.org). According to the handbook used by mental health professionals to diagnose mental disorders, the Diagnostic and Statistical Manual of Mental Disorders fourth edition text revised, or DSM-IV-TR (http://www.psych.org/mainmenu/research/dsmiv/dsmivtr.aspx) , SAD is not considered a disorder or syndrome on its own. Instead, SAD is considered a pattern specifier, or subtype, of another mood disorder diagnosis . For example, an individual may be diagnosed as having a major depressive episode with a seasonal pattern (http://www.minddisorders.com).
It is a subtype of a major depressive disorder, also known as bipolar disorder. SAD has biological origins that are seasonal in nature. (www.clevelandclinic.org) The most common type of SAD begins in late fall or early winter. This depression is gone by summer. This type of depression is also known as the winter blues. There is a less common type of SAD known as summer depression that begins in late spring or early summer. This depression goes away by winter. (familydoctor.org) The possible cause of this disorder is linked to melatonin. The pineal gland in the brain secretes this sleep-related hormone. Its level of production is increased in the dark. Thus when the days become shorter and darker there is a greater production of the melatonin hormone.(www.nmha.org)
Who suffers from SAD? Those in the highest group of sufferers are women and young children. (www.nmha.org) Many SAD sufferers come from families where either a close relative or a parent has suffered from SAD. Women are most susceptible to depression than men so it is not odd that the majority of SAD sufferers are women. In fact, 75% of all people who experience SAD are women. This is an indiscriminate mood disorder however in that it effects people of all classes, races and occupations. Men and children can also suffer from SAD. It is found in both the northern and southern hemisphere but gets worse the further from the equator. The problem being the length of day from summer to winter. In America, 10% of the population are thought to suffer from SAD. (www.holistic-online.com)
A person suffering from the winter time SAD may experience any or all of a list of symptoms. Those experiencing SAD may avoid social situations, they may have an increased sensitivity to social rejection and may experience trouble concentrating. They may also suffer from a heavy feeling in the arms and legs as well as feeling an increased appetite particularly for sugary or starchy foods which often leads to weight gain. SAD sufferers will experience irritability, fatigue and excessive sleeping. There are other symptoms as well. Summer time SAD sufferers may experience poor appetite, weight loss and insomnia, as well as other symptoms found in depression. (familydoctor.org)
Causes and risk factors
The Mayo Clinic's web site states that genetics, age and your body's chemical makeup all contribute to the cause of SAD. Reduced sunlight levels disrupt the circadian rhythm in certain people, which regulates their body's internal clock. This effects their wake and sleep cycle, causing depression. Other theories center around melatonin, a sleep-related hormone which also has been linked to depression. During the winter our levels of melatonin increase. Also, lack of sunlight causes a lowering of serotonin, a natural brain chemical that affects your mood. Risk factors include family history, as SAD tends to run in families, but research on a genetic component has been mixed. Another risk factor is for people who live in northern locations at higher latitudes that are farther away from the equator. SAD commonly begins during early adulthood, but not usually before the age of 20. Although studies show that it is more common in women, men with SAD tend to have more severe symptoms.
Application in classrooms and similar settings
Teacher
So, how does this impact a classroom? How can we apply this information to a classroom setting? Seasonal Affective Disorder contains two major impacting issues on a classroom. One being the teacher, the second being the student.
One, the majority of classroom teachers are women. Seventy-five percent of SAD sufferers are women. This creates a huge impact on the classroom. Below is another range of symptoms experienced by SAD sufferers taken from a list at www.hoistic-online.com/hol_sad.htm. Some are particularly related to women.
-anxiety -sleep problems -mood swings -menstrual difficulties -hopelessness -increased sensitivity to pain -physical ailments such as:constipation, diarrhea, palpitations
A teacher experiencing any of these symptoms would be diminished in her ability to perform her job well. Interaction with students could be very negative and the ability to focus on and present lessons could be lessened. Classroom discipline and or management may feel impossible to manage while physical ailments could lead to multiple sick days. Teacher absence is difficult on students who need consistency and regularity. Teaching is almost like being on stage and each day "the show must go on". This may become impossible for the teacher suffering from SAD.
Student
Who fills the classroom, children? In a study done in a suburb of Washington D.C., 3.3% of a student population of 2267 students showed signs of SAD. In another study conducted in Minnesota, 6% of the children interviewed stated they experienced extreme shifts in mood during the winter. (www.holistic-online.com)
Let's look at the signs and symptoms of SAD for children taken from www.holistic-online.com/hol_sad.htm, that may impact their education. There are others as well but let's focus on those making an impact on the classroom setting. The impact is all encompassing on a child and his education.
Almost all children with SAD suffer the following symptoms during the autumn and/or winter months:
-sadness -anxiety -irritability
Some will show symptoms such as:
-fatigue -sleep problems, disturbed sleep, tendecny to fall asleep during the day -headaches
Keep an eye for the following tell-tale signs of the performance at school:
-decline in academic achievements -loss of desire to take part in activities, especially sports -memory impairment -poor organizational skills -difficulty in writing
Children suffering from SAD may also show behavioral difficulties such as:
-withdrawal from family and friends -crying spells -temper tantrums -tendency to watch a lot of television without retaining what is seen -in springtime become hypomanic with feelings of elation, talkativeness, sleepless nights and hyperactivity
Each of these signs or symptoms can make a huge impact on a child's educational life. The winter form of SAD takes up 2 quarters of the traditional school year. If a child suffers from SAD and has the symptoms of irritability, falling asleep in class, temper tantrums and has any or all of the academic signs listed above, they may very well fail the year of school. If they do progress to the next grade, it may be by the skin of their teeth. In the elementary grades in particular, students may miss huge segments of fundamental learning in math, reading and writing which will make them behind their peers even if they do move to the next grade level. As those in education know, that child is now at a huge disadvantage in his new grade.
What can parents do?
Talk to your doctor if you suspect your child has SAD. Doctors and mental health professionals make a diagnosis of SAD after a careful evaluation and a checkup to ensure that symptoms aren't due to a medical condition that needs treatment. Tiredness, fatigue, changes in appetite and sleep, and low energy can be signs of other medical problems, such as hypothyroidism, hypoglycemia, or mononucleosis.
When symptoms of SAD first develop, it's not uncommon for parents to attribute low motivation, energy, and interest to an intentional poor attitude. Learning about SAD can help them understand another possible reason for the changes, easing feelings of blame or impatience with their child or teen.
Parents sometimes are unsure about how to discuss their concerns and observations. The best approach is usually one that's supportive and nonjudgmental. Try opening the discussion saying something like, "You haven't seemed yourself lately — you've been so sad and grouchy and tired, and you don't seem to be having much fun. It seems like you've been feeling kind of worn out and exhausted — like you just can't get enough sleep. So, I've made an appointment for you to get a checkup. I want to help you to feel better and get back to doing your best and enjoying yourself again."
Here are a few things you can do if your child or teen has been diagnosed with SAD:
- 1. Participate in your child's treatment. Ask the doctor how you can best help your child.
- 2. Help your child understand SAD. Learn about the disorder and provide simple explanations. Remember, concentration might be difficult, so it's unlikely your child will want to read or study much about SAD — if so, just recap the main points.
- 3. Encourage your child to get plenty of exercise and to spend time outdoors. Take a daily walk together.
- 4. Find quality time. Spend a little extra time with your child — nothing special, just something low-key that doesn't require much energy. Bring home a movie you might enjoy or share a snack together. Your company and caring are important and provide personal contact and a sense of connection.
- 5. Be patient. Don't expect symptoms to go away immediately. Remember that low motivation, low energy, and low mood are part of SAD — it's unlikely that your child will respond cheerfully to your efforts to help.
- 6. Help with homework. You may have to temporarily provide hands-on assistance to help your child organize assignments or complete work. Explain that concentration problems are part of SAD and that things will get better again. Kids and teens with SAD may not realize this and worry that they're incapable of doing the schoolwork. You may also want to talk to the teachers and ask for extensions on assignments until things get better with treatment.
- 7. Help your child to eat right. Encourage your child to avoid loading up on simple carbohydrates and sugary snacks. Provide plenty of whole grains, vegetables, and fruits.
- 8 Establish a sleep routine. Encourage your child to stick to a regular bedtime every day to reap the mental health benefits of daytime light.
- 9 Take it seriously. Don't put off evaluation if you suspect your child has SAD. If diagnosed, your child should learn about the seasonal pattern of the depression. Talk often about what's happening, and offer reassurance that things will get better, even though that may seem impossible right now.
Evidence of effectiveness
There is evidence of effective measures that can be taken to battle Seasonal Affective Disorder.
- 1. Bright light therapy. The "patient" sit in front of a 10,000 lux light box that contains fluorescent light tubes that have a plastic screen to block ultraviolet rays. The patient is to have this daily therapy of keeping their eyes open but not looking directly at the light. Beginning sessions will last 10-15 minutes and are increased to 30-45 minute sessions. It is typical to prescribe 90 minute sessions until spring. The majority of patient notice improvements within 2-4 days.
- 2. Medications:
- a. Bupropion. An extended-release version of the antidepressant bupropion (Wellbutrin XL) may help prevent depressive episodes in people with a history of seasonal affective disorder.
- b. Other antidepressants. Antidepressants commonly used to treat seasonal affective disorder include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor) (http://www.mayoclinic.com).
- 3. Counseling
- 4.Electroconvulsive therapy. This is a very controlled charge of electricity discharge to create a seizure-like activity in the brain.(www.clevelandclinic.org)
- 5. Negative Ion Therapy. Ion air cleaning machines release negative ions that cling to dirt thus creating fresher air. Researchers have found that having a machine like this in a bedroom or workspace can lessen irritation and depression and increase energy levels.
- 6. Dawn Simulation. A computer is used to simulate the gradual appearance of dawn and of dusk in the characteristic of spring. In researching this simulation, lood tests show the production of melatonin being cut off and a restoration of the circadian rhythm. The dusk simulation produced deep sleeop almost in a pleasant hypnotic sensation.
- 7 .Skin Illumination (www.hoistic-online.com)
The website holistic-online.com also offered some other "common sense care" suggestions.
-get more natural sunlight -sit near windows when possible -take a walk -take a winter vacation in the sun -plan active events for the fall -laughter -educate yourself -try a support group -maintain a healthy and positive mental and physical lifestyle
Critics and their rationale
Light therapy doesnot work for everyone. In fact there can be side effects. The website clevelandclinic.org lists a few.
1. Photophobia (eye sensitivity to light) 2. Headache 3. Fatigue 4. Irritability 5. Hypomania (a mental state charcterized by excessive excitability, optimism, hyperactivity, talkativeness, heightened sexual interest, quick anger and irritability and a decreased need for sleep) 6. Insomnia (if light therapy is used to late in the day) 7. Possible reinal damage (though this side effect has not been proven)
Also tanning beds are not recommended as light therapy as they are high in ultraviolet rays which can harm the eyes and skin. (familydoctor.org)
Alternative explanations due to Diversity considerations
Signed "life experiences", testimonies and stories
I am so relieved there is an explanation to the different feelings I experience during the winter months. I feel this past year of teaching has definitely brought out more of the blues than previous years. One major reason could be the reduced amount of holidays teachers in my school district receive during this school year. For some unfortunate reason, the usual Christmas vacation time was shortened by two days and three other holidays we usually get off were also taken away (Martin Luther King, Jr. day, President's Day, and Casimir Pulaski day). Due to the change in the school year calendar, we are getting out one week earlier than usual. While I might enjoy this when June comes around, I sure would have liked the extra long weekends occassionally to experience the little sunshine that the winter months have to offer. After all, it is believed one reason people experience SAD is due to receiving lowered amounts of Vitamin D that we get from the Sun's rays. -Tricia Pearl
My father has SAD and he gets really depressed during the winter months. After living with this for years, he finally saw a doctor about it. The doctor was able to give him a special light that he turns on at night when he watches TV. It has helped him immencely. I wonder if something like this would work in the classroom during winter months. It has to be better than the floresent lights that are in most schools. A Dorough
One of my brothers, both sisters, and I all suffer from SAD. I also have several friends who do as well. Last year one of my doctors suggested getting a special light. I priced these and found them to be so expensive, I couldn't justify one. Then in our local home improvement store I saw light bulbs that claimed to have lights in the spectrum needed to simulate sunlight. Not only that, but there were also standard floor and desk lamps that now came with that type of bulb, and at regular lamp prices. I immediately purchased one for myself and one for a friend with whom I had jsut discussed this the day before. I started using it every evening while I worked, read, wwatched TV., etc. It made a world of difference. This year, I haven't needed it. We moved into a house over the summer that gets more direct sunlight than our previous home, and this winter seems to have had more sunny, if not warmer, days than last year. However, since I know it worked before, I already have a replacement bulb ready and waiting in case I need to use it next winter. --S. Sheahan
I taught in an inside room of a High School for 8 years that had no windows. Every winter, there would be a stretch of time where I would go to school in the dark, teach in the classroom all day, and then drive home in the dark. I definitely noticed a change in my mood during these times, and after a realized what the cause was, I began noticing that I was having more classroom discipline issues during these winter weeks, both because the students were more irritable and I was less patient. I feel like rooms like this could definitely benefit from ‘sunlight simulating’ lighting options. There definitely is something to feeling better about things on a nice sunny day vs. a dark, cold, and overcast day. - J. Linnenburger
References and other links of interest
References:
- Smth, Laura L. (2007). Seasonal affective disorders for dummies. Hoboken, NJ: Wiley
