Someone I know quite well was telling me that a few weeks ago he began waking up around three in the morning and had difficulty getting back to sleep. I know he has a history of Seasonal Affective Disorder and suspected this was the first sign. For many people with the disorder, the onset comes sometime in August just as the days begin to get shorter. Anyway, he said that the sleep disturbance didn't bother him that much because he was relieved that he wasn't feeling depressed. I know he has a history of clinical depression and I also know how devastating it can be, so I certainly understand his relief.
But then he went on to say that just last week the depressive symptoms began. Although mood still wasn't depressed (only one of many symptoms of depression) he was having some of the cognitive symptoms that go with depression. He was feeling less secure about his thoughts and judgments, more tentative in some social interactions, and an increase in his baseline anxiety. And he said his mind sometimes feels like chipmunks on steroids!
He said he is able to do his work but he is much more tired than usual. He is a part-time writer and sometimes he feels his work isn't quite the quality it was before all this started. Of course that is probably just as negative perception because I know his work and I think it has been excellent.
The reason I know this guy so well is because I have been living with him for 63 years!
Seasonal Affective Disorder affects many people to varying degrees. Although we don't know why some people get it and others don't, we do know that there is a genetic link and people with a history of depression are at increased risk. I have had three previous episodes of clinical depression and currently take a maintenance dose of medication. What I am experiencing is technically in the mild range of depression, but for some, the depression can be quite severe, triggering thoughts of hopelessness and despair.
The experience of even moderate depression is to be living with a mind that feels out of control. Thoughts race, everything feels worrisome, hopeless and never-ending. Those with depression have a tendency to be terribly self-critical and blame themselves for their problems which only adds to the shame.
The experience of depression is not well known by the general public. Of course I was being humorous when I talked about chipmunks on steroids, but depression does make one much more self-conscious. And because of the shame and stigma attached, many feel very alone afraid to talk about what's happening for fear of being harshly judged.
But the big question here is what to do about it. One could easily say that it's only seasonal and you just have to live with it, and maybe that's true. But depression is not good for your brain and if possible needs to be dealt with quickly and effectively.
Many recommend light boxes to supplement the lack of external light. This is not FDA approved as the research is not definitive, but there is plenty of evidence that this does have an effect for many people. It's good to consult your doctor or mental health professional, but not all are knowledgeable about these things.
I have been using lights attached to a sun visor for about two weeks and I have been feeling a bit better. Of course there is no way of knowing whether the lights are contributing, but I certainly hope so because I look incredibly silly in my hat!
Of course medication can be helpful for this like it is any other depression. And some doctors recommend getting all in a preventative dose of medication before the symptoms begin.
Most people should get about eight to nine hours sleep a night, but it's especially important for those with depression as fatigue can make depression worse and vice versa. However, those with depression shouldn't be spending extra time in bed as that will only increase fatigue and make the depression worse.
Like with any other depression, frequent aerobic exercise helps as does a healthy diet. Meditation and yoga are also quite helpful. My meditation practice has helped you feel less attached to the depression. Although I still feel it, it only feels like one of many experiences in my and it doesn't control my life.
Depression like any other illness is helped by the care and support of others. Despite one's instinct to withdrawal , silence makes shame worse. So even though it might feel awkward, it's important to share what is happening with people whose compassion you trust.
I just did.
I've been enjoying your blog, Dr. Gottlieb. You said something in your last post that I've been sharing with people: "Laughter is like chicken soup for perfectionism." Loved it. Bix
Dear Dr. Dan Thank you for your "Fall Illness" article, .... I thought I was losing my mind! You described my symptoms to a T... About 2 or 3 weeks ago I started waking up at 3 am (or 4) in a panic about some random item I was concerned about. Then I started having a hard time getting anything done due to the squirrel cage situation going on in my head, couple with an intense feeling of insecurity about my thoughts and feelings which you described. Having struggled with depression in the past and having gotten steadily away from it over the years (with therapy, recovery, medication, exercise, yoga, meditation) I was REALLY scared that I was headed into the abyss again.... it had been a long time since I had felt so disturbed. I've made enormous strides in dealing with the various forms of depression over the past 27 years (I'm 52) but this fall (last fall was tough too now that I think of it) I was having a harder time than usual shaking it (could be the added dimension of going through menopause???? ) Thankfully, as you mentioned also, despite the feelings of shame and actually feeling a bit paranoid, I had been mentioning my symptoms to my husband over the past few weeks - he caught your article and passed it on to me. I almost didn't read it because I figured it wouldn't be helpful (that insidious and isolating thinking which is so characteristic of depression). Ssince having read your article I am so relieved that I'm NOT losing my mind that many of the symptoms have lifted.... we'll see how the sleeping goes tonight.... Thank you so much for sharing your experience. Your article was a real blessing for me. 1824spee
Dear Dr. Dan. I have been diagnosed with SAD for about 23 years, and on Prozac. I also have clinical depression. My problem is that I have been feeling symptoms of my depression coming bak- paranoia- no body really likes they are talking about me , sleeping alot. I am very scared of going thru again what I did before Prozac. I am nervous about changing meds. I am trying to stop these feelings and I hope I can. I will discuss this with my Dr. I hope you will be well, I enjoy reading your column. Mary Fiedler
Mary, I hope you are not afraid to change or supplement the Prozac. These paranoid feeling are terribly painful, lonely and frightening to live with and they really call for a review of your medication. Daniel Gottlieb Ph.D. DrDanGottlieb@aol.com www.DrDanGottlieb.com Blog: www.philly.com/askdan DrDanGottlieb
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