Download Dr. Margaret Austen, B.A. (Hons, Psychology, PhD in Psychology

Dr. Margaret Austen B.A. (Hons. Psychology) PhD in
Psychology
Admitted to Doctor of Philosophy, December 2003
University of Tasmania, Hobart
Winter Blues, also known as Seasonal Affective Disorder
(SAD) is prevalent in locations of greater than 40⁰ N or S.
Circannual biological rhythms are disrupted creating
variations across the seasons to mood, sleep and eating
patterns, and motivation. Vulnerability to changes with the
seasons will be discussed as well as some self- help ways to
overcome it. Emotions, energy level and performance have
also been shown to vary with the seasons without any mood
changes
.
AETIOLOGY
•
Prevalent in a high percentage of the population at
latitudes of greater then 40 degrees N or S.
•
Known to have a biological basis
•
Thought to be the reduced amount of light each
day in autumn and winter that disrupts circadian
rhythms and biochemicals/ neurotransmitters
•recurrent autumn/winter mood variations
• hypersomnia, fatigue
•carbohydrate cravings, weight gain
• social withdrawal
• lack of energy, unmotivated, concentration
difficulties
11
Mean hours of sleep
10
9
Control
S-SAD
8
C-SAD
7
6
Winter
Spring
Summer
Autumn
What are the risk factors that predispose people to getting SAD? What
is it like to have the winter blues, as opposed to SAD with extreme
depressions?
How common is it?
1.
Inherent vulnerability SAD runs in families, women more likely, ethnic groups? survival of the
fittest, hunter-gatherers, symptoms of SAD are energy conserving, e.g.,
hibernating bears, squirrels, failure of intrinsic factors to cope with seasonal
change
2. Light deprivation –
style of home, elderly, grey days, those living in country, dark buildings
3. Stress –
Demands of work don’t change with the seasons, stressful circumstances,
relationship difficulties, etc







Understanding SAD, and your own cyclic seasonal pattern
of symptoms
Changing the environment, the value of light, sun and
warmth
Holidays, Relocation
Exercise, diet
Pamper yourself, massage, warm spa, listen to music
Stress management
Avoid major decisions during winter






Understand that what they are going through is real. Hear their pain,
empathise with them
No cliches! e.g., “oh, it’s all in the mind!”, “there’s always someone else
worse off!”, “you need a good kick in the . . . To get you going!”
Not helpful to point out there’s dust or the floor’s not swept, big pile of
ironing etc. Helping them isn’t helpful – they’ll feel guilt and shame.
You’ll feel more needed if you care for them rather than to reward yourself
or pat yourself on the back
Take them out for lunch (hearty soup?) or a walk in the park. Alternatively
give them a pot of soup and/ or garden flowers
If you feel they aren’t coping – ask them would they seek assistance
Listen for any suggestion of suicide.
SAD, WINTER BLUES

autumn/winter
depression
MAJOR DEPRESSION

Major Depressive
Disorder

hypersomnia

insomnia

overeating

undereating

weight gain

weight loss
low arousal e.g.,
sullenness

high arousal e.g.,

anxiety
• When should you consider entering therapy?
a. Difficulty getting to work on a regular basis
b. Marked reduction in your ability to think and concentrate
c. Difficulty performing tasks that you could previously manage
• Light Therapy
• Psychotherapy
• Cognitive Therapy
• Behaviour Therapy
• Anti-depressant Medications
• Combined Therapies
Tension and Effort Stress Inventory• Participants overall showed less relaxation, excitement, and placidity; and more
anger, sullenness, humiliation, shame and guilt during the A/W months compared to
S/S months.
• The 2 SAD groups felt less relaxation and excitement, and more anxiety and anger
than controls. Regardless of emotion, the SAD groups rated negative emotions
greater than control participants
Motivational Style Profile
• Controls showed decreased measured for emotionality/ effortfulness in winter as
compared to summer. All participants showed greater optimism than pessimism.
• Regardless of group, all subscales showed more extreme measures for summer than
winter.
Stressor Scale
All participants rated greater stress level following a stressor task (amithmetic) than
priod to the task, but SAD groups reported stress greater in the A/W months
Metabolic symptoms:
• All participants report greater fatigue, as well as a lesser quality sleep in June
• Tendency to crave carbohydrates in A/W, though greater for SAD groups than
for controls.
Cognitive Impairment:
• Deficits to psychomotor speed, concentration, abstract thinking, and accuracy,
IQ STM numerical tasks. Unclear whether impairment is related to neurophysiology or as a result of depressed ideation.
• No differences shown on a verbal IQ task
• RVF/ LH – verbal: LVF/ RH – spatial. Slowed reaction time to RH spatial task
in winter months may relate to a competion between emotion and response time
in the RH.
Connection between seasonality, melancholy, and creativity
•
•
•
•
•
•
•
“No great genius was without a mixture of insanity”Aristotle,
12th C.
Composers: Handel, Mahler, Schumann
Artists: Michaelangelo, van Gogh
Writers: Milton, Poe, Hemingway, Wolfe, Dickinson
Politicians: Lincoln, Churchill
Comedian: Spike Milligan
Emphasis on winter themes: cold, black bile, death and gloom i
comparison to spring themes: life, sunny, fragrant, cheeriness
•
•
•
•
First named in Maryland, US in 1974
In early history, physicians emphasised the effect of the seasons
on all illness, taught by Hippocrates (460-370 B.C.), known as
the father of medicine
In early 1st C. A.D., Galen saw emotion to be the result of
biological processes, first to report association between lethargy
in seasonal depression and hibernation
Seasonality fell into disfavour mid 20th C when biological and
medical theories dominated medicine
“See! Winter comes, to rule the varied Year,
Sullen, and sad.”
From “Winter”. James Thomson, 1726
“To everything there is a season and a time to every purpose under
heaven”
Ecclesiastes 3:1
“. . . . . cold weakens the mental activities. This is evident in animals
which are forced by the frost to hibernate”
Galen (129-200 A.D.) (Galen, trans., 1976)
“Ah, woe is me! Winter is come and gone,
But grief returns with the revolving year.”
Percy Bysshe Shelley
Cont.
There’s a certain Slant of light,
Winter afternoonsThat oppresses, like the Heft
Of Cathedral TunesHeavenly Hurt, it gives usWe can find no scar,
But internal difference,
Where the Meanings, are.
We grow accustomed to the DarkWhen Light is put awayAs when the Neighor holds the Lamp
To witness her Good-bye-…
Either the Darkness altersOr something in the sight
Adjusts itself to MidnightAnd Life steps almost straight.
Emily Dickinson, 1830-1886






SAD has symptoms of mood variation, along with hypersomnia,
overeating, weight gain, lack of motivation and decreased energy
Thought to be the shortened daylight hours that create disruption
to circadian rhythms and many physiological, biochemical, and
psychological functions
Vulnerability includes inherent factors, light deprivation and stress
Ways for self help include gaining light/ sun, exercise,
carbohydrates/ high protein diet
Important to seek further help if not coping a day to day basis
Non seasonal people still show some variation to sleep patterns.
Motivation, stress, energy level and cognitive performance have
been shown to vary with the seasons