Sunday, April 12, 2009

I Am Not SAD

What month has the highest rate of suicides in the northern hemisphere?  What about the lowest? You will find the answer at the end of this post. 

Seasonal Affective Disorder 

Some people get depressed in the winter.  Along about October or November, they start to feel lethargic.  They want to sleep a lot.  They crave carbs and gain weight.  They may lose interest in their normal activities, not want to see people, feel hopeless, think about suicide.  The deeper the winter, the sadder they feel.  In April, they start to feel better, regain their energy, and even feel giddy by the time May comes round.  It happens almost every year.

This is not major depressive disorder.  It is SAD, Seasonal Affective Disorder.  It is no fun.

The best treatment for SAD is to increase your exposure to light, to get outside more, or use very bright lamps to simulate an earlier sunrise and a later sunset.  The "dosage" of light required depends on the individual.  If your symptoms are mild, light will probably do the trick.  If they are severe, consult a mental health professional. 

Major Depressive Disorder 

But SAD is not major depressive disorder.  MDD is a disease, and a different disease than SAD.  People with MDD do not feel better when spring comes.  This is important.  When everybody else gets over their winter blues, we do not.

In the winter, everybody feels grumpy and blue.  Those of us with MDD have lots of company.  Nobody expects us to smile.

In the spring, everybody else cheers up.  They tell us, "Don't you feel better now that the sun is shining, the birds are back, the flowers are blooming?"  Or they say, "What's wrong with you?  It's a beautiful day!  You would feel better if you went outside!"  In other words, "It is your fault you are so sad, and I am tired of you behaving this way."

The other day a very cheerful medical student who is doing a rotation in psychiatry beamed at me that spring is here, so I should be feeling better.

In the spring, people with MDD are alone in our misery. 

Suicide Rates Vary By Season 

Emile Durkheim examined the suicide records of several European countries for his study On Suicide, first published in 1897.  He said that social isolation is what increases the suicide rate.  He examined other theories, including that the environment contributes to the suicide rate.  Durkheim discovered that the month with the highest rate of suicide is June.  The lowest is December.

What did you guess?  Please leave a comment.

photo by John O'Neill, permission to use under the terms of the GNU Free Documentation License

reformatted 11/26/10

2 comments:

  1. Why do you suppose...June? What is the same statistic for the Southern Hemisphere?

    I've been pondering the experience of the Ethiopian eunuch (Acts 8:26-40), a man literally cut off from the ancient social world defined by the family. Something in his experience connects with Isaiah's description (53:7-8) of the 'Suffering Servant,' providing an opening for God.

    So I am thinking about connections between human experiences--even those beyond the pale of assumed everyday existence. This leads me to wonder...to what other human experiences does MDD connect? Or is it unique?

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  2. Durkheim used the fact to build the case that the cause of the suicide rate (not individual suicides, but the trend)has to do with social integration. The longer the day, the more people get out and about. Except those who are depressed, who feel all the more cut off from the rest of society. My conclusion and my warning: to tell people who are depressed that they should feel better because the sun is shining does not help; it heaps on pain.

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