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

Sunday, April 5, 2009

In The Beginning

In the beginning I went to my doctor for a med check. I had been on Prozac for three months. I was anxious and agitated, irritable, couldn't concentrate and couldn't sleep. I thought I needed a higher dose.

I was wrong. 

As I walked in the door, I had a thought. It was more intrusive than a fantasy, and less welcome. Never mind for now what it was, but it involved a nail file... I didn't tell my doctor about this thought. I just got my higher dose.

That is when things started to get really bizarre. 

The Birth Of Prozac Monologues 

A short while later, while coming off Prozac, I tried to imagine how I could tell people about what it was like to have to come off Prozac. The only medium that seemed appropriate was the stand-up comedy routine.

And that was the birth of Prozac Monologues, with its first chapter, Bizarre.

Someday, Prozac Monologues will be available to the purchasing public. For now, come here to find out about depression and its treatment, drugs and research, the brain and its wonders.

Welcome -- Willa


photo modified from original by Tom Varco

reformatted 11/26/10