The Light at The End of The Tunnel

Seasonal affective disorder (SAD) is a type of depression stimulated by the changing of the season. In previous articles, we have reviewed what SAD is, how it manifests itself, and the physiological and psychological approaches to understanding the disorder. The best ways to deal with SAD are to ensure you are aware of it, sleep well, and eat well. However, your physician may recommend you use a light box. This week, we will investigate light therapy and explain its uses when fighting SAD.

Light box therapy is an effective and non-invasive treatment for SAD – it stimulates your brain as much as sunlight does. It probably will not cure SAD, “nonseasonal” depression, or other conditions – but it may ease symptoms, increase energy levels, and make the condition more bearable as it has a positive effect on mood and helps with vitamin D deficiency.

Here are some tips on ensuring you get the most out of your lightbox:

·        Get the right light box. Brands like Lumie make fantastic products, but you need to know what specifications to look for.

·        Be consistent by sticking to daily routines of light therapy sessions. It’s better to do more frequent but shorter sessions than fewer but longer sessions.

·        Never look directly into the light as it can severely damage the retina. Ensure that you only look at something the light reflects off, such as a book or magazine.

·        Do not interrupt your schedule as the symptoms could return stronger. Ensure you follow a plan set out by your physician.

Your physician will advise you on how to best purchase and use a lightbox. They will explain to you: which brands are most suited for your personal condition, how long you should sit under it, at what point in the day, and how far from the box you should be positioned. Like any other prescriptive medicine, light box therapy should be taken in “doses,” and there is not a “one size fits all” approach. Each dose should be appropriately prescribed as per your personal situation.

If your symptoms do not improve you may need to consider additional therapy. Your physician will advise you about other treatment options, such as antidepressants or psychotherapy.

To see whether a lightbox could improve your quality of life, contact your physician or book into Mount Sinai for expert advice.

SAD can have an extremely negative impact on your quality of life. If you need a consultation, or are suffering from any of the symptoms outlined at the end of the article, please contact us on (212) 241-6321 to book an appointment.

SAD – Nature’s Effect on Nurture

Historically, Seasonal Affective Disorder (SAD) has been understood as being the result of one of two binary positions: biological (your genetic composition) or environmental (learned behaviours and other external influences). In more recent years, it has become widely accepted that the two elements feed into each other. That means that while people have predispositions toward depression, that depression is simultaneously affected by an external influence (in this case winter). SAD is made distinct from other types of depression due to its temporal pattern. Major episodes begin in the winter, and there is always a full emission in the spring.

Let’s take a quick look at the two factors before seeing how they link into each other.

Is It in The Genes?

The bracket of “Biological Vulnerability” covers a vast field of potential reasons one experiences SAD – but is generally understood as a rhythmic abnormality in the winter. This simply means, a biological composition or a natural disposition to biological changes in winter causes SAD. Some of the most well understood reasons are as follows: there could be a delay or advance in the release of melatonin (the hormone that tells us it’s time to sleep), a retinal sensitivity to light, a dysfunction between neurotransmitters (the chemical substance which sends messages between nerves), a genetic variation in brain composition, and a reduced release of serotonin. 

SAD can be a result of one or more of these biological aspects, but more often than not, they are emphasized by psychological factors.

How Our Environment Can Make Us SAD

Depression is understood as an interaction between a cognitive vulnerability to depression (as we looked at above) and a stressor. There are different cognitive models that propose different vulnerabilities, let’s take a look at the main ones.

Alongside the genetical predisposition, it is common for the sufferer to also be affected by one of the following: a dysfunctional attitude (learned negative attitudes and outlook on the world), rumination (focusing attention on dysphoric moods and/or potential negative consequences), and a negative attributional style (catastrophizing negative events to a global scale). These aspects are usually interwoven.

Once a predisposition is influenced by one of these negative cognitive aspects, this combinatorial (see below for a visual representation of this process). All of these cognitive aspects are stressors.

Combining the Two. 

Source: Biological and Psychological Mechanisms of Seasonal Affective Disorder: A Review and Integration. Kelly J. Rohan, Kathryn A. Roecklein, and David A.F. Haaga. Current Psychiatry Reviews, 2009, 5., 37-47

As we can see following the graph, the environmental aspect (on the left) can run its own path to SAD, as can the biological (on the right). It is widely accepted that the psychological vulnerability and the physiological vulnerability feed into each other (as seen with the double-arrow that links the two sides together).

If you would like to learn more about the symptoms of SAD click here.

If you would like an introduction to one of our physicians that specializes in SAD click here.

SAD can have an extremely negative impact on your quality of life. If you need a consultation, or are suffering from any of the symptoms outlined at the end of the article, please contact us on (212) 241-6321 to book an appointment.

A Physician That Can Stop You Feeling SAD – Dr Wayne A Gordon (PhD)

In a previous article, we explored Seasonal Affective Disorder (SAD), its manifestations, and some ways in which you can cope with this type of depression. As we said, symptoms tend to get better on their own, but sometimes they don’t. That is why this week we introduce Dr Wayne A Gordon, Mount Sinai’s response to SAD in the Department of Rehabilitation Medicine.

Dr. Gordon is the Jack Nash Professor and Vice Chair of the Department of Rehabilitation Medicine at the Icahn School of Medicine. He holds a PhD in Psychology from Yeshiva University alongside an internship in Neuropsychology from Rusk Institute. His specialization in Rehabilitative Psychology has finessed his clinical expertise toward dealing with SAD.

His clinical focus is centred around brain rehabilitation. That extends to fields of Anxiety, Concussion, Dementia, Insomnia, Parkinson’s, and all manifestations of Depression. His work in academia prove his profound understanding of how to help deal with SAD, and other types of Depression. He has published more than 100 articles and book chapters, and has received several awards during his career including recognition for “visionary work” in TBI (Traumatic Brain Injury).

When is the best time to see a physician about SAD?

One of the primary concerns with SAD is that it is difficult to diagnose, and equally sensitive to manage. The first step to dealing with SAD is diagnosis. This job is best done by a physician such as Dr Gordon, who can remove possibilities of other disorders that have similar symptoms. At this stage, it is possible to manage SAD using the step-by-step we supplied here. 

It is also important to see a physician if you feel the disorder is unmanageable. The step-by-step is helpful to some patients, but not to all. The symptoms of SAD don’t need to be managed alone. Dr Gordon has dedicated his life to helping people deal with SAD and equipping them with effective bespoke methods to deal with their personal battles. This can range from learning to deal with your symptoms to understanding what your symptoms are. SAD can manifest itself in “cycles” and become self-feeding. Dr Gordon can give you a metaphorical manual to your disorder which will help you understand what you are going through. This makes SAD manageable.

SAD can have an extremely negative impact on your quality of life. If you need a consultation, or are suffering from any of the symptoms outlined at the end of the article, please contact us on (212) 241-6321 to book an appointment.