SAD cont'd

[doreen T]

Hi all,

Just thought I'd start a new thread, for reading ease if nothing else :D

It is another incredibly beautiful, bright morning - and I'm not going to let it slip by this time. Out I go, as soon as I have a nice protein-y brunch - scrambled eggs and back bacon (aka CANADIAN bacon). Yumm. Obviously, I slept well LOL

I hate when I have to rely on prescription meds to feel better, but gosh-darnit, they really do work. My doc gave the go-ahead to double up on my doxepine whenever I felt the need. I don't abuse this - partly because this particular class of drug (tricyclic) has an unpleasant side effect - altered carbohydrate metobolism and weight gain.

So, I will let Mother Nature work her wonders on my psyche. And, if I have energy to spare when I get home, might make a half-loaf of Wa'il's bread. (I don't dare make a whole recipe, it's so delicious - dangerous). Maybe he should accompany the recipe with an addiction warning! :p

Doreen

p.s.- will get correct bulb for SADlite later today, when crowds die down.

[doreen T]

Today is definitely not a good day. Dark, cold, wet snow and the wind is just howling out there. I turned on my SADlite first thing this morning and it's still on. Even my cats are sitting in its glow, as if they instinctively know it's good for them.

I've been doing more reading about SAD, and learning an awful lot in the process. You're right, Rachel, there's not a heck of a lot out there that isn't geared toward selling light boxes. And a lot of outdated and downright incorrect information too. I did find a few good, up-to-date articles, though, here are some snips -

(1) from Dr. Robert Oxlade, Kingston ONT, March, 2000 - How does lack of light cause these symptoms? The mechanism is not completely understood. Past research focused on the day/night rhythm co-ordination centre in the brain ... which receives messages about light intensity and exposure from nerve fibres from the eye's retina .... Melatonin is involved in the regulation of the night/day sleep/activity rhythm, and SAD was thought to be an out-of-synch phase problem with the sleepiness and depression triggered by excess melatonin secretion during the morning, instead of at night. But new research indicates that only in rare cases do drugs that block melatonin cure the mood problem and further, that people don't get depressed when given melatonin. Also, exposure to light works no matter what time of day it is. So, most likely SAD is a complicated interaction between the body's long seasonal cycle controls, and reproductive hormone cycles, especially in women. Biologically, SAD probably functioned as a strategy to enhance fertility and infant survival by avoiding winter climates through seasonal migration. SAD is thus the result of unusual or extreme seasonal sensitivity combined with inability to migrate towards safer winter circumstances. In our modern civilization, SAD is perhaps a second best solution a strategy of eating more, staying warmer with more fat and feeling bad and withdrawn: in short, nature is saying "Go South or Hibernate"! ( :) sounds good to me)

(2) from Dr. N. Rosenthal, SAD research pioneer, and sufferer - "Winter after winter people experience lethargy and fatigue, sadness and despair." "The S.A.D. illness disrupts personal relationships, causes victims to overeat, gain weight and to become indifferent toward their jobs." "Women, by a margin of 3 or 4 to one, are often more affected by S.A.D. than men, and the disorder in women usually starts after puberty and diminishes after menopause," also, "it is speculated that female reproductive hormones somehow sensitize the brain to the effects of LIGHT deprivation."

(3) from the Lancet, British medical journal, on bright light therapy - Side-effects, including eye-strain and headache, are common (each in about 19% of patients) but are well-tolerated and seldom lead to cessation. A cumulative duration of exposure for up to 1250 h over 6 years has not led to ocular damage, and bright-light treatment otherwise seems fairly safe, although subthreshold photochemical damage cannot be ruled out when the lights are used for long periods. Patients at risk, such as those with progressive retinal disorders, need to consult an ophthalmologist for follow-up examinations.

(4) on the subject of St. John's Wort, one article suggested that it should NOT be used along with the light therapy because of the risk of photosensitivity to the eyes. http://www.sjwinfo.org/


Doreen

[r.mines]

Thanks for the clips, Doreen!

The 'migration' theory isn't one I've heard before, though it's interesting! (and, as you say, tempting!)

One thing that keeps jumping out at me: the 'fact' that more women suffer from SAD than men. I suspect the difference is simply one of reporting, i.e. that women are more likely to seek outside help for depression, while men are more likely to self-medicate with alcohol, etc., or just ignore the symptoms. If that's true, SAD wouldn't (necessarily) have anything to do with female reproductive hormones, fertility, infant survival, etc.

This is the first fall/winter in eons (probably in recorded history!) that we haven't had much dark rainy weather (so far, anyway). I'm noticing that the hours of sunlight, reduced as they are, seem to be enough to hold the worst of the symptoms at bay. It seems that if I get an hour of SAD-light in the morning, followed by an hour's walk in the sun sometime during the day, plus maybe a half-hour of SAD-light in the late afternoon, I'm OK! So for me, the SAD seems to be triggered more by the persistent gloom we get here in the winter, coupled with the endless rain that means I can't get out and walk. (OK, I *can,* technically, but you ain't suffered till you've tried walking in a winter Vancouver monsoon!)

I don't have any more 'light' to shed on the subject. I'm keeping a daily diary of how I'm feeling, the weather, any light therapy or sunlight walks I'm doing, and any supplements I'm taking, plus what I'm eating. Maybe some patterns will emerge.

Rachel

[doreen T]

Hi Rachel, and all,

I uncovered another worthwhile site, very up to date, and full of juicy tidbits if you take the time to read through it ;) Here's the link - http://www.sltbr.org/

The Society for Light Treatment and Biological Rhythms is a not-for-profit international organization dedicated to fostering research, professional development and clinical applications in the fields of light therapy and biological rhythm disorders including: seasonal affective disorder (SAD), jet lag, shift work, sleep disorders, eating disorders, nonseasonal depression, bipolar disorder, premenstrual syndrome, and others. They study and use treatments including: light therapy, chronotherapy, melatonin, serotonergic medications, and others.

There is currently a study underway at Columbia University, using not only standard bright light therapy, but also dawn simulators and negative ionizers. I have a HEPA air cleaner, and keep the ionizer on all day. Hmmmm, this is interesting. They are looking not just at SAD, but also at eating disorders as well.

Much of what I am reading there seems to refute the female predisposition, as you noted too. I agree with you, for depression and other illnesses in general, women are just more likely to report and/or seek help than men are. I still like the migration theory though. St. Lucia, here I come!!

I've started keeping a closer watch on what and when I eat also, and how I feel after. Thanks for the suggestion.

My weight-loss has pretty much stalled out; I'm going to try eliminating ALL dairy foods for now, including the whey protein shake mix, and my intuition is saying I should bump up my carbs a bit by adding a few more veggies - I'm currently only eating about 10 carbs a day. And I confess I'm only getting in 4 glasses of water.

I'll keep you posted,
Doreen

[r.mines]

Hi, Doreen, all:

I checked out the link you posted in your last message, which led me to the UBC Mood Disorders Centre page:
http://www.psychiatry.ubc.ca/mood/sad/index.html
I haven't had time to look through it yet, but it looks like it has the latest info, including recent publications and more. I've bookmarked it and will look through it carefully later on. So between us, it looks like we're coming up with some pretty good info!

I'm totally stressed at the moment - I told you about being offered an English sessional at UBC for January - it turns out they want me to teach TWO sections. Of course I said yes, but the truth is I'm suffering a crisis of confidence. I've never taught composition, I'm not familiar with the textbook or the pedagogical approach (teaching has changed since I were a young'un, so I can't even rely on my own ancient memories), and I have only a few weeks - over Xmas, no less - to get my ass in gear. I'm also gearing up to start tutoring a distance ed course starting in January, which is much less stress, but still a new factor in my life. Yikes!

I should check out the negative ionizer thing. Do you think it works? I know they were all the rage in the 80's or thereabouts, but I haven't seen any in use since.

St. Lucia sounds like a marvy idea! Make room for me!!!!

10 carbs a day doesn't sound like very much, especially over the long term. Adding some high-fibre green veggies probably can't hurt. I don't like going much under 20 carbs a day, about half of which is from veggies (she said, scanning her food diary). (Is coffee a vegetable? it's a bean!) I'm a slow loser, maybe 3-4 pounds a month, but better slow than not at all, or gaining. I've been drinking a lot more water than I ever used to - trying for the ol' 8 glasses a day. Don't know if it's making me lose weight, but it's for sure making me lose sleep!

Well, take care,
Rachel

[doreen T]

Originally posted by r.mines
.... I'm not familiar with the textbook or the pedagogical approach (teaching has changed since I were a young'un, so I can't even rely on my own ancient memories)...
Rachel, I just had a thought (doesn't happen often, LOL). Why don't you use your ancient memories and take a "retro-" approach to instructing. Then sit back as the awards and accolades pour in over your NEW and INNOVATIVE thinking. Hey, it works for the fashion and music industry!! :D

I should check out the negative ionizer thing. Do you think it works? I know they were all the rage in the 80's or thereabouts, but I haven't seen any in use since.
I have to use the HEPA filter when I must keep all my windows shut tight and can't get fresh air. I have to confess, I've only started turning the ionizer switch on recently. I will try to find more info about it. It's supposed to energize the atmosphere, so you only use it during waking hours.

10 carbs a day doesn't sound like very much, especially over the long term.
No it isn't. I had intended to slowly up the carbs by 5 per day after I went off Stillman two weeks ago. I did increase my fat intake, in the form of unsaturated oils mostly - olive, flax, homemade mayo. (canola), but got carried away with cheese and dairy, as I mentioned. It was so good to have broccoli last nite, and a big spinach and mushroom omelet this morning! (Missed the cheese though) I must take a foray into my favourite natural foods store, I know they carry organic soy cheeses, including cheddar and parmesan, and as I recall, they are lowcarb too. Just wish they were low PRICE! :eek:

Doreen

[doreen T]

The articles and links below show how negative ions benefit people.

Negative Ions and Ozone: Myths vs. Facts http://www.bright.net/~comtech/ions_ozone_myths_facts.html
Negative ions - Vitamins of the Air http://www.bright.net/~comtech/ions_vitamins.html
Negative ions and Computers http://www.bright.net/~comtech/negions_computers.html
Reader's Digest article: Ions Can Do Strange Things To You http://www.bright.net/~comtech/readersdigest_ions.html
Project: Air - Asthma and ions http://mypage.direct.ca/g/gcramer/asthma.html
An introduction to indoor air quality (EPA) http://www.epa.gov./iaq/ia-intro.html
Negative ions and the treatment of depression http://www.websciences.org/sltbr/yoa7395a.htm
Chronobiology and Depression Home Page http://www.lightandions.org/
Negative Ion Therapy Page http://www.cet.org/ions.htm

News

It now appears that the exact relationship of melatonin (and perhaps serotonin) to seasonal depression - if any - is unconfirmed. Recently, researchers have suggested that the issue may be, not the actual levels, but how a lack of negative ions and/or light might disrupt the cycle of production of these brain chemicals. More research needs to be done in this area.

Hope you find something useful,
Doreen

[r.mines]

Hi, all, I'm back after a weeklong or so holiday - not from LC, just been too busy to spend much time on the board.

I just found a book at the library that draws a connection between high carb and circadian disruptions (The Circadian Prescription, by Sidney Baker). I haven't read it through yet, but it's written by a medical doctor, not that they necessarily know everything, but I suppose that gives it some credibility. He advocates a low-carb WOL for sleep disorders, SAD, jetlag, ADD, and a host of other complaints. The diet he recommends is more like CAD than like Atkins or PP, in that he says we should eat some carbs in the evening, to help our bodies repair themselves overnight, but not during the day, when we should be consuming proteins and fats.

Well, it's interesting, and the first connection I've seen before on diet and SAD, aside from the well-known comment that SAD people often have carb cravings.

I've been feeling a bit SAD this week myself - the rains seem to have set in finally, about two months later than usual, and I'm feeling the effects. I quit taking the ephedra (1/2 dose twice daily) a couple of weeks ago, since I couldn't tell if the energy I was feeling was from the herb or the sun, but today I'm starting again. If I start feeling better, it's probably the herb. It's all experiments!

How are you doing, Doreen? And where's that wonderful signature pic of you?

Rachel

[doreen T]

Originally posted by r.mines
...Well, it's interesting, and the first connection I've seen before on diet and SAD, aside from the well-known comment that SAD people often have carb cravings.hi Rachel, nice to see you're getting a bit of a break. In her book, "Don't be SAD", Celeste Peters recommends a low-sugar and starch diet, similar to "the Zone" for Winter SAD.

I have been having a really rough time of things. Besides craving carbs - I gave in and ate some beans, and a yam - my fibromyalgia is flared big-time. It has snowed here in ONT a lot, so gray and cloudy most days. Today was brilliant, sun and deep, blue sky - but it was -18, with a windchill of -25. Even colder tonight. Hard to get out for a walk in the sunshine when you risk frostbite! :eek:

On a happier note, we have just passed the Winter Solstice, so now the days will be getting longer. Hooray!
And where's that wonderful signature pic of you :o Ooops! oversight - fixed now. thanx.

Doreen


[Edited by doreen T on 24-12-00 at 10:13]

[doreen T]

Early Morning Light Exposure Benefits Seasonal Affective Disorder Patients

WESTPORT, CT (Reuters Health) Jan 24 - Patients with seasonal affective disorder may need to wake up earlier to receive the greatest benefit from bright light therapy, investigators report January issue of the Archives of General Psychiatry.

To better understand the effects of light therapy on seasonal affective disorder, Dr. Michael Terman of the Columbia University College of Physicians & Surgeons in New York City and associates measured plasma melatonin in 42 patients. Measurements were performed in the evening or night while the patients were depressed, and in the morning or the evening after 10 to 14 days of light therapy.

While total overnight melatonin production did not differ according to the timing of light therapy, the time-curve of melatonin production did. The time curve was advanced up to 2.65 hours after morning light exposure, and was delayed up to 2.80 hours after evening light exposure.

According to results verified by the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version, improvement in symptoms was positively correlated with the size of phase advance.

According to Dr. Terman's group, the maximum advantage is achieved when light therapy of 10,000 lux for 30 minutes is scheduled approximately 8.5 hours after the baseline melatonin onset. Sleep midpoint, compared with sleep onset and offset, correlated best with melatonin onset, the investigators found. Therefore, they estimate that the optimum timing of light therapy would be 2.5 to 3.5 hours after the sleep midpoint.

The investigators clarify their recommendation, noting that it applies to "stable sleepers with 6 to 9 hours duration, onset between 10:00 PM and 1:00 AM and waking between 5:30 AM and 9:00 AM." In a university statement, Dr. Terman explained that "short sleepers will use the lights around the time of normal waking, while longer sleepers will need to wake up earlier."

Arch Gen Psychiatry 2001;58:69-75.
------------------------------------------------------

:confused: ... Ok, have I got this straight now??

Depending on when I go to bed, how long it takes me to get to sleep, then how long I sleep FOR, I might need to get up earlier to sit in the glow of my SADlite.

I take my doxepin (for alpha-delta sleep disorder related to fibromyalgia) at least one hour before bedtime to prevent frequent waking during the night. I must avoid taking Ibuprofen within 4 hrs of bedtime, as it has been shown to interfere with sleep. Unfortunately, so does my pain. Okay, I must take my levothyroxin on an empty stomach in the morning, one hr away from any food. According to the lowcarb experts, I'm supposed to eat a protein-containing breakfast within 2 hrs of rising.

I NEED A SECRETARY.

Doreen

[Edited by doreen T on 28-01-01 at 17:29]