A SAD Story

 

      Engraved on the chunk of plastic pinned to her blue grocer's smock was the word “Delphine.”  She was one of five clerks handling the pre-holiday crush in a grocery store with aisles wide enough to accommodate forlklifts. Delphine was not smiling the smile that  “mystery shoppers” have forced upon the unions.
     She slapped the bacon down like she was squishing scorpions. She hammer-threw five pounds of spuds against the back boards. She scooted the catsup with enough force to score against a Canadian goalie, smacked that bottle with the maple syrup, bowled a strike on the orange juice with a back-handed grapefruit, then helicoptered a dozen eggs into the pile. 
     "That'll be nineteen dollars and thirty-five cents." 

     I've never wanted to become a grocery clerk when I grow up. Even a good union clerk doesn't draw enough of a wage to compensate for standing in a laser-infested stall, handling raw chicken and greeting cards for eight hours a day. But Delphine was cranky beyond the realm of occupational disgust, so while I was smoothing the creases out of a twenty-dollar bill, I stomped on thin ice and asked her how she was doing.
     "Not worth a nun's fanny. I have SAD."
      I said I was sorry to hear it and asked why she was sad.
     "I did not say I am sad, ding dong, I said I have SAD, Seasonal Affective Disorder, get it every November, lasts till Spring. That's nineteen thirty-five, forty, fifty, seventy-five and twenty. Have a nice day."
     Delphine and I weren't good enough pals for me to ask if this disorder got any more severe during certain times of the month, so I just retrieved the bag of mangled food, and began looking for my pickup in the icy parking lot. 
     When I reached my writer’s sanctuary, I fired up the magic box and began to study Seasonal Affective Disorder, which, I learned, is generally thought to be caused by the lack of sunlight in mid to polar latitudes during winter months. The operating phrase among the folks who make a living by counseling these despondent sufferers is "Latitude is Attitude," meaning, that the farther north one lives during the period between September and March, the more likely one is to go batshit.

     The typical symptoms of SAD include depression, lack of energy, increased need for sleep, a craving for sweets, and weight gain. Symptoms begin in the fall, peak in the winter and usually resolve in the spring. Some individuals experience great bursts of energy and creativity in the spring or early summer. Susceptible individuals who work in buildings without windows may experience SAD-type symptoms at any time of year. Some people with SAD have mild or occasionally severe periods of mania during the spring or summer. If the symptoms are mild, no treatment may be necessary. If they are problematic, then a mood stabilizer such as Lithium might be considered. There is a smaller group of individuals who suffer from summer depression.

     About 70-80% of those with SAD are women. The most common age of onset is in one's thirties, but cases of childhood SAD have been reported and successfully treated. For every individual with full blown SAD, there are many more with milder "Winter Blues." The incidence of SAD increases with increasing latitude but does not continue increasing all the way to the poles. The Inuit are not seasonably moody. 

      There seems to be interplay between an individual's innate vulnerability and the degree of light exposure. For instance, one person might feel fine all year in Maryland but develop SAD when he/she/they/it moves to Toronto. Another individual may be symptomatic in Baltimore but have few symptoms in Miami. Some very sensitive individuals may note changes in mood during long stretches of cloudy weather.
     Let us leave aside for a moment the possibility that we are being fed another slice of scientific cowpie. If we do suffer from a need to suck down a couple of shots of Jack Daniels with our fries, can't finish a sentence without someone butting in, have trouble getting from the couch to the toilet without knocking over a lamp, and feel like jumping rope after supper, does this mean that we are sick, and if it does, what can we do about it?
     Phototherapy is the cure. We need light. The web therapist recommends l0,000 lux for two hours a day. A lux is the amount of light that one candle sheds on a square meter. In more modern terms, the average room is lit to the tune of about 500 lux. The medical device to deliver all these lux is a light bar containing seven to ten 100 watt incandescent bulbs.

     Some individuals who use a 10,000-lux box may only need 30 minutes of daily light treatment. However, the amount of light needed varies widely from individual to individual. The light treatment is most often done in the morning, but studies have suggested that either morning or evening light can help SAD. Some people may get insomnia when they use the light in the evening. Initially, researchers felt that one needed full spectrum light. Now, studies suggest that regular fluorescent lights will work as well. 
     The individual measures the distance from face to the light source. This measurement is important. The light needs to strike one's eyes, but one does not need to look directly into the light source. It is fine to glance directly into the light for a moment.  It takes up to three weeks for light therapy to show effects.

    And finally, for Delphine’s sake, there has been recent research using light therapy for PMS, obesity and non-seasonal depression. The results have not been as striking as the results for SAD. More research needs to be done. However, it may make sense to use light therapy as an augmentation of other depression treatments or in cases in which the individual is unable to use other forms of treatment. She and I both need to stare into the light this winter.