The Jennie Blog

Here It Is...

A friend of mine, a sage and prolific man, told me recently that the best parts of my blog are those in which I’ve told the truth about my experiences.  These are the posts in which I have not hid behind abstract ideals and mores; they are the entries that have been spawned directly from my bleeding heart and messy guts.  They’re not pretty, but life is gloriously sloppy…and mine is certainly no exception.

In the spirit of truthfulness, and having been so inspired by my friend, I am challenging myself to be, simply put, honest—to not hide behind labels, abstracts or carefully a constructed persona, which I would calculate to be socially acceptable.  In short, I shall try not to hide behind a character that I believe that other people would like, but to be the person that I am, whether others like it or not.

And the whole truth is, I am a coward.  I’m afraid of love, or more succinctly, of intimacy.  I am terrified of being hurt, and because of my fear, I’ve constructed carefully laid defenses to keep others from becoming too close.  I’m sure, if you’ve read my blogs or my Twitter and Facebook pages, you’ve seen my abrasive snark.  It’s my biggest defense.  I love that part of myself—it’s entertaining and witty (at least, I think so), but it’s also a lot bravado.  The real “me” is found in my quieter moments and softer writing.  My most thoughtful observations are those in which I communicate in a whisper.  As I was preparing to post this entry to my blog, I found myself worrying about what others would think.  I'm always worried about that.  Screw it.

For this reason, I feel as though many of my friends have never seen me, the real me.  And I’m afraid of their reactions if they did.  I am messy.  Two of my best friends in the world are cats (indeed, I like my cats a great deal more than many people that I know).  I take 40 minute showers and clog the drain with my hair.  I love to eat peanut butter right out of the jar.  I have a temper that would have frightened Hitler.  I am living with my parents again after being on my own for seven years, failing at almost every endeavor that I had undertaken in my twenties, including marriage.  I’m sadly disorganized.  I’m too indulgent in regard to my bad habits: caffeine, sweets, alcohol, politics and things that are cute.  And I still dream, perhaps naively, that the “love of my life” (whose identity has yet to be determined) will whisk me away to Paris.

That’s just the tip of the iceberg, but it’s me.  Just as I’ve embraced the c-word, I am now embracing my flaws, and I wholeheartedly encourage any reader of my blog, who isn’t yawning with boredom, to do the same.  Work out your flaws, but love yourself.  I’m tired of being a coward.  This is me—like it or not.

 

Thank you, Andy Parker, for your wise guidance and inspiration.

The "C-Word"

My dad’s jaw dropped—literally—and he howled with indignation when he spied the title of the book that I am currently reading.  It’s called “C*nt.”  But without the asterisk. 

“Why are you reading such…smut?!”  His nostrils were flaring and his face was red.  He was completely aghast that his little girl, who had once voraciously devoured “The Baby-Sitters Club” books, could be reading such material that is, at least from his perspective, complete derogatory trash.

After 31 beautiful years on this planet, I’ve learned a few things.  Effectively dealing with Dad’s anger is not one of them.  In this case, however, I calmly responded to his outrage with my best therapist training techniques.

“Wow, that was a really strong reaction, Dad.  Let’s talk about it.  What is it about that word that offends you so?”

And just like that, my father was disarmed.  He didn’t know how to respond, other than to stammer that “c*nt” is a dirty word—the queen mama of foul language, in fact.  No disrespect is intended to my dad, or to anyone who finds this word to be offensive, but why is it so terrible?  How can a word that was once synonymous with “woman” in ancient Egyptian culture be considered so vile today? 

I cannot answer that question definitively, but my suspicion is that it has everything to do with diminishing feminine power, turning femininity into a dirty, offensive concept, instead of one that is embraced and revered.  To that end, I am effectively adding the c-word to my vocabulary.  I am claiming it as my own, embracing it as a part of my identity and allowing it to empower me.  I am a c-word, a b-word and every other derogatory term that culture will use as an attempt to diminish my feminine power.   I am all of these things, and then some.

And don’t forget it.

And So I Return...

It is such an extradordinary thing, to live at home again,

To return as a woman.

Not to resent interference, but to embrace it…

To appreciate concern, not as an intrusion

But as an expression of love and protection

To the utmost.

Integrating my new thoughts, my habits

My pain and scars—misunderstood—

With those of my childhood

Challenging the state of home and tipping the scales

Unafraid of retribution and the perspective of a higher realm.

Not a Tuesday Person

    Ah, good old Tuesdays with Morrie, a tome that is drenched in sadness and the business of dying.  It’s a book that I had purposely (and successfully) managed to evade--until I took a grief counseling class, for which Morrie was a required text.  I had previously vowed never to read it for several reasons. Firstly, Mitch Albom is the author…hello there, mass-produced, forced-inspirational tearjerker nonfiction.  As my friend, Julie, has so eloquently stated, reading Albom is like settling for a Reese’s Cup when you really want a Peanut Butter Meltaway from Godiva.  The writing is good, not great, but the plot is straightforward and threatens to beat the reader over the head with its inspiration.   Just like a Lassie story, Morrie is guaranteed to evoke tears…which is why I had sought to avoid it.

    Here's the premise: busier-and-cooler-than-you Mitch Albom has lost sight of that which is truly important in life (hint: SportsCenter doesn't make the list of the "truly important").  He turns on the TV one fateful day and sees his former professor/mentor, Morrie Schwartz, being interviewed.  Morrie is dying; his honesty and love in the face of his own demise inspire Albom to reconnect with Morrie.  Together, they learn life's greatest lesson: how to die.  As Morrie says,  it's only when you learn how to die that you understand how to live. 

     This is my problem with this type of story: all of my literary snobbery aside, I don’t like "entertainment" that is published with the intention of exploiting the public's vulnerabilities about death and dying for the purpose of making money.  Maybe I'm too harsh.  Maybe Mitch Albom truly did experience a life-altering event that he had wanted to share with the rest of the world; it's really nice that, in doing so, he has become the reigning tearjerker champion of the publishing industry.  All snark aside, however, I'm sure that Morrie Schwartz's motivation was to be true to the teacher that he was and to add a little more love to a world that is greatly in need.

     As expected, Morrie has been a difficult book to read, indeed.  Reading this particular passage was especially difficult: “But there are days when I am depressed.  Let me not deceive you…What am I going to do without my hands?  What happens when I can’t speak?”  Losing one’s functionality in that way and the threat of not being able to communicate with others could very well be worse than death.  It makes me face the harsh reality of my own struggle with chronic illness.  I don’t know how functional I will remain this year or next, and I always feel as though I’m living precariously.  I feel terrified that my own health and independence could be taken away, just as Morrie is losing his.  The beauty of it is that Morrie has accepted life as a dance, knowing that he was losing the ability to perform all of the steps, but still choosing to listen to the music.  Most importantly, he chose to appreciate it.

     For this reason, I am glad to be experiencing Morrie’s story.  I have much to learn, and though he has passed on, Morrie has much to teach me.

http://www.youtube.com/watch?v=dcnL2o385Gw&feature=related

New Orleans--the Garish and the Grieving

        I can officially cross off a bucket list item.  I've experienced the whole "New Orleans for Mardi Gras" adventure and it was absolutely thrilling and mesmerizing!  The culture, the music, the celebration…it was all incredibly invigorating and will always be an experience that I will remember and cherish.  Though the celebration of Mardi Gras was colorful and exhilarating (and garish at times), the most poignant moments of my trip occurred after the festivities and high-adrenaline atmosphere had abated and the solemnity of Ash Wednesday settled upon New Orleans as they once again set about the task of living.  And it’s a task that they must perform often.

            New Orleans has become very accustomed to getting back to “living” throughout its complicated, and often painful, history.  So many times, on so many occasions, this city has been forced to rebuild, to rebound from destruction, and move back into living—or something that resembles it.  Hurricane Katrina was one of the worst natural disasters in our country’s history; it has left an indelible imprint upon the people, the culture and the spirit of the city itself.  It has been almost six years since Hurricane Katrina devastated and irrevocably changed the lives of New Orleans residents.  Six years...yet for many of the natives with whom I had the honor of speaking, the pain is still raw and intense.

            The lasting effects that Katrina has had on New Orleans simply cannot be understated.  Residents still speak of “the storm” quite frequently, almost daily, in fact.  Its effects have drenched and mildewed every detail, every aspect and every corner of their lives.  They are still grieving.  It is quite understandable, as most of them had watched in agony as their houses, their possessions and their very ways of life were washed away.  Even now, the smallest, seemingly minute decisions can evoke painful memories of what used to be.  For example, my friend of mine wanted to take me to a restaurant for an “authentic” Cajun meal.  Before deciding upon where we were going to eat, she wistfully mentioned several restaurants that were once excellent, but sadly, had never rebuilt after Katrina.

            The saddest, most heartrending moment of my trip occurred during a visit to the Ninth Ward, one of the most devastated neighborhoods, which bore the brunt of the levee failure.  My friend showed me “Katrina houses,” which are structures that were once domestic residences…and now, they are sad, rat-infested, uninhabitable hobbles.  There were holes in some of the roofs that the former inhabitants had made in order to escape from the rising water.              As we journeyed through the streets of the Ninth Ward, I saw a plot of land that had once held a house; all that was left of the structure was the front door.  No roof, no walls, no foundation…just a door that opened to nothing.  It was extremely humbling to see how much loss had occurred and how much pain and suffering had taken place, and will never be completely erased.  A door without a house is much like a body without a soul—it is entirely meaningless unless it is used by its inhabitants.  I wondered if New Orleans had lost its soul, if its great grief and despair were terminal.  After meeting so many wonderful, strong and resilient new friends there, I do not believe that this is the case.  They have been hurt, but they, the residents of New Orleans, are surviving and have not been defeated.  They are grieving their losses and their broken hearts but they will rise again and reclaim their former brilliance.  The human spirit is capable of sustaining immense hurt and injury, but it is also capable of restoration and resiliency.  What an incredible motivator.                                   

Stop Hurting Her

Rush Limbaugh acted his typical, classy self when he recently criticized First Lady Michelle Obama’s weight and eating habits.  He attacked her nutritional campaign by calling her a “hypocrite” for eating ribs while encouraging kids to make healthier dietary choices.

"The problem is, and dare I say this, it doesn't look like Michelle Obama follows her own nutritionary, dietary advice...I'm trying to say that our First Lady does not project the image of women that you might see on the cover of the Sports Illustrated Swimsuit Issue or of a woman Alex Rodriguez might date every six months or what have you."

The huge sigh in my heart can probably be heard around the world.  I’m not going to defend Mrs. Obama (she’s a big girl and her husband is the President—I’m sure she’ll be fine).  This is not about swimsuit models, eating ribs or political hypocrisy…the truth is, Mr. Limbaugh’s comments were disrespectful to all women.  In a culture that is hopelessly obsessed with being thin, making comments about a woman’s weight is grossly irresponsible. 

We’ve all heard this argument before.  Women are under an extreme amount of pressure to pursue the elusive “thin.”  Western culture is inundated with what one of my professors calls “fat talk”:  obsessions with skinny jeans, Weight Watchers, Curves…it never ends.  Any size over 0 is “too big.”  Why, why, why do we try to diminish ourselves?  ‘Zero’ means nothing, literally, yet it’s the ultimate goal for many women.  Dress size dictates value and self-worth. This is why so many of us struggle with eating disorders—because if we’re “fat,” then we are told, in so many cruel and subtle ways, that we’re worthless.  When an ex recently told me that I had “put on a few pounds,” I was absolutely mortified and felt completely humiliated.  That it was the worst possible thing he could have said to me is absolutely appalling; had he insulted my intellect instead of my weight, I wouldn’t have been nearly as upset.  And that is a repulsive situation, indeed. 

This isn’t about Rush Limbaugh’s hateful observations or Mrs. Obama’s rib dinner.  This is about ending the endless discussion about weight.  It’s about protecting the important women in our lives and making them see that they mean more than a dress size, that they are more than simply “fat” or “skinny.”  It’s about prohibiting Weight Watchers or Curves or Jenny Craig to exploit—and validate—our fears of weight gain.  Everyone, women and men (they’re victimized by fat talk, as well), should strive to be healthy, but should not try to diminish themselves.  We are human beings and as such, we deserve to be respected, not encouraged to seek the scale to find self-worth.

Maybe Rush Limbaugh could put that on his agenda today. 

 

Love Letters to Existentialism

    I’m writing love letters to Existentialism.  We’re studying it in Grief Counseling, and how the power of choice can facilitate healing.  Nothing gets my little mind humming as much as existential thought, and the voices and words of Heidegger, Buber and Sartre.  What speaks to me the most about this particular school of Philosophy (and Psychology) is the element of choice.  It is extremely difficult to make meaning in a world in which there seems to be so little control.  We medicate ourselves with substances, with food, with bad relationships, all in desperate (and ultimately futile) attempts to dull the pain.  We have a compulsion to fill the vacuum and avoid the overwhelming nothingness.

    The beauty of Existentialism is that it teaches us to accept the pain, to choose it.  Pain is always going to be present, but the only way to true, real healing is to “sit with” the pain, to feel and explore it.  This is especially pertinent during times of loss.  It’s essential to feel a loss and to allow the wound to heal itself naturally; that is, with time, with tears and with love.  I think that emotional pain is part of the human experience and to avoid it would be to deny oneself a crucial part of being alive.  As Descartes said, “Cogito ergo sum,” and the same holds true to feeling.  I feel, and though the feelings that I may be experiencing are painful, and though they may be torturing my soul, they are also making me feel alive.  I am.

    This is not to say that pain is necessarily a positive emotion, or that the suffering that grief causes should be anticipated with joyful expectancy.  It is, rather, an emotion that cannot be denied.  Emotional pain is like water—it will find its way into any crack and crevice that it encounters and it is simply impossible to avoid it indefinitely.  Only by allowing oneself to explore it, to feel it and to accept it as a essential part of the grieving process can one truly overcome that harrowing specter that is hurt, sadness, despair…pain.  In so doing, there is a choice: confront the pain or deny it (and inevitably, prolong it).  This choice is not always clear or apparent.  I feel that those who are in the most emotional pain, such as one who has lost a child or parent, would frown upon such lofty ideals.  I do, however, believe, from the bottom of my heart and soul, that we do have choices.  These choices lend meaning and a measure of control to world that lacks both.

                I had a very strong reaction to this line, from one of our assigned readings: “Our awareness of mortality helps to bring home a much humbler message, that eventually, perhaps, it will not matter if we lived or not.”  I vehemently disagree.  It does matter, we do matter.  We, as humans, contribute (if only in small part) to the legacy of the human race.  We can choose to add love to the world and to make others feel loved and needed.  I do not hate many things, but nihilism is one.  It’s the complete antithesis to my core beliefs.  Each of us, as a human being, matters.  We are here to love and be loved.  Though we sometimes fail pathetically at this task, the times that we are successful overwhelmingly negate our missteps.  Our need to perpetuate love and to build connections and a sense of community with others is the reason that death is so excruciatingly painful.  As difficult as this can be to admit, we need others.  The very fact that grief and pain about a death are being experienced at all obscures nihilism.  Mourning a death and celebrating a life…this implies meaning.  That could be the greatest gift.

The Signs, they are A-Changin'

What kind of universe is this? 

To answer my own question, it’s apparently one with a snazzy “new” astrological sign, which has effectively launched the largest identity crisis that I’ve ever experienced. Thank God my therapist, Doc Shelkey, is on speed dial—I almost had a panic attack while frantically dialing her number with one hand and trying to rip open an emergency carton of Cherry Garcia with the other.  I go to bed with very few certainties in my life, albeit one--I was a Libra.  A balance-desiring, Venus-loving, scale-clutching LIBRA.  And now I have been informed that I am a Virgo.  WTF.

I don’t even know what it means to be a Virgo, which planet rules this sign, or what this sign even looks like (what the hell is a “Virgo”, anyway?).  I feel like I’m dwelling in the 7^th House of Stupid; one of the fundamental, unchangeable facets of my life, to which I had rarely paid more than fleeting attention, is suddenly and unabashedly different and I actually care.  (Great…something ELSE in my life that I can’t control.  Doc Shelkey will have a field day with this one.)

Really, most of life’s statuses are subject to change: marital status, religious and political affiliations, young/old, working/unemployed…we give ourselves so many labels, and though we’d like to believe otherwise, most of them aren’t permanent.  (We can even change our genders if we want to!)  Some things, however, are fixed by nature.  You can’t change your blood type, for example.  And, 99.9% of the time, one’s birthday is PERMANENT.  If I don’t like the fact that my birthday is in October, I cannot arbitrarily change it to May (legally, I mean)…so WHY is it ok that my zodiac sign has changed?

The answer is, simply, that it’s not ok.  This change is ridiculous and unacceptable.  Whoever decided to change the zodiac had better be prepared for the consequences.  What if I had a Libra tattoo, huh?  What then??  Would these pretentious zodiac changers pay for my laser removal surgery?!  Furthermore, are they prepared to cough up the divorce costs for those who are now incompatible?  I thought I was supposed to be searching for an Aries to marry…what if I have to start looking for a Gemini?  I don’t know those people. This is scary and I am not prepared for it.  I don’t even know which planet I’m supposed to be following now; what if I develop Venus Envy because my new planet bites?  (Is this in the DSM-IV? Doc Shelkey would know.)  What if, instead of following the goddess of love and beauty, I’m now represented by a stupid planet like Pluto, or worse…Uranus?  I shudder at the thought.

Thank you, arbitrary astrological a-holes for effectively ruining my life.  Your horoscope says that your faces have dates with the back of my hand—and that’s one prediction that I can guarantee.  Just sayin’.

Think You're SAD?? Part II

Part II of this exciting, edge-of-your-seat, nerdifiable series about Seasonal Affective Disorder (SAD)...the TREATMENTS.  Bottom line: save yourself 10 minutes and buy a light box.  The end.

Treatments for Seasonal Affective Disorder

            Several modalities of treatment have been shown as efficacious in SAD patients.  Light therapy, cognitive behavioral therapy and the usage of antidepressants have all been utilized with varying degrees of success.  Additionally, preventative measures have been identified for usage in those who are especially susceptible to SAD.

Light Therapy Treatment

            The most frequently researched and widely accepted form of treatment for SAD is light therapy.  The preferred device for light therapy is a fluorescent light box that emits 2,500 lux (a unit of illumination intensity) of light.  In comparison, office light has 500 lux or less, a cloudy day has 4,000 lux and a sunny day could provide as much as 100,000 lux (Westrin & Lam, 2007).  The results of light therapy are obtained quickly; Westrin and Lam (2007) report that SAD patients experienced “significant clinical improvement” after only 1-2 weeks of light therapy treatment, though in extremely severe cases, additional time (and, perhaps, alternate methods of treatment) may be required.  Patients are susceptible to relapse after only a few weeks of discontinuing light therapy, so it is advised that they commence treatment as soon as SAD symptoms begin to emerge and continue until spring/summer remission (Westrin & Lam, 2007).  Patients should have their eyes open during light therapy, but they should refrain from looking directly at the light source.  The standard recommended “dosage” of light is 10,000 lux for 30 minutes per diem (Westrin & Lam, 2007).  Side effects to light therapy include headache, nausea and blurred vision.  Interestingly, Westrin and Lam (2007) have noted a potential risk of inducing a hypomanic or manic episode in vulnerable individuals; therefore, patients with Bipolar disorder should either be taking mood-stabilizing medications before beginning light therapy, or should refrain from it entirely and seek alternative treatment (Westrin & Lam, 2007).

            The consensus of light therapy literature suggests that it is most effective when administered during the early morning hours, possibly due to the synchronization of circadian rhythm and melatonin production.  However, Putilov and Danilenko (2005) conducted a study in which they were unable to establish a “best time” of day for light therapy administration.  Additionally, they compared light therapy to “natural” methods of SAD treatment.  They found that one week of light therapy was as effective as a trip to a location with more sunlight, or natural seasonal remission (Putilov & Danilenko, 2005).

Antidepressants

            Several antidepressants have been noted for their efficacy in the treatment of SAD.  Both light therapy and antidepressants are considered to be “first-line treatments” for SAD patients (Lam et al., 2006).  Light therapy, however, requires a substantial time commitment in order for it to be effective, rendering it difficult for some SAD patients to adhere to treatment (Rohan et al., 2007).  Though they have not been studied as extensively as light therapy in relation to SAD, Selective Serotonin Reuptake Inhibitors (SSRIs) have been identified as effective and have been proven successful for SAD patients. 

            Many studies have focused on fluoxetine as a possible alternative to light therapy.  Since fluoxetine alters serotonin reuptake, it has been theorized that the increased serotonin dissemination acts as a mood-improving agent, thereby alleviating some of the depressive symptoms of SAD.  Similarly, sertraline and citalopram, also in the SSRI family, have been shown to be effective for SAD patients (Westrin & Lam, 2007).  Overall, fluoxetine has been proved to be as effective as light therapy, though light therapy produces results at a slightly faster rate (Lam et al, 2006).  Counselors should note, however, that antidepressants have been known to cause an increased risk of suicide in children, teenagers and young adults.  Overwhelmingly, the literature cautions that all antidepressant usage should be closely monitored.

Cognitive Behavioral Therapy

            A possible alternative to, or supplement for, light therapy is cognitive behavioral therapy (CBT).  Rohan et al. (2007) recommended that SAD patients undergo an intensified version of CBT, which utilizes 1.5 hour sessions, twice a week, for a duration of six weeks.  It has been found that CBT, when used in conjunction with light therapy, produces complete remission in SAD patients (Rohan et al., 2007).  Light therapy, when used by itself, has also been shown to produce complete remission; however, combination therapy has been associated with “lower atypical depression severity” (Rohan et al., 2007). 

            Though there has been a relatively small amount of research conducted as to the effectiveness of CBT when compared with light therapy and antidepressants, the literature that exists is primarily optimistic about its successful treatment of SAD.  CBT, therefore, should be considered as a possible means of treatment for SAD.

Discussion

Seasonal Affective Disorder is a condition that can easily be confused with other forms of depression, but contains its own unique symptoms, causes and treatment modalities.  It is crucial that counselors who are treating individuals with other forms of depression (Unipolar, Major Depressive Disorder, etc.) are cognizant of the distinction.  Because the treatments have been widely researched and successfully implemented, it is imperative for the counselor to identify SAD and to treat accordingly with light therapy, antidepressants or CBT (or combinations of the three).  The three forms of treatment have been proven to be successful, but may not be effective for every patient with SAD.  The counselor, therefore, should be well-versed as to the specifics of each of the previously named modalities and should evaluate each case of SAD as individual and unique.

There are still vast and plentiful opportunities for SAD research.  For example, the efficacy of SSRIs and SNRIs has been proven, but little is known about the side effects that could potentially occur with specific regard to SAD patients.  Additionally, there exists much opportunity for combination studies: antidepressants when used in conjunction with light therapy and/or CBT, etc.  Because each individual presents a unique case, knowledge about the causes and treatments for SAD will help those who suffer from this disorder to obtain an accurate diagnosis and will aid in the development of an effective treatment plan.

Think You're SAD??

I know a great many people who suspect that they may be suffering from Seasonal Affective Disorder (SAD), aka "Seasonal/Winter Depression."  (Think those late-night bagel cravings are harmless?  Think again.)  The following is a sampling from the paper that I've written about SAD for those of us in the 'Burgh who are perpetually sunlight-deprived. 

 This probably won't be the most interesting thing you'll ever read, but I hope it helps! 

Overview of SAD and Defining Characteristics

            For some individuals, the cycle of seasons not only entails a change of weather pattern, but it also includes a drastic and difficult alteration in mood.  SAD patients feel the effects of the light-dark cycle during specific times of the year (typically winter), as it is closely aligned with the ebb and flow of depressive symptom patterns (Dagleish, Spinks, Golden, & du Toit, 2004).  Observation of patterns in mood disturbances have been observed since ancient times by the likes of Hippocrates and Kraepelin, who reported clear and identifiable depressive episodes in winter months (Westrin & Lam, 2007).

            The DSM-IV TR, characterizes SAD as pattern of major depressive episodes that regularly materialize in the fall or winter and remit in the spring or summer (American Psychiatric Association, 2001).  Sohn and Lam (2007) note that “seasonality” is a widely-experienced behavior that consists of consistent and regularly occurring fluctuations in mood and behavior; SAD is considered to be at the “extreme end of the spectrum of seasonality.” 

            Though many of the symptoms mimic those of Major Depressive Disorder and other subtypes of depression, there are distinct disparities in those of SAD.  Hypersomnia and increased appetite are usually present, instead of early morning waking and loss of appetite, as in other forms of depression (Dalgleish, et al., 2004).  Weight gain, with subsequent weight loss in the spring/summer, is accompanied by a specific desire for carbohydrates, sugars and starches; binge eating can occur in SAD, as well (Westrin & Lam, 2007).  The weight gain could result in a greater risk for obesity and/or diabetes (McElroy, Kotwal, and Malhotra, 2003).

            It is interesting to note that Schlager, Froom, and Jaffe (1995) found that SAD patients in a primary care clinic “were found to have greater functional impairment than those with many other common medical conditions.”  Indeed, the quality of life and severity of symptoms were markedly worse in SAD patients, as compared to those with a nonseasonal depressive disorder (Westrin & Lam, 2007).

Circadian Rhythm Shifts in Seasonal Affective Disorder

            Several theories exist that attempt to explain the causes of Seasonal Affective Disorder.  Those studied with the highest frequency are: shifts in circadian rhythm patterns, defective neurotransmitter functionality (namely serotonin and dopamine) and possible genetic factors and predispositions.

            One of the current prevailing hypotheses as to the etiology of SAD is the shift in circadian rhythm.  A shorter photoperiod during winter months may induce depression because of a prolonged secretion of melatonin, which is only secreted in darkness and functions as a signal for mammalian circadian rhythms (Sohn & Lam, 2005).  It has been suggested that “healthy” people have lost the seasonal time signal, while those with SAD respond to the photoperiod with an overabundance of melatonin secretion (Sohn & Lam, 2005). 

            A second theory about SAD causality in regard to the circadian rhythm is the Phase-Shift hypothesis.  This theory states that SAD results from internal circadian rhythms that are delayed because of differing sleep-wake cycles or lack of regular light exposure, primarily during morning hours (Lam & Levitan, 2000).  Sohn and Lam (2005) report that the Phase-Shift hypothesis has been one of the most consistent theories in SAD research, but it has also been one of the most debated.  Light exposure, physical activity and sleep are all considered to be “external zeitgebers” (synchronizers), and could hide internal phase shifts, making it difficult to substantiate the validity of the Phase-Shift hypothesis (Sohn & Lam, 2005).

Tomorrow: possible treatments for SAD.  Riveting!!!