There are days until World Mental Health Day 10th October 2017

SAD: SEASONAL AFFECTIVE DISORDER

The symptoms of Seasonal Affective Disorder (SAD) are similar to those of normal depression, but they occur at a particular time each year.  Most people’s symptoms start in the autumn or winter and improve in the spring.

The symptoms of SAD are usually fairly mild at the start of the autumn and get worse as the winter progresses and the amount of sunlight decreases.  However, the nature and severity of the symptoms of SAD will vary from person to person.

Some people with SAD experience recurring episodes of unipolar depression, while others may find they experience mild episodes of bipolar depression.

Unipolar depression is where you only experience depressive symptoms.  Bipolar depression involves depressed periods (lows) followed by manic periods (highs) where you feel happy, energetic and much more sociable.

As with all forms of depression, the main symptoms of SAD include a low mood and a loss of pleasure or interest in normal, everyday activities. Other depressive symptoms can include: 

• social problems – irritability, and not wanting to see people

• feelings of guilt, low self-esteem and worthlessness

• indecisiveness

• depression – feeling sad, low, weepy, guilty, a failure; sometimes hopeless and despairing, sometimes apathetic and feeling nothing

• mood changes – in some people, bursts of over-activity and cheerfulness (known as hypomania) in spring and autumn

• anxiety – tenseness and inability to cope with everyday stresses; panic attacks

• loss of interest in sex or physical contact

• be less active than normal

• feel lethargic (lack energy) for everyday tasks

• feel tired and sleep more than normal (Hypersomnia)

• find it difficult to concentrate

• have an increased appetite and eat more than usual (Hyperphagia) particularly craving carbohydrates and putting on weight (which may increase negative feelings)

• being more prone to illness – some people with SAD may have a lowered immune system during the winter, and may be more likely to get colds, infections and other illnesses

For many people, SAD can be a difficult condition to live with and it can have a significant effect on your day-to-day life.  However, SAD can be successfully treated.

SAD light boxes can be purchased from the following.  (When buying lights, don't be tempted to purchase cheap ones and if you get a headache whilst using them, turn it off).

BIPOLAR DISORDER (MANIC DEPRESSION)

Someone diagnosed with Bipolar Disorder (formerly known as Manic Depression) experiences swings in mood from periods of overactive, excited behaviour known as mania to deep depression.  Between these severe highs and lows can be stable times.  Some people also see or hear things that others around them don't (known as having visual or auditory hallucinations) or have strange, unshared, beliefs (known as delusions).

Everybody experiences mood shifts in daily life, but with Bipolar Disorder these changes are extreme.

Manic episodes, symptoms may include: 

• feeling euphoric – excessively ‘high'

• restlessness

• extreme irritability

• talking very fast

• racing thoughts

• lack of concentration

• sleeping very little

• a feeling a sense of own importance

• poor judgement

• excessive and inappropriate spending

• increased sexual drive

• risky behaviour

• misusing drugs/alcohol

• aggressive behaviour

A person may be quite unaware of these changes in their attitude or behaviour. After a manic phase is over, they may be quite shocked at what they've done and the effect that it has had.

You feel like you're a genius, you feel you're the only person in the world who can see it the right way.

Sometimes, people experience a milder form (less severe and for shorter periods) of mania known as hypomania.  During these periods people can actually become very productive and creative and so see these experiences as positive and valuable.  However, hypomania, if left untreated, can become more severe, and may be followed by an episode of depression.

Depressive episodes symptoms may include: 

• a sense of hopelessness

• feeling empty emotionally

• feeling guilty

• feeling worthless

• chronic fatigue

• difficulty sleeping or sleeping too much

• weight loss or gain/changes in appetite

• loss of interest in daily life

• lack of concentration

• being forgetful

• suicidal feelings

Types of Bipolar Disorder

Some people have very few Bipolar Disorder episodes, with years of stability in between them; others experience many more. Episodes can vary in both length and frequency from days to months, with varying lengths of time in between.

Although some people may cope very well in between episodes, many still experience low-level symptoms in these relatively ‘stable’ periods which still impact on their daily lives.

The current diagnoses in the UK are likely to be: 

• Bipolar I – characterised by manic episodes – most people will experience depressive periods as well, but not all do.

• Bipolar II – characterised by severe depressive episodes alternating with episodes of hypomania.

• Cyclothymic disorder – short periods of mild depression and short periods of hypomania.

• Rapid cycling – four or more episodes a year. These can be manic, hypomanic, depressive or mixed episodes.

• Mixed states – periods of depression and elation at the same time.

Note: An Overactive Thyroid Gland (Hyperthyroidism) can mimic the symptoms of Bipolar Disorder, and it is very important that this is excluded by a test of thyroid function (this is a simple blood test).