Friday, April 1, 2011

Seasonal affective Disorder (SAD) ,we can say that winter depression or winter blues



Seasonal affective disorder

Seasonal Disorder (SAD), also called  winter depression or winter blues, is a disorder in which people who have normal mental health throughout most of the experience of depressive symptoms during the winter or, less frequently, in summer, spring or autumn, repeatedly, year after year. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), SAD is a single disease, but it is the designer of depression. If you think that the specialists doubt, depression, seasonal affective disorder is well established. Epidemiological research studies of its prevalence in the adult population ranges from 1.4 percent (Florida) to 9.7 percent (New Hampshire). U.S. National Library of Medicine notes that some people experience a serious mood change when the seasons change. They may sleep too much, there is little energy, and may also feel depressed. Although the symptoms can be severe, usually disappear.



The condition of this disorder in summer is often called reverse seasonal affective disorder, and may also include heightened anxiety. SAD has been formally described and named in 1984 by Norman E. Rosenthal and colleagues at the National Institute of Mental Health. There are many different treatments for classic (winter-based) seasonal affective disorder, including light therapy or sunlight, antidepressants, cognitive-behavioral therapy, administration of ionized air, and carefully timed melatonin supplements.

In different species, activity is reduced during the winter season in response to food availability and reduce the difficulties of survival in cold weather. Hibernation is extreme example, but even non-hibernating species often behavioral changes during the winter. It was argued that the SAD is an evolutionary adaptation in humans which is a variant or vestige of a sustained response in a distant ancestor. Presumably, food was scarce during much of the prehistory of man, and a tendency to depression during the winter months were adjusted to reduce the need for caloric intake. The preponderance of women with seasonal affective disorder indicate that the response may also somehow regulate reproduction.

Pathophysiology

Seasonal mood swings are considered related to light. One argument for this view is the effectiveness of light therapy. Seasonal Affective Disorder is measurably present at latitudes in the Arctic part, such as Finland (64 ° 00 'N), where the rate of SAD is 9.5 percent. Cloud cover  can contribute  to the  some negative effects of Seasonal Affective Disorder. The symptoms of Seasonal Affective Disorder resemble those of depression or even dystymi. There is also a great risk of suicide in few patients experiencing this disorer. One research  study reports 6 to 35 percent of hospitalizations needed to hit a period of illness. Sometimes patients feel depressed, but rather lack energy to perform daily activities. Various proximate causes have been suggested. One possibility is that SAD is linked to a lack of serotonin, and serotonin polymorphisms could play a role in SAD, although this is disputed.

Mice incapable of moving from serotonin to N-acetylserotonin (by serotonin N-acetyltransferase) appear to express depression as the behavior and antidepressants such as fluoxetine  can increase the amount of N-acetyl-serotonin enzyme, resulting in a antidepressant like effects. Another theory is that the cause could be related to melatonin, produced in low light and darkness by the pineal gland, as there are direct connections by the retinohypothalamic tract and suprachiasmatic nucleus, between the retina and pineal gland.

Sub-syndromal Seasonal Affective Disorder is a milder type of Seasonal Affective Disorder experienced by an estimated 14.3percent (vs 6.1percent seasonal affective disorder ) of the U.S. population. The blue feeling experienced by both patients SAD and SSAD , and can usually be reduced or extinguished by exercise and increased outdoor activity, especially sunny days, resulting in increased solar exposure. Connections between human mood and energy levels, and the stations are well documented, even in healthy individuals. The mutation of a gene expressing melanopsin has been implicated in the risk of seasonal affective disorder



Symptoms

The symptoms of SAD can include difficulty in waking in the morning, the morning sickness, tendency to fall asleep and overeating, particularly a desire for carbohydrates, which leads to weight gain. Other symptoms include lack of energy, difficulty concentrating on tasks, and withdrawal from friends, family and social activities. All this leads to depression, feelings of hopelessness, pessimism and lack of fun that a person suffering from this disorder. People who were sad (spring and summer, depression) has classic symptoms of depression, including insomnia, anxiety, irritability, decreased appetite, weight loss, social isolation and decreased libido. In addition, many patients are unable to cope with rising temperatures in spring and summer.

Diagnosis

According to the criteria of the American Psychiatric Association DSM-IV, seasonal affective disorder is not considered a separate disorder. This is known as a course specifier and can be applied as a description added to the configuration of major depressive episodes in patients with major depressive disorder or bipolar disorder patients. The seasonality of the specifications must meet four criteria for depressive episodes at any time of year, rebates or mania / hypomania in a characteristic time of year, these models should have lasted two years with no major depressive disorder during the same seasonal period, and these seasonal depressive episodes outnumber other depressive episodes throughout the patient's life. There are three types of SAD, each with its own set of symptoms.


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