SAD: Seasonal Affective Disorder

This topic has been on my mind a lot lately, as the seasons are changing. Seasonal Affective Disorder, or SAD, is a type of depression that's related to changes in seasons. It begins and ends about the same times every year. For most people, the SAD symptoms start in the fall and continue into the winter, sapping energy and making you feel moody. Less often, though also important to note, SAD causes depression in spring or early summer.

Treatment for SAD can include light therapy, psychotherapy and medications.

Don't brush off the feeling as simply the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep yourself in check. Work to keep your mood and motivation steady throughout the year.

More often than not, SAD symptoms appear during late fall or early winter, when days are short and dark, and go away during the sunnier days of spring and summer. However, some people do have symptoms that begin in spring or summer. Either way, symptoms generally start out mild and become more severe as the season progresses.

Seasonal affective disorder is a subtype of major depression that comes and goes based on seasons. So symptoms of major depression may be part of SAD, such as:

•Feeling depressed most of the day, nearly every day
•Feeling hopeless or worthless
•Having low energy
•Losing interest in activities you once enjoyed
•Having problems with sleeping
•Experiencing changes in your appetite or weight
•Feeling sluggish or agitated
•Having difficulty concentrating
•Having frequent thoughts of death or suicide

Symptoms specific to fall/winter SAD may include:

•Irritability
•Tiredness or low energy
•Problems getting along with other people
•Hypersensitivity to rejection
•Heavy, "leaden" feeling in the arms or legs
•Oversleeping
•Appetite changes, especially a craving for foods high in carbohydrates
•Weight gain

Symptoms specific to spring/summer SAD may include:

•Depression
•Trouble sleeping
•Weight loss
•Poor appetite
•Agitation or anxiety
•Seasonal changes in bipolar disorder

The specific causes of SAD are unknown. Some factors that may come into play include:

•Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may cause winter-onset SAD. The decrease in sunlight may disrupt your body's internal clock and lead to feelings of depression.

•A drop in serotonin, a brain that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression.

•Melatonin levels. The change in season can disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood.

Factors that may increase your risk of SAD include:

•Being female. SAD is diagnosed more often in women than in men.

•Age. Young people have a higher risk of winter SAD.

•Family history. People with SAD may be more likely to have blood relatives with SAD or another form of depression.

•Having clinical depression or bipolar disorder. Symptoms of depression may worsen seasonally if you have one of these conditions.

•Living far from the equator. SAD appears to be more common among people who live far north or south of the equator. This is probably due to decreased sunlight during the winter and longer days during the summer months.

Take signs and symptoms of seasonal affective disorder seriously! As with other types of depression, SAD can get worse and lead to problems if it's not treated. These can include:

•Suicidal thoughts or behavior
•Social withdrawal
•School or work problems
•Substance abuse

Treatment can help prevent complications, especially if SAD is diagnosed and treated before symptoms get bad. Don't be afraid or ashamed to see your doctor if you have any symptoms of SAD.

Remember that you are worth whatever it takes to help you feel better. There is nothing to miniscule or insignificant in the way you feel. Get help if you need it through these cold winter months. You're needed and wanted and you are worth the fight.

Everything Is Awful And I'm Not Ok. Questions to ask before giving up.

Someone gave me a handout once called Everything is Awful And I'm Not Ok. It has suggestions of things you can do in that very moment of crisis. Things that are good, logical, and practical, but in a moment of crisis do not come easily to mind. I suggest having a list like this at the ready at all times whether you're prone to depression and crisis or not.

1. Are you hydrated?
If not, get a glass of water now.

2. Have you eaten in the past three hours?
If not, get some food now. Get some food with protein in it if you can, not just simple carbs

3. Have you showered in the past day?
If not, take a shower right now.

4. Have you stretched your legs in the past day?
If not, do so now. Walk around the block, go to a big chain store and walk the aisles. Walk around your house. Just move.

5. Have you said something nice to someone in the past day?
Do so, whether online or in person. Make it genuine. Find something really wonderful someone did and compliment them on it.

6. Have you cuddled a living being in the past two days?
If not, do it now. Don't be afraid to ask for cuddles from friends, even pets.

7. Have you seen a therapist in the last few days? 
If not, hold on until your next session then talk things through.

8. Have you changed any of your medications in the last couple of week? Including skipped doses or changed to an off brand medication.
This can mess with your head. Give it a few days then talk to your doctor if things don't settle down.

9. If daytime, are you dressed? 
If not, put on some clean clothes that aren't pajamas.

10. If nighttime, are you sleepy and fatigued but resisting going to sleep?
Put on pajamas and make yourself cozy in bed. Lay there with your eyes closed for 15 minutes. No electronic screens allowed. If you're still awake after 15 minutes, you can get up. No pressure.

11. Do you feel ineffective? 
Pause right now and get something small completed. Load the dishwasher, check your email. Good job!

12. Do you feel unattractive? 
Take a bloody selfie. Your friends will tell you how great you look, and you can help fight societies stigma of beauty.

13. Do you feel paralyzed by indecision? 
Give yourself 10 minutes to sit back and figure out a game plan for the day. If a particular decision or problem is being a roadblock, give yourself permission to set it aside for now, and accomplish something doable. Right now we're just trying to get out of the stasis, even if it means doing something trivial.

14. Have you over exerted yourself lately? Phycically, emotionally, socially, or intellectually.
This can take a toll that can linger for days. Take time to yourself to regroup, whether that be some alone time, physical rest, or relaxing with some entertainment.

15. Have you waited a week?
Sometimes our perception of life is skewed. We can't tell were not thinking clearly, and there's no obvious external cause. It happens. Keep yourself going for a week and see if you feel different then.

Life is hard. But it can also be beautiful. You've made it this far, you can make it through again. You are stronger than you think.

Exhausted

I am so exhausted. I can barely lift my body to do anything. I sleep so much. I don't know why I'm so tired all the time. I don't know if it is my thyroid. I don't know if it's the depression. I don't know if something else is going on. Maybe it's all things combined. I don't know. Abull I know is that my body has no energy and all I want to do is rest.

Today was rough. Today is the first time in months I've fought off self harm thoughts. I've been feeling so much better since I was released from the hospital, that I had hope the real bad days were behind me. It makes me nervous to have these feelings creep up like this. I know where they can go. I hate that when I start to feel bad, it seems dying is still an option. That disappoints me. I don't want to be in that place still.

I haven't been overly impressed with my new therapist. I'll give it a few more times to see if our patient/client relationship improves. Then I guess I'll play by ear. I transfered to the Port Orchard office when I moved over here, and it's just a teeny little office, I don't even know if I could see anyone else. She's a nice person, just maybe not the best fit for me.

I see my new psychiatrist at this office on Tuesday. I'm only nervous because it's new. Change is hard for me. But my medication seems to be at a working level right now, so hopefully we won't change anything up and it'll be a quick appointment.

I know a lot of my loved ones are hurting right now. It hurts me to see so much pain. I wish I could just take it all away and make the world a safe place for everyone.

Until then I guess we just fight the good fight.

I'll update again soon.