Tuesday, February 14, 2017

It's Been a Blue, Blue Day..."

Arnold, is that really you?  This is Bob Bartlett, Robert was what you called me 50 years ago.  Fifsty years!  CAn  you believe it!  I could believe it even though I would never have recognizd the voicae or he speech patterns.  But last year during  a trip to Utah I had made a special effort to visi his brotherReed and share a dinner so graciously set by Reed amd jos wofe Afton.  Afton wasn't sure she remembered me even though and Reed had double daated  with me and my wife.  The boys had lived across the street from us all through grades k ==-12 and into collevge.  Reed was a ear older thab nem /rkbert a gear  younger.As often happens with threesomes, I was often tight with one while on the outs witiih the oher.



So begins the Country-Western hit by ____________  which describes a syndrome common in the higher latttitudesnbut not so well known closer to the equator - Seasonal Affective Disorder or SAD for short.  SAD is one of those mental illnesses that are difficlt to someone supervising a SAD oersib ti aacceot.  But trdrstvhrttd hsvr frrtminrf yhsy proplr who seasonally get less and less sunlight suffer depressioin,listlessness, .  And in many cases, streatment with light psrimarily blue spectssru , will find smany of these symptsoms decresing and even disappearing.





What is the treatment for seasonal affective disorder?
In addition to being key in the prevention of seasonal affective disorder, regular exposure to light that is bright, particularly fluorescent lights, significantly improves depression in people with this disorder when it presents during the fall and winter. The light treatment is used daily in the morning and evening for best results. Temporarily changing locations to a climate that is characterized by bright light (such as the Caribbean) can achieve similar results. Light treatment has also been called phototherapy. Individuals who suffer from seasonal affective disorder will also likely benefit from increased social support during vulnerable times of the year.
Phototherapy is commercially available in the form of light boxes, which are used for approximately 30 minutes daily. The light required must be of sufficient brightness, approximately 25 times as bright as a normal living room light. Contrary to prior theories, the light does not need to be actual daylight from the sun. It seems that it is quantity, not necessarily quality of light that matters in the light therapy of seasonal affective disorder. The most common possible side effects associated with phototherapy include irritability, insomnia, headaches, and eyestrain.
Antidepressant medications, particularly those from the serotoninselective reuptake inhibitor family (SSRI) family, have been found effective treatment for seasonal affective disorder that presents during summer as well as that which tends to occur during the fall or winter. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), andcitalopram (Celexa). Common side effects for this class of medications include insomnia, nausea, diarrhea, and decreased sex drive or performance. As with any other mood disorder, psychotherapy tends to accentuate the effectiveness of medical treatment and therefore should be included in the approach to addressing this disorder. In individuals who are perhaps vulnerable to the development of bipolar disorder, either light therapy or antidepressant medication can cause a manic episode as a side effect.
Since stimulant medications like modafin



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