Our Guest Blogger Writes About S.A.D.: Seasonal Affective Disorder

Our Intro to to this is in the previous blog post: http://just-call-me-frank.blogspot.com/2011/09/tonight-mri-guest-blogger-entry.html.

Are You Feeling S.A.D.?

I had a tweet from one of my follower @TheOnlyMinx who is an awesome lady and also follows Frank, her writing and mine to. She has S.A.D and asked me to write something about it, which of course I said I would (I will write for anyone!). I really hope that I do not disappoint her so here goes – wish me luck!

As I write, it is a beautiful autumnal day. Autumn is my favourite time of the year. The trees are greens and golds and reds. There is that smell in the air. I get to cover up (I look better with more clothes on, I promise you not just my body confidence issues :S). I live in the middle of the countryside so I can feel the effects of the changing weather. I moved here from a VERY large city and I noticed a tension in EVERYTHING (lambs, cows, sheep, humans, dogs – everything) during the Spring time, then something just popped and it all resorted back to normal. It was my first real experience of what is called Spring Fever. But Autumn is definitely my favourite. Nights in snuggled up in front of the TV. Stodgy comfort stews. Bonfire night. Toffee apples. Heaven!

However, for many it’s just hell on earth. Seasonal Affective Disorder (SAD) is where a person experiences mood changes with the onset of a new season. Affect is a psychiatric term for mood, not that you become super efficient or anything like that! It can happen in any season. I have a friend who always goes low in mood during the summer months, however, it is much more common for people with this disorder to become low in mood during the autumn and winter months. Listed below are some of the range of symptoms you can get. As always it’s not exhaustive and comes from 2 different trusted websites :

http://www.rcpsych.ac.uk/mentalhealthinfo/problems/seasonalaffectivedisorders.aspx

http://www.sada.org.uk/

Depression

• Low mood, worse than and different from normal sadness
• Negative thoughts and feelings
• Guilt and loss of self-esteem
• Sometimes hopelessness and despair
• Sometimes apathy and inability to feel

Sleep Problems

• The need to sleep more
• A tendency to oversleep
• Difficulty staying awake during the day and/or disturbed sleep with
  very early morning wakening

Lethargy

• Fatigue, often incapacitating, making it very difficult or impossible to carry out normal routines

Over Eating

• Craving for carbohydrates and sweet foods leading to an increase in weight

Cognitive Function

• Difficulty with concentration and memory
• The brain does not work as well, or as quickly

Social Problems

• Irritability
• Finding it harder to be with people

Anxiety

• Tension
• Stress is harder to deal with

Loss of Libido

• Less interest in sex and physical contact

Sudden Mood Changes in Spring

• Sharp change in mood
• Some experience agitation and restlessness and/or a short period of
  hypomania (over activity)
• No dramatic mood change but a gradual loss of winter symptoms

OK Here is the really crappy thing: it comes back. For those of you lucky enough not to have experienced clinical depression before please read my entries on depression and suicide to get a flavour of what it’s like. Having depression is a bit like being an Easter egg: looks nice and normal on the outside but once you take the wrapping off it’s just hollow and disappointing on the inside. Coping with depression just once is hard enough but having to live with the knowledge that it is a long term condition takes the biscuit!

As those of you who follow me on twitter, or who have read my book (http://www.amazon.co.uk/s/ref=nb_sb_noss?url=search-alias%3Dstripbooks&field-keywords=kerry+stott&x=0&y=0 blatant book plug) will know I have had cancer and have to live with the fact that it might return. I guess that qualifies me as having a long term condition. Anyway, having a long term condition like SAD is kind of like pacing yourself for a marathon. I frequently say to my patients, and myself when I want to go and splurge on chocolate or wine, that sensible is not glamorous, sensible generally is not fun, sensible is definitely not fair. However, sensible keeps me alive, sensible helps my mental health, sensible ensures that I see tomorrow with my lovely family.

Any long term condition requires you to be as healthy as possible. That means eating the right sorts of food. People who have SAD tend to want more carbohydrates. A way around this is to keep a record of what you eat. It need not be as prescriptive as they do at Weight Watchers but just keeping a note of what you put in your mouth. There may be a pattern to it that you were unaware of before. If there is, then it can be planned for. I am not suggesting having a set amount of carbs per day, but perhaps a weekly upper limit that you are comfortable with. So if you want to pig out on Wednesday that’s ok but try not to on Saturday – you get my drift? If carbs are your weakness, clean out and detox your kitchen, if it’s not there you can’t eat it! Food is my weakness, I eat too much.

Micro nutrients. Vitamins A,D,E,K; C and B complex and the full range of minerals is essential to proper brain function. Vitamins C and B complex are water soluble so you urinate them out daily and it can be very difficult to overdose on the (please don’t go trying or I will laugh at you, you complete plank!). Vitamins A,D, E, and K are fat soluble, which mean that they require fat to be absorbed into your body. In return they can be stored in your fat supplies, thus making is easier to take too many. That said the western diet is so shitty that most people NEED a radical overhaul of it to even get anything close to the correct balance of nutrients. Which is why supplement companies make a fortune! There is plenty written on the internet about food and mood. Most of it is quite good and sensible; don’t go for any weird and wonderful advice because it is normally shit; you have been warned. For a more technical take I would recommend ‘Changing Minds, Changing Diets’ by Courtney Van de Weyer. It was published in 2005 so the research is a little dated but the principles are there and it is easy to read, if you like that sort of thing (I am an unashamed geek – deal with it!).

What to do. Roughly a portion of carbs is the size of your fist. Yes that’s right small isn’t it. One portion per meal! A portion is meat is about the same size as a computer mouse, a portion of cheese is only the size of a match box. The rest should be fresh veg, cooked so that it retains its goodness; not to a uniform yellow where if you put your ear close to it you can hear crying from the last vitamin alive because it is lonely! So boring things keep you healthy: at least 5 portions of fruit and veg per day, smaller portions than you are used to, keep a food diary.

Light boxes. These are sometimes recommended for suffers of SAD. The theory behind it is that the body requires more of the right kind of light that is not always readily available during the winter months. There are dawn lights which start to brighten up the room at a set time in the morning helping sufferers get out of bed, as sleeping loads and finding it difficult to get up in the morning are symptoms of SAD. There is evidence out there that this can help. However, if it works for you, great, but it does not work for everyone. On top of that the benefits may only be slight and go unnoticed until you stop using the light box. My personal stance would be that if it’s not doing you any harm keep going, unless you really don’t want to, then stop. Simple really.

Exercise. OK I am no exercise Nazi I promise. I have been everything from a couch potato to and exercise fanatic and back to a couch potato, and all points in between. I know that when you don’t feel like it, even a slow walk around the block is a huge effort but I do know that usually after I’ve done it I feel mentally a bit better. Cardio is the key. Doing weights and stuff like that requires a lot of mental focus and motivation but dragging your sorry arse out for a 15 minute walk is do-able. Most places have classes on and going with a mate is a great way of ensuring that you at least go. If it is only one class per week that is one evening where you are not slumped in front of the tv seeing if you can really overdose on Pringles (I’ve tested that one out and I can tell you that it is NOT possible no matter how hard you try). Mix it up, keep it fun. If you don’t enjoy the exercise you won’t do it. I don’t care if it’s Zumba or pole dancing, tap dancing might be your thing…anything to get your body moving and have a laugh!

Socialisation. Strangely people find me easy to talk to and tell me their problems – it makes me good at my job. Of my friends in real life (as we say on twitter) we have an agreement that we go to each other with our problems. That old nagging feeling of ‘well everyone has a lot on their plate’ has been done away with and replaced with ‘I would be offended if they did not feel that they could come to me with their problems so I will share mine with them’. Having a network of people to turn to is a good plan, even if it’s just to get you out of yourself and away from your negative thoughts. Planning nights out, or days out is a great way of breaking up weeks and the monotony of feeling so low. It gets you involved in the world around you, gives you things to aim for.

Professional help. It is out there and available, rather than bore the pants off you even more and make this rather long blog entry longer. Please see my other post on depression. From a clinical perspective I have no worries about someone with SAD coming to see me in the winter and being discharged from my caseload in the summer.

SAD like clinical depression is way more than feeling a bit blue for a couple of days. It is a dark, deep, pit of blackness – pretty damn hellish! If you suffer from it and have been diagnosed, I suspect that this post holds no surprises for you. If you think you have these symptoms get your ass to a health care professional and stop diagnosing yourself off the internet *rolls eyes*. Try and take care of yourself, you are special even if you don’t feel like that today.

Kerry x

Our Guest Blogger Writes About Endopsychic Energy

Happy Sunday!

It's funny how things work out sometime.

Kerry, our guest blogger, sends us her entries whenever she completes them, and we don't generally read them until the day we decide to post them. Like today.

So it was funny how things work, because just as we wrote yesterday about being a good person, and posing the question to anybody who chooses to consider the reasons as why anybody should bother. She reminds us that most people are good people, and sometimes in life negative forces work against us, and if we look at it in the right way, it can be used as a time of growth and creativity, not self-destruction/moral-destruction/stagnation/unhappiness.

Creative (Endopsychic) energy, as Kerry writes about, is exactly how we saved our own lives. By creating an outlet, by using art & writing therapy as a way to deal with our mental illness, and the things that were going on in our life; and by turning into a project, an example, to provide others with a means of learning to deal with difficulty, no matter what it is. We could go on and on about the benefits of writing (and art) therapy...but we probably have in some other entry.

Kerry hit's the button on the nose. Creative energy, and the desire for forward momentum, for change, can take your life, turn it into something else, and help you deal with stress, anger, confusion, illness, and any number of things that you encounter, any number of things that try to push you down in life, try to eat away at you and try to destroy you.

Now, as many of our readers, and our Twitter followers/friends know - we may not all subscribe to this upbeat and empowering message (however, some of indeed found her words empowering); but, at the end of the day...

[...]Out of the Ashes the Phoenix Will Rise

I was on some training recently and I was introduced to the psychological term endopsychic energy.  Now I know that psychologists can be an odd but lovable bunch and they have a panache for making up phrases to describe things, those phrases baffle the rest of us lesser mortals.  However, I like to think of myself as an educated lady who knows a thing or two, but even I was thinking ‘what the fuck?’

Endopsychic energy is part of a model that looks at group working, particularly in a work environment rather than a therapeutic one.  The endopsychic stage of the model comes at the time of conflict and argument and how this discomfort and resistance induce us to be creative and energetic to escape from that situation.  It may be a new concept to some of you to realise that from conflict comes creativity.  It is something that I see in my patients on a regular basis but I am often cautious about highlighting that having a mental illness can be a very creative process – as a punch in the mouth often offends.

A classic example is a woman who has PMS comes home and the kids are fighting, hubby is asking what’s for dinner, there is a pile of ironing to do and then she snaps. ‘Fuck it’ she shouts, ‘we’re eating out because I can’t be bothered to cook!’  Sound familiar?  It’s a frequent occurrence in my house. I can hear you thinking – where’s the creativity? I will break it down.  The woman is tired and frustrated, other people are putting their needs before her own, she may feel that she is not getting the attention or love that she needs/deserves and there is social pressure there to maintain the status quo.  To extract herself from this quagmire she shouts, which tells people that she is not happy and forces them to focus on her.  To move away from working in a pattern that she does not want to do she changes it, thus the eating out.  She releases the others from their pattern of behaviour by suggesting something new.  All in all, pretty amazing, shame we have to feel shitty to get there in the first place.

This is only one example, there will be many in your own lives if you look back.  I put on heaps of weight when I was pregnant, so after I finished breast feeding I went to Weight Watchers and lost 5 stone (70 pounds).  I was stuck in the same dead end job so I overcame my fear of learning due to my dyslexia and went back to uni[versity] (I got a first class degree).  My writing stemmed from my frustration and me trying to make sense of situations.  My cancer has lead to so many opportunities including working with Frank et al (I would have preferred not to have cancer but we don’t always get the choice, I think it’s better to try and make the best out of whatever life hands us).  Out of the ashes the phoenix will rise.  People do not change because they want something, they change because they don’t want something.  People who smoke don’t desire to be ex-smokers but they’re bloody sick of that smoker’s cough and paying out all that money.  Fat people don’t want to be thin, rather they dislike how they feel about themselves right now.

At the time of writing this post, we are still coming to terms with nearly a week of rioting in the UK.  It has sickened the majority of the British people to see others behave in such a violent way.  The most famous of which is when Malaysian student Ashraf Haziq Rossli had his jaw broken and then when he thought he was getting help he was robbed by his ‘helpers’ http://www.youtube.com/watch?v=Og-0xQDC8Dg (be warned it does not make pleasant viewing).  His mother was naturally worried about her son and wanted him to come home but Ashraf said that he wanted to say here and that most of the people in the UK were good people.  He was right, people have donated money, so much money (over £22,000/ $36000) that his mother can now fly over here to see her son.

Hard and difficult times means that we need to make choices, we do not need to make these choices when we are happy with our situation.  Often adversity, illness, prejudice and all manner of negativity force us down a path that we had never thought of.  Sometimes it’s not a pleasant path, sometimes we don’t like where we end up but it is that creative energy that enables us to change what is happening to us.

 - Other entries written here by Kerry-

• Our New Guest Blogger (Kerry Stott @kerrystott) 
• Our Guest Blogger Writes About Depression (Kerry Stott @kerrystott)
• Our Guest Blogger Writes About Suicide (Kerry Stott @kerrystott)