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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Cece on June 13, 2002, at 23:31:51
I was interviewed recently by a reporter for the NY Times for a story on Reverse SAD. She found me
through a post that I made last year on P-B (Dr. Bob did not give her my personal info- just
forwarded her inquiry to me and left it to me whether to respond or not). It will be appearing soon in
a special supplement on Women's Health although it is not a problem unique to women. It has been
reasearched some but the cause is not known.Now I know for sure that there are others like me out there!
Most people with RSAD report that it is the heat that gets to them. But I seem to suffer most from the bright light of summer- I feel like it is attacking me. It is so much more intense than bright light days in other seasons. I become depressed, anxious, and socially withdrawn, and I want to stay inside during the hot bright hours of the day. Although where I live is relatively cool (Northern CA), I become virtually non-functional in a heat spell (we just had one and I was a real mess). Cold showers and swimming help some, but I get so depressed that it is hard to be good to myself. It is also dry, dry, dry here in the Summer and the lack of rain builds up a tension in me. August is my worst month usually, building from mid-June. I don't really feel okay until October when a breeze comes up with that smell of Autumn. I begin to relax and feel like I am being released.
I actually like the long days of summer since I like to be outdoors (I work with plants)- or rather I should say, I like the long twilights. Although I like the quiet of winter (except for the stress of the holidays), I get frustrated by not being able to be outside so much in the evening.
My favorite months are April and October, when the light is more balanced between night and day. I can get hypomanic in Spring if I don't watch myself and back off when I see that I am getting wound up. I can cool down with either a little (100mg) extra Neurontin, or a little (.63mg) Zyprexa as needed, and by consciously reining myself in. Usually, I take 900mg Neurontin and no Zyprexa. I would take the Zyprexa regularly except for the weight gain- it does a lot for my overall sanity. I take a bunch of other meds, and am trying to pare the cocktail down to the bare essentials- it got layered on over many years. I am BPII with a long history of depression.
I also like 'weather'- changes in weather, storms, clouds. If the air is clean I feel better in any season, and there's nothing like a good rain to clean the air. There's not a lot of 'weather' where I live.
I am also bothered by very bright light in general. Walking into a brightly lit convenience store is torture for me. Again, I feel attacked by the glare.
I have had these symptoms of RSAD since my 20's (I'm now 53), but didn't really begin to see the pattern til my 30's, and didn't clearly see it til I began treatment for my BP about 10 years ago.
I am convinced that this pattern has connection to my BP as both are cycling disorders.
Working with nature, I observe that we live out of synch with the natural cycles. With plants, I see that Winter is rest and restoration, Spring is vigor and new growth, Summer is the slow fruition of Spring, and Autumn is letting go and preparing for rest. We live, most of us, at a hectic pace year round, not able to respect our place in nature. I feel much better in Summer if I can move at a very slow pace and have few worldly pressures- not very easy to come by except in small snatches.
One thing I learned from the NY Times reporter is that RSAD is mostly reported in countries near the Equator. This really puzzles me since there is much less seasonal variation in that part of the globe than anywhere else. Is it just not reported in other latitudes?
I'd be interested to hear from others who experience anything similar. I'm also going to begin a new thread on something that is related to this: Day is day and night is night.
Thanks,
Cece
Posted by Ritch on June 14, 2002, at 10:05:37
In reply to Reverse (summer) SAD, long, posted by Cece on June 13, 2002, at 23:31:51
>
> I was interviewed recently by a reporter for the NY Times for a story on Reverse SAD. She found me
> through a post that I made last year on P-B (Dr. Bob did not give her my personal info- just
> forwarded her inquiry to me and left it to me whether to respond or not). It will be appearing soon in
> a special supplement on Women's Health although it is not a problem unique to women. It has been
> reasearched some but the cause is not known.
>
> Now I know for sure that there are others like me out there!
>
> Most people with RSAD report that it is the heat that gets to them. But I seem to suffer most from the bright light of summer- I feel like it is attacking me. It is so much more intense than bright light days in other seasons. I become depressed, anxious, and socially withdrawn, and I want to stay inside during the hot bright hours of the day. Although where I live is relatively cool (Northern CA), I become virtually non-functional in a heat spell (we just had one and I was a real mess). Cold showers and swimming help some, but I get so depressed that it is hard to be good to myself. It is also dry, dry, dry here in the Summer and the lack of rain builds up a tension in me. August is my worst month usually, building from mid-June. I don't really feel okay until October when a breeze comes up with that smell of Autumn. I begin to relax and feel like I am being released.
>
> I actually like the long days of summer since I like to be outdoors (I work with plants)- or rather I should say, I like the long twilights. Although I like the quiet of winter (except for the stress of the holidays), I get frustrated by not being able to be outside so much in the evening.
>
> My favorite months are April and October, when the light is more balanced between night and day. I can get hypomanic in Spring if I don't watch myself and back off when I see that I am getting wound up. I can cool down with either a little (100mg) extra Neurontin, or a little (.63mg) Zyprexa as needed, and by consciously reining myself in. Usually, I take 900mg Neurontin and no Zyprexa. I would take the Zyprexa regularly except for the weight gain- it does a lot for my overall sanity. I take a bunch of other meds, and am trying to pare the cocktail down to the bare essentials- it got layered on over many years. I am BPII with a long history of depression.
>
> I also like 'weather'- changes in weather, storms, clouds. If the air is clean I feel better in any season, and there's nothing like a good rain to clean the air. There's not a lot of 'weather' where I live.
>
> I am also bothered by very bright light in general. Walking into a brightly lit convenience store is torture for me. Again, I feel attacked by the glare.
>
> I have had these symptoms of RSAD since my 20's (I'm now 53), but didn't really begin to see the pattern til my 30's, and didn't clearly see it til I began treatment for my BP about 10 years ago.
>
> I am convinced that this pattern has connection to my BP as both are cycling disorders.
>
> Working with nature, I observe that we live out of synch with the natural cycles. With plants, I see that Winter is rest and restoration, Spring is vigor and new growth, Summer is the slow fruition of Spring, and Autumn is letting go and preparing for rest. We live, most of us, at a hectic pace year round, not able to respect our place in nature. I feel much better in Summer if I can move at a very slow pace and have few worldly pressures- not very easy to come by except in small snatches.
>
> One thing I learned from the NY Times reporter is that RSAD is mostly reported in countries near the Equator. This really puzzles me since there is much less seasonal variation in that part of the globe than anywhere else. Is it just not reported in other latitudes?
>
> I'd be interested to hear from others who experience anything similar. I'm also going to begin a new thread on something that is related to this: Day is day and night is night.
>
> Thanks,
> CeceOkay here is my post from up above
Cece,
That is very interesting reading. I have two SAD episodes a year-one in the winter and one in the summer. The summer one is already starting and it is marked by early morning awakenings (most of the last week or so). Imipramine is making this worse and I have stopped it (because of REM suppression?). I work evenings with artificial light and don't have the option of synching myself with nature. However, my take on the origin of the "reverse" SAD symptoms isn't the *bright* light-it is the *DURATION* of the available light. Let me start from scratch. I get depressed the worst in the winter centered around the winter solstice (lack of light). BUT, there are a lot of factors influencing the amount of light that you expose yourself to. One is the amount of natural vegetation in your environment and how much time you spend indoors versus outdoors. Anyhow, I notice that I feel *recovery* from the wintertime episode about mid-January. Snow makes things better. I have to get outside to shovel the snow away, walk to the store after a blizzard, etc. But, by the end of February I clearly notice the marked intensity of light coming through my windows (no trees yet). That is when I start developing hypomanic and mixed states. That worsens *until* the tree "canopy" is fully developed (which provides shade). So, though the temperature is increasing outside, the amount of light *INTENSITY* is drastically reduced, however the light *DURATION* is increasing. That is when I start to get my 2nd "reverse" SAD depression. It starts to significantly remit (and another hypomanic spell usally happens-however less intense) whenever the trees start dropping leaves and there is no storms or rain and the sky is cloudless and bright during the fall, while the light *DURATION* is decreasing and decreased, but the light *INTENSITY* is coming back up again-everything is very bright and "contrasty" outside.
Oh, and one important thing to add about MEDS: Stuff that messes with the sleep messes with my mood. There is no stronger correlation than my sleep quality::mood.
Mitch
Posted by Chloe on June 15, 2002, at 12:40:25
In reply to Reverse (summer) SAD, long, posted by Cece on June 13, 2002, at 23:31:51
Cece,
I always *thought* I liked summer because the temperatures were warmer. I live in New England. But I think most of my depressions begin after a hypomanic/agitated april and May. The whole "daylight savings" thing sends me into a lather. Why do we have to change the clocks so there is dramatically more light during the waking hours???Makes me furious. And I am upset for a week trying to adjust to this outdated government imposed change...GRR.
I then tend to crash in June/July/August. There is just too much damn light. I find myself hiding in the house until the sun is very low about 7 pm, then I go for my walk or do some weeding, etc. I too, love the rainy dark days were the light does not intrude on my pillow at 4:30 am in the summer.
I remember one summer in college, I spent most of my days in my apartment bedroom with the shade drawn all day and night. I could see the light beaming in intensely at the bottom, and it would make me uncomfortable. I would feel calm when the sun would finally drop below the horizon.I really don't like when we have to change the clocks in the fall, either. I find it very disruptive and upsetting and it takes me at least a week to adjust and feel "normal" again. I think it's harder than spring, since I don't usually have the hypofeelings. But I do find the darkness more comforting. I like taking a walk at 6 pm and having it be pitch black. I never feel scared or alone. But when March starts rolling in, I can see the days getting longer and longer, and my anxiety rises...and the cycle starts again. I am also BP2, BTW.
I always thought my goal should be to live closer to the equator, then I would not experience these drastic changes in light, mood, energy level, cycling, etc. But from what you wrote, most RSAD complaints come from folks living on the equator...Go figure. I never considered my aversion to the intense, long sunny days of summer as RSAD. But it's an interesting notion. It would explain some things...And why most people think I am nuts when I feel like I need to be indoors in the daytime of summer. And my precious dark nights are so short, I get so little done :( without stayin up way too late.
Thanks for starting the thread.
Chloe
Posted by Gabbi on July 9, 2002, at 21:10:28
In reply to Re: Reverse (summer) SAD, long » Cece, posted by Chloe on June 15, 2002, at 12:40:25
I really wish I could offer some help, but right now I'm just stunned that someone else has worsened symptoms in the summer. At first I thought it was just part of the "cycle" of my cyclical depression, but now I realize its definately the sun, on cloudy days or in the evening I'm a "regular" depressive. But when its hot and sunny my anxiety is absolutely mind bending. It makes my regular depression seem like a holiday. Its been happening for 7 years now, and I just don't think I can live through another season of this. I've been prescribed Benzo's (which I wouldn't recommend, but thats another story) however in the summer they don't even make a dent, unless I take enough to just make me sleep through it, which is dangerous, unproductive, has ruined what was left of my social life, but its that or suicide.I'm wondering now, after analizyng the subject to death if it is perhaps too much serotonin, I'm on 60 mgs prozac, augmented with thyroid hormone, and the sun increases serototin levels as well doesn't it. Help anyone, I've absolutely seriously contemplated moving to one of the poles where I can have six months without sun.
Posted by Ritch on July 9, 2002, at 21:51:58
In reply to Re: Reverse (summer) SAD, long, posted by Gabbi on July 9, 2002, at 21:10:28
>
> I really wish I could offer some help, but right now I'm just stunned that someone else has worsened symptoms in the summer. At first I thought it was just part of the "cycle" of my cyclical depression, but now I realize its definately the sun, on cloudy days or in the evening I'm a "regular" depressive. But when its hot and sunny my anxiety is absolutely mind bending. It makes my regular depression seem like a holiday. Its been happening for 7 years now, and I just don't think I can live through another season of this. I've been prescribed Benzo's (which I wouldn't recommend, but thats another story) however in the summer they don't even make a dent, unless I take enough to just make me sleep through it, which is dangerous, unproductive, has ruined what was left of my social life, but its that or suicide.
>
> I'm wondering now, after analizyng the subject to death if it is perhaps too much serotonin, I'm on 60 mgs prozac, augmented with thyroid hormone, and the sun increases serototin levels as well doesn't it. Help anyone, I've absolutely seriously contemplated moving to one of the poles where I can have six months without sun.
Hi Gabbi,This is just a hunch-but I think it has to do not with the sun being the culprit in the summer-I think it is the *heat*. When late summer/early fall rolls around and the sky is bright blue and the temps are cool and breezy I immediately feel recovery from the summertime funk. Researchers are focusing more and more on the neuroendocrine system instead of just neurotransmitters (like serotonin, norepinephrine, etc.). A behavioral neuro I saw once told me that a lot of his bipolar patients experience this *down* cycling mid-summer. I wonder also if *avoidance* of the midday sun in the summertime (due to the high heat) might have a negative impact. I find that I feel better when I get out in the yard and do stuff midday-whether it is summer or winter.
Mitch
Posted by Gabbi on July 9, 2002, at 22:56:22
In reply to Re: Reverse (summer) SAD, long » Gabbi, posted by Ritch on July 9, 2002, at 21:51:58
> >
> > I really wish I could offer some help, but right now I'm just stunned that someone else has worsened symptoms in the summer. At first I thought it was just part of the "cycle" of my cyclical depression, but now I realize its definately the sun, on cloudy days or in the evening I'm a "regular" depressive. But when its hot and sunny my anxiety is absolutely mind bending. It makes my regular depression seem like a holiday. Its been happening for 7 years now, and I just don't think I can live through another season of this. I've been prescribed Benzo's (which I wouldn't recommend, but thats another story) however in the summer they don't even make a dent, unless I take enough to just make me sleep through it, which is dangerous, unproductive, has ruined what was left of my social life, but its that or suicide.
> >
> > I'm wondering now, after analizyng the subject to death if it is perhaps too much serotonin, I'm on 60 mgs prozac, augmented with thyroid hormone, and the sun increases serototin levels as well doesn't it. Help anyone, I've absolutely seriously contemplated moving to one of the poles where I can have six months without sun.
>
>
> Hi Gabbi,
>
> This is just a hunch-but I think it has to do not with the sun being the culprit in the summer-I think it is the *heat*. When late summer/early fall rolls around and the sky is bright blue and the temps are cool and breezy I immediately feel recovery from the summertime funk. Researchers are focusing more and more on the neuroendocrine system instead of just neurotransmitters (like serotonin, norepinephrine, etc.). A behavioral neuro I saw once told me that a lot of his bipolar patients experience this *down* cycling mid-summer. I wonder also if *avoidance* of the midday sun in the summertime (due to the high heat) might have a negative impact. I find that I feel better when I get out in the yard and do stuff midday-whether it is summer or winter.
>
> MitchMitch,
Thank-you for answering my letter, and having it be such an informative response was a bonus. I can't believe I never thought about the heat... and God knows we depressives can be pretty self obsessed. But now that you've brought it to my attention, I think its right because the sun doesn't bother me in the winter...Hmmmm...
Thanks for both the support and the information.
Posted by Cece on July 10, 2002, at 0:28:33
In reply to Re: Reverse (summer) SAD, long, posted by Gabbi on July 9, 2002, at 21:10:28
Well, the heat certainly does get to me too. But still, it is for me the particular driving quality of the Summer sun that pushes my own anxiety button. I like Spring sun, Autumn sun, and Winter sun- but not Summer sun. Since most of my work is outside and active, I'm moving around in midday sun almost every day. And- compared to a lot of the country- Summer is not so very hot here in Northern CA.
This summer I'm doing better overall even though we are having more hot spells (global warming). We are having a really intense one right now and I'm basically fine. I think that it has to do with my meds.
Two years ago I was reworking my mood stablizer cocktail and beginning on Lamictal (in combination with 900mg Neurontin and 250mg Depakote which I had been on for awhile). I had a noticeably less difficult summer than usual. Last summer I was on 125mg of Lamictal, same others and again had substantially less misery. This year I'm at 300mg Lamictal (the rest the same) and, knock on wood, am doing pretty damn well.
The other things that are different in my meds this year are that I am now on thyroid supplement (T4, Levothroid) as an anti-depressant, and, I am getting off of benzos. Both of these changes- one addition, one subtraction- are clearing my mind remarkably and improving my overall energy. Benzos can be kind of a two edged sword- they work great for certain kinds of anxiety, but in the long run can really mess with mood. I've also learned that taking just a little extra Neurontin can help me a lot if I get 'anxiety wind-up'.
Having a lot of anxiety when on Prozac may be a sign that it's not the right med. Mood stabilizers seem to be helping a good number of people who appear to be unipolar depressives. Like me. I was diagnosed in my 20's with "acute depressive anxiety"- in the summer. My pdoc who first treated me for BP said that I looked like a regular depressive except for my "simmering quality"- and of course, a history which on careful examination revealed cycling problems with the scale tipped to depression.
Best to all,
Cece
Posted by Gabbi on July 10, 2002, at 12:53:03
In reply to Re: RSAD, this year, Gabbi et. al., posted by Cece on July 10, 2002, at 0:28:33
Its amazing just knowing their are other people in the same medication/anxiety/depression Jungle. I guess I always knew there were, but never got to talk to anyone. I tried a few support groups but I kind of thought they were an odd idea, seeing that for many of us with Major depression If there was a cure for it across the room we wouldn't be able to walk over and get it. I've also seen some other "Chat boards" and they were juvenile, and just plain rude.
As for the Benzo's Cece I agree. I believe (my humble opinion) that they have there purpose as in relieving acute anxiety before the Anti-depressant begins working, but over the long haul.... I think its a slippery slope, never mind the rebound anxiety they can cause, which for me was another dimension of terror I didn't know existed. I'm going to try Effexor now instead of Prozac, here goes another 3months of my life (sigh)Thanks for being here
Posted by phoeb on October 2, 2003, at 10:50:54
In reply to Re: Reverse (summer) SAD, long » Gabbi, posted by Ritch on July 9, 2002, at 21:51:58
Help. I have a cyclical depression that is not linked to my menstrual cycle, nor is it completely predictable. I just "got over" a 9-month horrible, serious depression, but now with this cycling in and out of suicidal depression I don't know what to think, or do. I'nm on Nardil, Nortriptyline, lamictal, and lorazepam or zyprexa when needed. Does anyone else have this experience? I'm desperate to know, as I feel like a freak experiencing this on my own.
Posted by Cece on October 2, 2003, at 19:58:49
In reply to Re: Reverse (summer) SAD, long, posted by phoeb on October 2, 2003, at 10:50:54
Hi-
Sorry for your horrible times- I remember them. Yes, remember them, since I haven't had one for about 5 years since my (complicated) med cocktail got worked out well for me. I'm very grateful, having in some aspects, lost years of my life to instability and terrible depression.
The fact that you are on Lamictal indicates that your doctor probably feels that there is a bi-polar component to your depression. This can be hard to recognize yourself if the depressive side of your cycling is most causing you to suffer. It was for me. Since being diagnosed correctly as BPII, I have been able to start trying different meds and combinations that are appropriate. But even so, it has taken years to get it right, and from time to time they still need adjusting.
Cycling is not unusual, it's more the norm with affective mood disorders- if that's any reassurance.
The best thing to do is to work with a doctor who is smart, up-to-date, and who you trust and communicate well with. If your current doctor doesn't meet these criteria, interview other possible doctors in your community. If you are near a medical school, that's a very good resource. I began my successful treatment with a resident at an excellent med school.
What the right meds are for each person is very individual, so I certainly can't give you advice on what to try or what to get off of. Do however discuss dosages with your doctor- if Lamictal seems to help you, pushing the dose up might help more (it did me).
I will mention that one thing that has made a big difference for me is thyroid supplement, even though I tested only barely below normal. It is an accepted treatment for depression, expecially bi-polar depression. I now take enough Levothroid (same as Synthroid) to push my thyroid level up to the higher end of the normal range. There are 2 types of thyroid supplement, T-3 and T-4, and Levothroid is T-4. I previously took Cytomel (T-3) for several years but it didn't do much if anything for me, although it apparently works well for some people.
I'm curious why you put your post on this particular thread. Do you have a feeling that your depression is seasonal?
Take care,
Cece
> Help. I have a cyclical depression that is not linked to my menstrual cycle, nor is it completely predictable. I just "got over" a 9-month horrible, serious depression, but now with this cycling in and out of suicidal depression I don't know what to think, or do. I'nm on Nardil, Nortriptyline, lamictal, and lorazepam or zyprexa when needed. Does anyone else have this experience? I'm desperate to know, as I feel like a freak experiencing this on my own.
This is the end of the thread.
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