Feeling sad? Maybe you have SAD

Katie Couric used to be called "perky." When I think of perky, I think of my mother's old coffee percolator with Chock Full O'Nuts. Most patients and people I know say to me, "Where do you get your energy? You are so perky!"

My response is, "Better living through chemistry and a mortgage to pay my therapists." Many people are clinically depressed, but there are some who are depressed only in the wintertime. They have what's called "seasonal affective disorder," or SAD. (Do you think Batman has SAD– living in that cave and working mostly at night? I think the guano alone would make anyone depressed.)

Too many people try to be John Wayne: rough, tough, and stoic. But then again, almost no one has won an Oscar like John Wayne, so it isn't realistic to live up to that tough image. "Buck up, dude! Get yourself together!" "Cheer up, babe! Life isn't so bad!"

Ten to forty percent of patients seen by primary care physicians have depressive symptoms: down in the dumps and/or not enjoying things in life. Other symptoms include change in appetite and weight, sleeping poorly or too much, thinking about death or suicide, crying a lot, withdrawing and becoming inactive, fatigue, poor concentration or memory, feeling guilty, having low self-esteem, and sinking to the depths of watching Jerry Springer to cheer up– or worse yet, Dr. Phil.

About nine percent of the population wrestles with SAD, mostly in places in high latitudes. Most people believe SAD is caused by the lack of sunlight during the cold winter months. In fact, there are two varieties of SAD: fall-onset and summer-onset.

So, yes, some people become depressed every summer into the fall, but this is pretty rare. Most people have fall-onset SAD, in which every late fall when the days become shorter– like your weekends and days off– depression and sometime anxiety set in. For those folks, not only does Halloween make them want to toilet paper houses and soap windows, it also makes Thanksgiving dinner as attractive as going alone to Chuck E. Cheese.

Those with SAD want to hibernate for the winter like Yogi Bear and Boo Boo. Eating becomes a soul-sharing experience with Oprah Winfrey with resulting marked weight gain. Irritability and difficulties with other people are common in SAD, which makes visiting the relatives over the holidays as fun as a visit from Bree Van De Kamp's mother-in-law in Desperate Housewives. Eggnog, anyone? More nog than egg, please!

Besides feeling tired all day and night, people with SAD feel like their arms and legs weigh a ton. But come the spring– "Here comes the sun/And I say it's all right." The mood improves with "Sun sun sun, here it comes!"

Antidepressants work very well in SAD, and some people take them six months out of the year to get through the dark months. I guess you could move to Australia half the year to escape fall and winter, but that would be a hassle for most people. Some people use light boxes, but studies still have not fully proven their effectiveness (though most of my patients swear by it, and I think it does help). Light sources of 2,500 to 10,000 lux are used from thirty minutes to two hours a day. Sounds luxurious, huh?

Maybe Ebenezer Scrooge wasn't such a bad guy. Maybe he just had SAD all year long. Instead of the three ghosts visiting him on Christmas Eve, maybe all he needed was a good GE light bulb or Rudolph's shining red nose.