SAD Symptoms - some lesser commented on observations

I have no idea if I am typical of other people with SAD but here are some observations and conclusion that I have come to.

* My SAD is worst in the mornings and I am almost brain dead until about mid-day and then slowly start to function. My peak mental state usually comes between 10 pm and 2 am, and hardly surprising, it is at this time that I can actually get on and do all the things that have eluded me all day.

* When I wake up on the morning, I have distinct bright red patches around my nose and following my nose up towards and partly around my eyes. As the day goes by and my mental state improves, these red patches disappear. I have come (I think) to realise the reason and significance for this. More on this later in this posting.

* My diagnosis earlier this year of persistent higher than it should be blood sugar (an indicator of adult on-set diabetes) has set me thinking. Is there a connection between this and SAD, or at least the worst aspects of it. I have a reason for thinking this and again this will be explained later in this posting.

OK lets start with the SAD symptoms. I start this discussion with the pre-conception that these symptoms and associated behaviours relate to a genetically inherited trait that favours winter survival.

I have often felt that I am hibernating, so to speak, in winter. I refuse to go outside unless I absolutely have to. This is an "instinctive" behaviour, not driven by any fears at a psychological level, but probably related to an inherited genetic ancestry of behaviours that tended to favour survival in the harsh winters. I can go out, and often when I have done so, I feel much better for having done so. But the logic of going out making me feel better is not powerful enough to overcome the instinctive behavioral pressure NOT to go out. I really do think that this is, in some way, an instinctive "energy saving" and "keep out of risk" strategy on the part of my brain. If you have enough food and it is warm and comfortable inside, it is better strategy for surviving the winter than going out Sit at home and do put yourself at risk of losing your energy stores that will keep you going through the winter season, or succumbing to hyperthermia (an almost negligible risk today, but not so to our genetic ancestors not so many years ago).

The other issue that set me thinking was the curious matter of what happens to me when my depression comes on and when it lifts. When it comes on there is a distinct phase when my body temperature appears to drop. I say appears to drop because this is a perceptive thing that I have not measured with a thermometer. Needless to say, it usually happens around September/October at which time I have to ask people if THEY feel cold. It is a funny thing because I do not feel that my environment is cold... I kind of know that it is ME that is cold, but I need to get people to verify this by confirming that they don't feel the same way. This tends to come on bad during the middle of the day when I am at work and may last for a couple of hours before wearing off. And the symptoms may recurr every few days before stopping. I now suspect that this is the first perceptive signal that things are going to be different, but until last year I did not cognitively make this connection. I suspect that Mother Nature is sending me a signal to prepare for the winter. Keep warm, get eating and build some fat reserves for the winter!!!! So starts the food cravings, and the periods of long inactivity and the desire to stay home at all costs.

Another related observation came at Christmas time a few years back. I was going out with my son and he was amazed at how lightly I dressed to go out. He said it was freezing cold out there.. but to me it was just mildly chilly. Now some might say that this is the result of the layers of fat around my body that tend to come on over winter. But I think not. For this reason. When spring comes, there is usually day or a few days that come when again I feel absolutely freezing cold. But this is completely different from the Autumn chill I go through. This time i KNOW that it is MY ENVIRONMENT that has become cold (or seemingly so). My reaction to this is to want to get moving and generate some internal heat. What's more, when this happens, suddenly all the energy that I lacked in the winter is gone and I can be wonderfully active and "normal" again. I know for a fact that this is a PERCEPTUAL experience because my thermometers at home confirm that the interenal and external temperatures have actually NOT changed. The upshot of all this is that IN WINTER, I DO NOT FEEL THE COLD AS MUCH AS I SHOULD. Somehow mother nature has blessed me with a coldness perception blocker, but she has also landed me with a set of "behaviours" and "conditions" that protect me from getting exposed to the cold. These "behaviours" are in fact my depression. When spring comes, it's as though that cold protection mechanism in my head that stops me feeling cold has been turned off.

Now what about the red nose and eyes that I seem to have when I wake up in winter? This is actually one of the best indicators of my mental mood! The redder the patches, the more zombified I feel. This year, I have been fortunate enough to be unemployed and have time to watch these things a little more closely. I now realize that in fact, the blood supply to my facial skin changes. The patches seem really red, and I have been inclined to think my skin there is inflamed. But having paid more close attention to these things I now realise that in fact I really have white skin that is drained of blood around most of my face and in effect, the skin around my eyes and nose are really is more or less as it should be!!!! As the day goes by, the colour of the skin in the other areas of my face reddens up and so the so called patches around my nose and eyes seem to disappear or blend in. So I conclude that the blood supply to my skin is severly restricted in the mornings. What I think is happening is that when I go to sleep at night, as heat saving measure, the external blood capilliaries around my skin close up. For all I know, it may be happening in my brain too, which may explain the zombie like feeling I have at that time of day. I have now noticed that at night time, the skin all over my body tends to redden up. I think what is happening is that my body's internal furnace is being turned up, probably to counteract that historic genetic expectation that I will experience winter's cold and need some protection from it. This "opening up of the furnace" is really just the increased activation of all the cells in my body. It is why I feel alert at night and dead during the day when the furnace is turned down.

The mind and body connection is really quite marked. I recently bought a skipping rope to lose some weight. I find that if I use it when my skin is pale, I tend to trip up more easily in the rope and can only skips about 10-12 times before starting to feel tired. When I feel mentally alert, I have noticed the skin on my face as well as elsewhere (such as the backs of my hands) is quite "pink" and I can skip hundred or so times and perhaps make just one or two trips in the rope. I think this blood circulation issue is the reason why I can't run for the train in the winter and why the heart rate monitor at the gym behaves as it does. Because I have poor circulation, my poor heart is pumping like mad to push blood round contricted capilliaries, and not succeeding! Which is why I get so ****** tired and why my brain is not working as it should!!! But why are the eyes and nose not deprived of their blood supply? Well, if you take an evoltionary biology view of this issue, I think that is clear why Mother Nature has not deprived me of all my senses!

Well at least I now think I know what is going on. Of course, it will be for others to find out why.

One last thing. A few years back I started the Atkins diet and lost an amazing amount of weight. I think I went from over 195 lbs (14 stone or 89 kilos) to 175 llbs (12.5 stone or less than 80 Kg), which is still slightly higher than the recommended weight for my height. This was the only winter I can recall when I did not get a severe winter depression. And my activity levels went up and I was a regular caller at the gym. That year I felt incredibly "smart". My technical job as a computer systems analyst suddenly seemed easy. I could do in a few hours what would normally take me a day and half to do. I could read my newspaper on the 30 minute journey train journey to work. I would know that I had skim read all the key articles of the day that interested me, read in depth all the articles that I wanted to read deeply, and knowingly scanned and declined to read all the articles that I did not want to read. If that is how you read a newspaper then I think you may think me mad for mentioning this. But because of my depression, I no longer function like this most days. In winter time I have barely finished reading pages 1 and 2 of the paper before my journey's end. Not even in summer, though it is nowhere near as bad as in the winter. I felt like I had emerged from a nightmare into a wonderful world of colour and interest. I started a University Course. But as I neared my target weight, I started adding back the carbohydrates to my diet. And at this point I noticeable started to slow down mentally. This was around August /September 2000. At this time I had not even recognised the seasonal nature of my depressions thought I had been having them for at least 5 or 6 years. In fact, with a high pressure job, a busy family commitment and a university course to do it all became too much. I gave up the course and lost a lot of money as a result. Soon after, other external things made life even more complicated and I lost focus on my own health for a couple of years. By the time I did so, I realized that my weight problem was ever worse than before. Although in the description above the slowing down could be attibutable to season or carbohydrate addition to diet, I did not actually make the connection at the time.


The interesting thing about the carbohydrate factor was my recent diagnoses of adult on-set (type 2) diabetes. I read that in this condition, the body produces insulin to mobilse sugar, but die to factors unknown, people like me do not seem to get the energy into the cells. We tend therefore to put on weight and have high blood sugar. Under instructions from my doctor to lose weight and knowing whatI now suspect about carbohydrates, I re-started the Atkins diet. I did this knowing that it surely must get my blood sugar down if I stopped taking sugars/carbs in my diet. Again I quicky lost weight. I started about 8 weeks ago and have lost a steady 2 lbs or almost a kilo each week. And here is an amazing observation. My skin in the mornings was no longer blotchy. My skin colour was remarkably red.. I sometimes look as though I have been in the sun, even though this is Finland in Wínter and the snow has already come! I have been able to swim 1000m most days or go on long walks and not get tired. My body is largely fuelling itself on body fat, and at the beginning of November no sign of the winter blues. Then, as an experiment, this week, I started adding back a few carbohydrates to the diet. The ketone urine strips have stopped turning red and so my body is now out of ketosis. And guess what?!! The red eyes and nose are back, the problems focussing during the day are back, and its impossible to get to sleep before 3 am. I am tired and starting to crave carbs again. Back to the old routine. Well, as you can guess, I will be putting myself back on the Atkins diet soon, even though I have to go through that hunger pain barrier again. But I think it will be worth it. I have not yet reached the peak of mental alertness I experienced back in 2000 and I am only now at the weight I was then when I STARTED my 1999/2000 diet. But at least there is hope.

Success in resetting the body clock!

The success I had in resetting the old body clock was excellent news as it allowed me to get back to my studies. I have been keeping a sleep diary in MS Excel which clearly shows the periods when

• I get tired,
• when I actually sleep,
• when I wake,
• and whether, when I wake I am dreaming.

I have also been tracking my mood, by which I mean how active I wish to be intellectually.
When I am good,

• I feel bright, and
• want to be physically and mentally active.

When I am bad,

I feel as though my body is awake but my thinking brain is asleep...
I cannot think clearly, my memory is shot through, and I just want to sit and do nothing (these are the times when bliss is to sit and wash the washing going round and round in the washing machine. Anything more taxing than this is impossible).

Then there is a medium feeling between these extremes when

• it is hard to motivate oneself, but not impossible,
• though the effort to da anything is ridiculously taxing physically and mentally.

The upshot of keeping this diary is it confirms that

• my go-to-sleep-time is shifting forwards by about 30 mins on average a day
• I can only dream (or recall any dreams) when I have been asleep for at least 6 hours
• I feel better if I have been dreaming
• It is much better to go to bed in the early evening and wake when it is still dark than to go to bed late and wake up when it is light.. (this confirms my suspicion that the light coming up is like a wake up call (probably histaminic)
• If I get insufficient sleep at night, I can sleep in the afternoon, but this sleep does not culminate in dreaming..its as though my lower brain has completed its sleep cycle but did not trigger any useful sleep activitiy for my higher brain.
• My depressions are more a result of insufficient continuous sleep than anything else. Failure to regulate my go to bed time is probably the biggest cause

In the last few days, my get to sleep time was getting so late again I was beginning to miss classes at the university. So I have again gone a whole night without sleep in order to move my go to bed time to the early evening. It seems to have worked, as yesterday I was able to go to bed at 8pm, be asleep by 8.30 and woke up dreaming. But I was than able to get up and do the homework that had been staring me in the face for the previous 12 hours without gaining a glance from me (because of my poor mood). So some good success!!!

This time I need to find some strategies for stopping the body clock drifting forward. I will try being more firm about my go to bed time. If that works I will not resort to using the light box (because I have had mixed results in the past with this). Sadly, going to bed at 8pm is not very good for my social life, as I would like nothing better to go to the bar and socialize with my friends. However, if I can stop the body clock drift with regular hours I would be more willing to go out a bit later. But my health is most important to me right now and I must put that first. Speaking of which, last week I got some blood test results last week. The important things were that

• My TSH was 3.5 (which my finnish doctor thinks is OK, but I know is bad because I always feel better when it is below 2 and better still when it is at 0.5)
• My Creatine levels were above normal range (this is probably familial because my Dad had a similar problem). I'm not sure what this could mean. Doctor did not seem over concerned, but I should have told her about my brother's kidney cancer, because Creatine is a sign of kidney malfunction.
• My Cholesterol leves are also high. Last time they were tested they were also above normal. The advise was to cut down on animal fats (unsurprisingly). I am also trying Benecol.. a Finnish product I should add.
• And to make matters worse, my blood sugar levels were also considered to be too high. But no advice from the GP other than I need to lose weight (which I know anyway, but its hard to exercise when I feel low).

Next week I start my start my work placement as part of my university course. I am looking forward to this, but with a little bit of trepidation. Still, we shall see soon enough how it goes.