Well i’m a-gonna raise a fuss, i’m gonna raise a holler
About workin’ all summer just to try an’ earn a dollar
Everytime i call my baby, to try to get a date
My boss says, “no dice, son, you gotta work late”
Sometimes i wonder what i’m gonna do
’cause there ain’t no cure for the summertime blues’ (Eddie Cochran)
In a previous posting, I discussed the joys of having a stress free summer vacation, but I have noticed a significant trend among patients this summer. A trend, which at best, seems to be growing in a very rapid pace over the past few summers. This trend is the emergence of what the National Institute of Mental Mental (NIMH) has termed “reverse SAD” or reverse Seasonal Affective Disorder. SAD is most commonly asociated with the dark and gloomy days of winter where afflicted people suffer symptoms of depression including, but not limited to, fatigue, lethargy, excessive sleep, hopelessness, social withdrawal, decreased interest in activities, weight gain, irritability, and general feelings of apathy. “Reverse SAD” presents itself in the sunny summer months and will often include the symptoms of anxiety, restlessness, insomnia, feeling uncomfortably warm during the night, episodic anger, weight loss, irritabilty and decreased appetite.
Please humor me because I have to take a moment and again reflect back to my youth. Recently, I ran into a friend from the old neighborhood. It was great seeing him and catching up with all the happenings in our lives. Inevitably, we went back in time and talked about some of the fun things we did “back in the day”. During our summer vacations from school, we would gather other kids from the neighborhood and play baseball, capture the flag, football, head up to the community pool, ride bikes, tell jokes, and plan adventures. Growing up in a city community, there were always kids around to do all the aforementioned activities. I still get a minor thrill when I hear the bells from the ice cream truck or the sounds of the midway at a school festival. The very thought of a summer job or summer reading did send me in a bad mood, but I would quickly bounce back when a fun activity presented itself.
It was perplexing to me, at first, when patients came in suffering from reverse SAD. I thought, “How can you feel bad during the summer?” The signs and symptoms are very tangible and can be debilitating at times. Reverse SAD can be linked to the brain’s hypothalamus and temperature control issues in the body. As the temperature rises and the sun beats down on the patient afflicted with reverse SAD, the body’s natural ability to find a balance appears to be thrown off. The production of Serotonin (a brain chemical that is involved with the regulation of mood) and the hormone Melatonin appear to play a major role in the symptoms of SAD. There is also some evidence suggesting a low thyroid funtion could be the culprit in reverse SAD.
I can’t help to think environmental factors may play another large role in reverse SAD. We, as a nation, are going through some seriously stressful times. Last summer’s gas prices alone could send anyone into a depression. The unstable job market and economy has made people reduce spending in luxury areas. Families who have previously taken extended summer vacations may find themselves staying closer to home or not taking a vacation trip at all.
How can we treat reverse SAD and cope with the summertime blues? Unlike winter time SAD, light therapy is contraindicated. Minimizing light sources is the first part of the treatment. Patients may want to consider wearing polarized sunglasses, using room darkening shades in the house, and reducing activities during the daylight hours. Exercise and a healthy diet are always a good combination when it comes to combating depression. Drinking cool water along with regular cool showers may help reduce symptoms. An exam of the thyroid’s functioning from your primary care doctor is suggested. If symptoms persist, you may want to consider a prescription of an anti-depressant. Finally, as a good rule of thumb, try to surround yourself with friends and family who love and care for you. Human contact can often have healing powers.