This column offers mental health and wellness-related information to the Massachusetts legal community. Lawyers Concerned for Lawyers bases the column on questions frequently asked by its clients and help-line callers. The information is general in nature and not meant for treatment.
Q:I am 33, enjoy my current position with a small law firm, and consider myself to be a reasonably happy, well-adjusted person with a good home life. However, during six years of marriage, my wife has found me difficult to live with in the winter. I become unusually tired, irritable and unmotivated to do much, even to get out of bed. As I dread the next few months, I would appreciate your input.
A:Based on your description, you may have a classic case of “Seasonal Affective Disorder” (SAD). SAD is now conceptualized in the mental-health field as clinical depression with a seasonal pattern. It can share any of the symptoms of depression, including those associated with Bipolar Disorder (depression that cycles from manic to depressive states). The symptoms that you mention, along with weight gain and craving for carbohydrates, are very common to this type of depression.
Ongoing research indicates that there is no one factor to account for SAD. Exposure to light may influence the body’s circadian rhythm, or possibly the level of various hormones, though these hypotheses are still debated. It is almost certain that the disorder involves a low level of serotonin (a key brain chemical affecting, among other things, level of energy vs. “hibernation”).
Fortunately, you don’t have to wait for spring to feel better. Both light therapy and SSRI antidepressants can be prescribed by a physician and have proven effective.
Of various forms of light therapy, the best evidence of effectiveness is for the fluorescent “light box,” which (when it works) generally produces results in one to two weeks. Some studies also suggest that increased exposure to natural morning light, keeping a regular daily schedule, and getting exercise may be as helpful as light boxes.
Talk therapy can be a helpful adjunct.
LCL, as well as your primary-care doctor or mental-health professional, can assess your condition and make an appropriate referral. We recommend that you initiate treatment before the arrival of winter’s darker days, as you will have a better opportunity to head off a severe episode of seasonal pattern depression.