Seasonal affective disorder, Part II: Phototherapy, an expanded role of the psychosocial nurse

Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches

Seasonal affective disorder or SAD is a recurrent major depressive disorder with a seasonal pattern usually beginning in fall and continuing into winter months. A subsyndromal type of SAD, or S-SAD, is commonly known as "winter blues." Less often, SAD causes depression in the spring or early summer. Symptoms center on sad mood and low energy. Those most at risk are female, are younger, live far from the equator, and have family histories of depression, bipolar disorder, or SAD. Screening instruments include the Seasonal Pattern Assessment Questionnaire (SPAQ). Typical treatment includes antidepressant medications, light therapy, Vitamin D, and counselling. This paper provides an overview of SAD.

Understanding Sleep Disturbance: Pragmatics for Home Health Care Providers

Sleep is not only an integral part of everyone's life, but provides an incredibly accurate mirror on the quality of life. Disturbed sleep equates with disturbed daytime functioning. Such a correlation makes great sense, particularly with the realization that sleep and wake cycles are based in the same biological rhythms. While everyone has a few nights of suboptimal sleep from time to time, some people live their lives sleeping poorly, experiencing daytime sleepiness, and functioning marginally. The causes of these patterns of poor sleep are many, and this paper will focus on how to focus a lens on clinical assessment of sleep to make sense out of sleep-related complaints and related behaviors in persons receiving home care services.

Understanding seasonal affective disorder and experiences in northern Norway

PURPOSE

To better understand a diagnosis corresponding to mental distress and sleep disturbance associated with seasonal change known as seasonal affective disorder (SAD).

DESIGN

This ethnographically guided investigation, conducted from 1993 through 1995 in Tromsøo, Norway at a latitude of 69 degrees north describes how the residents experience extreme seasonal change.

METHOD

Qualitative interview data from 28 participants plus observation, folk wisdom, and literature were used to describe local understanding of seasonality and illustrate how cultural values, meanings, and practices can contribute to alternative experiences that differ from scientists' expectations.

FINDINGS

While there is evidence that human physiologic alterations occur in response to the changing seasonal patterns of light and dark and to a greater extent, at latitudes further from the equator, the findings related to psychological changes and their causes remain inconsistent and controversial.

CONCLUSION

Investigators concerned with the effects of seasonal change should be aware of and develop an appreciation of cultural perception and adaptation.

Seasonal affective disorder, Part I: A review of the neural mechanisms for psychosocial nurses

This article is the first of a two-part series on Seasonal Affective Disorder (SAD). Mental health and nursing researchers are beginning to investigate the implications of seasons on mood and mood states. Delineation of SAD and its treatment by phototherapy is an example. This article reviews the pertinent research regarding the hypothesized neural mechanisms of SAD. Three competing hypothesis are contrasted and compared: the melatonin hypothesis, the phase delay hypothesis, and the photon counting hypothesis. Although no one theory is universally accepted, current data supports the phase delay hypothesis and suggests that morning phototherapy is the most effective treatment.