Looking for advice on what treatment needed for SAD
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Posted by traceyd, 18:57 10 July 2004Hi Everyone
This is my first post to the forum. My husband has had SAD for the last 3 winters and suffers badly with panic attacks, paranoia, sleep disruption, tiredness, plus the depression and more. He is a technophobe so although would look at the forum, would not post without help (winter or summer)!! I help as much as I can but it's difficult to know what he needs at different times - sometimes wants to be alone, others I can't leave him in the house on his own. We have a lightbox which seemed less effective last winter than when we first used it 2 years ago. Have read the posts regarding getting into a pattern that suits you so will try that - thanks for those thoughts. My main area where advice is needed is that although our GP is sympathetic, so far he has only offered anti-depressants as treatment, he has no other SAD patients so no experience and seems to want to start with the easiest option. I would like to try to get referral to a specialist for expert help, but not sure how to go about this? Also we haven't had any counselling to establish whether there is a cause other than SAD - both his parents died in wintertime so there is another reason to feel bad in winter. Would counselling be good idea before taking drugs? Finally, if drugs is best, and working on the basis that it will be for long term each winter, are there ones specifically that are best for sufferers of SAD? In the meantime he's out there making the most of the summer (such as it is) and pretending that November will never come. Any suggestions or thoughts would be really appreciated. Thanks, Tracey | |
Posted by Bright One, 09:48 12 July 2004Hi Tracey
I think (don't quote me) that the SAD Association www.sada.org.uk have an info pack they can send to GPs. I'm not sure, I might have imagined it but there's no harm in giving SADA a call to find out if they have any advice/research contacts for GPs. I can't really add anything to the list of stuff you're already doing/getting your husband to do. The only thing I would suggest is keeping a journal/diary. And that advice is directed at you and your husband. It will help him keep track of his thoughts and feelings and directly tally them with the light levels and help you keep track of your feelings and if you agree that you can read each others diaries (with permission) then you can often find out how the other person feels without the risk of anger and frustration because it can't be explained properly. Remember it is as important to look after yourself and your sanity. I think the diaries help with this because sometimes I find it hard to verbalise what I want to tell my husband and writing it down either helps me get it straight in my head or lets me ramble so he can actually see how hard it is for me to organise my thoughts. Take care and keep up the good work B! | |
Posted by Lorraine, 22:07 13 July 2004Hi Tracey,
There could be other causes, as you say he has the anniversary of his parents's death in winter, but it certainly sounds like it could be SAD. In what sense is his sleep disrupted in winter? I ask because I think that standard clinical depression is typified by a tendency to wake very early for some people, while with SAD people may get the 'hibernation' urge with trouble waking up, so they're more likely to sleep late without help. To confuse things I can get either type of sleep disturbance when I'm feeling bad but the old hibernation thing tends to happen most often for me in winter. Where drugs are concerned, I have had Prozac during winter in the past. I may take them this winter, as I found it hard going last winter without antidepressants. I tended to stay on them until about March or April then go onto 1 every other day for a few weeks before stopping. I didn't find them hard to stop taking. My only real concern about it is, what if it is affecting brain chemistry long term, who knows? But there was no doubt they made a huge difference to me on the times I took them. What drugs is your husband's doctor suggesting? Lorraine | |
Posted by Anonymous, 10:28 14 July 2004First and foremost Tracy don't be afraid of boundaries with your husband if his moods are affecting you. Ultimately make sure you are okay because it can be very tiring and upsetting for you to support him.
I don't have a problem with Prozac and it helps a bit particularly in the depths of winter. Your guy needs to look at what works for him, I need lighbox first thing in morning and top up later on, regular strenuous exercise, keeping an eye on junk food that makes me lethargic e.t.c. Its all a bit of an effort and I know I am really narky with my partner (bloody nightmare really!). Anyway don't forget your needs, siddy | |
Posted by Maddy @ OI, 13:14 15 July 2004Hi there,
I work for Outside In and have a few suggestions. Firstly you say the lightbox is working less well now. It may be that the bulbs need replacing as they start fading after 2 - 3 years. I think Bright One's idea of a diary is very good. If you need to check light levels see http://www.weblightmeter.com/ Please feel free to call us on 01954 211955 if you have any questions. Maddy | |
Posted by traceyd, 13:18 10 August 2004Dear Bright One, Lorraine, Siddy and Maddy,
Thanks everyone for the useful information and suggestions, I've had a busy month and only just got back to the forum to see the posts. I have printed your responses out so I can talk about them with my husband. In answer to some of your questions, we need to go and see his GP soon in preparation for the winter, as I'm hoping we may be able to get a referral to a specialist, and I will get an info pack from SADA to take with us, so the GP is more informed. I'm not sure which drugs the GP was suggesting, so I need to check that out too, I think he mentioned SSRI's. The journal suggestion was really useful - my husband did keep a diary of how he felt for a couple of weeks last winter as I had to be away on a course, and he felt very vulnerable without me and needed lots of support from friends to keep going on a daily basis. It was very difficult for both of us, and was also quite a surprise how hard we found it. Sleep disruption in winter is nearly always waking very early in the morning, 5am or earlier, and not being able to get back to sleep. Some problems getting to sleep, with occasional panic attacks, but the early waking is very hard, it was interesting the comparison with clinical depression - he completed the SAD symptoms chart across 3 winter months and scored an avge of 44 for standard depression, and combined total avge of 48 - this seemed really high but I don't know if that is normal for SAD or not? If anyone can advise that would be useful. Regarding hibernation, he doesn't want to sleep loads more, but definitely says he feels safe in bed and often doesn't want to get up, and once up doesn't want to go to work. He has quite often avoided going out of the house and I find myself almost forcing him out for a walk together, on the basis that once exposure to daylight has got into his system, he will be OK for the day, and it usually works. A reversal of this pattern is on a sunday when we often walk with friends and are outdoors for most of the day, and when we get home he very quickly becomes upset and emotional when indoors. One thing he suffers from which I haven't noticed anyone else mention is that his speech (or brain activity) is affected when he is SAD, and he has problems in putting lucid sentences together, and his speech is almost slurred. I would be very interested to know whether anyone else has this problem or has experienced it. Thanks very much for the help, Tracey | |
Posted by Lorraine, 11:21 11 August 2004I don't really know about the slurred speech, it hasn't happened to me. I think many of us could probably relate to not being as sharp-witted in winter.
Lorraine | |
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