Read this week’s edition of Grand Rounds at Health Business Blog – there are more posts on wellness this week, and a very interesting post on the real dangers of Accutane, the drug commonly given for acne. Check it out! Pretty interesting to see what those within the medical community are thinking and doing.
Archive for Other
Check out this week’s addition of Grand Rounds at Dr. Wes, an interesting and varied collection of posts ranging the scary – a health blogger being harassed by a big-shot lawyer who does not like her posts about mercury in vaccines, to the hilarious – a TV commercial exposing how physical activity is simply not in our mindset – and everything in between. Well worth the read!
Okay, I’m feeling a bit the fool. You see, on Tuesday April 1, Grand Rounds came out, and my post that I had submitted was not included, or so I thought.
Now just to explain, Grand Rounds is published every week on a host’s blog, and it highlights the best posts of the medical blogosphere each week. Now I have submitted many posts to Grand Rounds, and most of the time my posts don’t make the grade, and I’m not included. Once I made it when HealthBlawg was hosting, when I submitted my post on cholesterol, mortality and cholesterol-lowering drugs, and that made my day. Since that time I have not been so lucky, so this week, when once again my post wasn’t included, I decided to ask for feedback so I could learn what the criteria are for inclusion. So, on April 1 first thing in the morning, I popped off an email question to GruntDoc, who was hosting this week’s edition of Grand Rounds, and then immediately headed off for a 3-day mini ski vacation to Whistler.
When I got home, I noticed that the baton of Grand Rounds was passed around amongst 7 different hosts this week, and my post showed up on the MedGadget segment. Yeah! I also found an email in my inbox from GruntDoc, explaining to me what had happened with this week’s edition, so, I guess it was April Fools on me! I simply wasn’t patient enough.
So, check out this week’s fun edition of the Roving Grand Rounds, starting at GruntDoc, then to “dregs” Grand Rounds at Dr. Val’s, then to “masterpieces” Grand Rounds at David E Williams Health Business Blog, then to “well conducted research” Grand Rounds at medgadget, and then onto “video” Grand Rounds at Dr. Anonymous, then to Dr. Rob and “Mutant” Grand Rounds at Musings of a Distractible Mind, and we finish up with “Valley Girl” Grand Rounds at Emergiblog.
It’s December, and that means that in my neck of the woods in southwestern Canada we are getting a lot of dark, dreary, rainy days. The sun comes up after 7h30am and goes down around 4h30pm. Many of us long for a nice sunny vacation at this time of year to cope with the lack of light and the winter blues. "The winter blues" is mild compared to what those that suffer from Seasonal Affective Disorder (SAD) go through – severe depression in the winter time that then clears up in the spring when there is more light. Seasonal Affective Disorder is not something to be taken lightly, as it can impair one’s life to the point of not being able to function. People that are affected not only feel depressed, but frequently also feel lethargic, sleep excessively, are more sensitive to pain, tend to withdraw socially, crave sugar and often gain considerable weight.
Just as we need adequate dark time each night, we also need adequate light during the day for good hormone function. It seems that those who suffer from SAD need bigger differences in light and darkness for their hormonal systems to function appropriately, and interestingly enough, a far larger percentage of SAD sufferers than would be expected by chance, were born in the fall and the winter when there is less bright light during the day, and fewer light-time hours. I wonder if the lack of light exposure in the first few months of life has anything to do with developing SAD later. If we consider primitive humankind, it would make sense to time the birth of children to when food would be plentiful to encourage survival, just like in the rest of the animal world. And plentiful food usually occurs when there is more daylight and plants are growing. That said, snow-cover in the winter can be extremely bright, but most of us in our modernized world do not spend all day everyday outdoors when it is cold and snowy.
The hormones melatonin and cortisol and the neurotransmitters serotonin and probably dopamine are involved in SAD. Melatonin doesn’t seem to turn off adequately at dawn, causing morning drowsiness and oversleeping. Cortisol doesn’t seem to rise adequately in the morning which may contribute to lethargy during the day. Melatonin and cortisol influence serotonin function, and low serotonin levels are linked to depression in general. So gaining control over cortisol and melatonin is key to feeling better.
The most successful treatment method for SAD is using a full-spectrum fluorescent light box that provides about 10,000 lux of light each morning upon awakening for half an hour to an hour. Such a light box provides about 25 times more intense light than does most indoor lighting, and research shows that this boosts morning cortisol and suppresses melatonin. These light boxes can be purchased for home use, and they need to be used consistently each morning for at least three weeks before most people suffering from SAD will begin to feel better. It makes sense to me that the opposite side of the equation should be addressed too – complete darkness at night, and a good nine hours of darkness to boot. Black-out drapes are very helpful. Because SAD seems to be a circadian rhythm dysfunction, being very consistent with bedtimes and wake up times may help get the body clock back on track. So, turning out the lights at 10pm and using the light box at 7am consistently should work well.
As I have explained before, light and darkness play a fundamental role in our desire for carbohydrates. The later the lights are on at night, the higher our evening cortisol, the more we want to snack on carbs and sugar, the fatter we get. The cortisol connection may explain why SAD sufferers crave carbohydates and gain so much weight. Eating quality fats when wanting carbs may help suppress the cravings.
Morning exercise would probably also be extremely helpful, as exercise would not only boost morning cortisol, but would also reduce depression.
Online at Mood Disorders Society of Canada
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Copyright 2007 Vreni Gurd
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