Living Well in Myanmar

Good News:  We’re 3/4 of the way through rainy season

While meeting with my editor at the Myanmar Times last week we discussed the feeling of ‘blah’ that tends to arise in friends, family, and colleagues at this time of year in Myanmar.  That got me thinking about Seasonal Affective Disorder (SAD), which is well known by doctors who practice in winter seasons in Western countries.  Although we don’t have research for seasonal depression specifically in rainy season countries, there is likely a good correlation between the disease in northern latitudes and the tropics.

SAD is defined as recurring down feelings that occur with a particular season and resolve when the season ends.  While the cause of SAD has not been biologically proven, the prevailing theory is that decreased daylight can cause alterations in hormones named melatonin and serotonin that regulate energy and mood.  Additionally, changes in regular light patterns may negatively affect the body’s internal 24-hour clock, known as your circadian rhythm.

Western winter-season SAD has depressive symptoms such as:

·      Sleeping more than usual

·      Having a bigger appetite than usual, especially for sweet or starchy food

·      Weight gain

·      Becoming cranky or irritable

·      Interpersonal difficulties such as rejection sensitivity

·      Heavy, tired feelings in the arms and legs

Interestingly, some of these symptoms are different than the typical vegetative symptoms of depression such as weight loss, decreased sleep, and poor appetite, which lends support to doctors that consider SAD to be diagnostically unique.

The other distinctive feature of SAD is its therapeutic response to light therapy. Up to 80 per cent of patients who receive the diagnosis from their doctor respond well to timed exposure to artificial light, and some psychiatrists and family physicians use light therapy to prevent the onset of SAD in people who have had it in previous seasons.

If you feel that you struggle in our overcast rainy months, a home version of phototherapy may help.  Exposure to bright light for 15-30 minutes per day, particularly early in the morning, might re-establish your circadian rhythm and fine-tune your melatonin and serotonin levels.  Bright light means a source with 10,000-lux (the equivalent of what your eyes would sense in full daylight). Flourescent light is best. While sitting under the light (not staring at it!) you can read, work, listen to music, etc as long as the light is in your field of view.  Many people begin to feel better within the first four to five days, and the benefit usually lasts as long as you continue the treatment.  The negative side effects of light therapy are headache, fatigue, irritability and excessive sensitivity to light.

In training to become a doctor we had 24-hour shifts delivering babies in which we never saw natural light.  In our meeting room we had a light box that we switched on in the morning with the intent of re-establishing our circadian rhythm.  I can’t say whether it really made us happier to be in the hospital, but you can know that some doctors do it.

If you or a loved-one is experiencing many of the symptoms above, even to a moderate degree, it is best to meet with a doctor prior to attempting treatment on you own.  There are often several factors impacting mental illness and treatment approaches – which also include medications and behavioral therapy – should be individually tailored.  © Christoph Gelsdorf 2013