Spring and summer seasonality depression” per Mayo Clinic – “Summer – Anxious, insomnia, irritability, agitation, weight loss, poor appetite, increased sex drive Seasonal bipolar worsening in spring and summer: thoughts and speech, persistently elevated mood, agitation, hyperactivity, increased enthusiasm out of proportion to situation DSM-V: Bipolar with seasonal pattern: temporal relationship between the of manic, hypomanic, or major depressive episodes and a “Regular particular time of year” exclude cases with seasonal worsening of psychosocial stress like school – starting. Full remission also occurs at a characteristic time of year. Documentation of 2 years of the pattern. Mood changes associated with the seasons outnumber” any other mood episodes “substantially that may have occurred over the individual’s lifetime. Treatment: 30-60 minutes 30-60 cm from the eyes; October 15 April 15 – Light: 10,000 Lux of full spectrum (“artificial sunlight”) 2500 Lux of 480 nm blue --- Philips Go-Lite Blu 350 Lux of 500 nm blue-green light Sun exposure Dawn simulation -- Effective 50% vs. 57% for bright light therapy Philips Wake-up Light, White – Negative air ionization Himalayan salt lamp – Vitamin D inadequate ultraviolet rays on skin to deficiencies studies mixed about Vit. D – – treatment Both fluoxetine and light therapy are 67% effective in treatment of SAD using direct head-to-head trials. Light therapy was faster (improvement begins in one week). Compliance better with pills. Melatonin to regulate circadian rhythm avoid high doses in kids. – Exercise DHA essential acid obtained in fish oil – I tell patients to get light boxes on eBay other brands: Verilux, NatureBright Sun Touch, Northern Light – Technologies Note: Tanning beds are not light therapy
Spring and summer seasonality – “Summer depression” – per Mayo Clinic Anxious, insomnia, irritability, agitation, weight loss, poor appetite, increased sex drive Seasonal bipolar worsening in spring and summer: thoughts and speech, persistently elevated mood, agitation, hyperactivity, increased enthusiasm out of proportion to situation DSM-V: Bipolar with seasonal pattern: “Regular temporal relationship between the of manic, hypomanic, or major depressive episodes and a particular time of year” – exclude cases with seasonal worsening of psychosocial stress like school starting. Full remission also occurs at a characteristic time of year. Documentation of 2 years of the pattern. Mood changes associated with the seasons “substantially outnumber” any other mood episodes that may have occurred over the individual’s lifetime. Treatment: 30-60 minutes 30-60 cm from the eyes; October 15 – April 15 Light: 10,000 Lux of full spectrum (“artificial sunlight”) 2500 Lux of 480 nm blue --- Philips Go-Lite Blu 350 Lux of 500 nm blue-green light Sun exposure Dawn simulation -- Effective 50% vs. 57% for bright light therapy – Philips Wake-up Light, White Negative air ionization – Himalayan salt lamp Vitamin D – inadequate ultraviolet rays on skin to deficiencies – studies mixed about Vit. D treatment Both fluoxetine and light therapy are 67% effective in treatment of SAD using direct head-to-head trials. Light therapy was faster (improvement begins in one week). Compliance better with pills. Melatonin to regulate circadian rhythm – avoid high doses in kids. Exercise DHA – essential acid obtained in fish oil I tell patients to get light boxes on eBay – other brands: Verilux, NatureBright Sun Touch, Northern Light Technologies Note: Tanning beds are not light therapy
Seasonal%20Affective%20Disorder.docx