Ain’t No Cure for the Summertime Blues

It is that time of the year yet again. It has been for a while now, but as I get further into the season I find it less and less bearable.

I hate summer. I hate it with as much passion as I can stir, which is actually very little because summer makes me so distressed and depressed that I cannot focus enough to have a passionate hate for it.

I hate sunlight. I hate heat. I do not like to set foot outside during it. If I could stay inside all the time, I would, and it would only help a little. It isn’t just the sun and the heat, it is all encompassing. I am better off if I put off any outings until night, but only marginally. I am less likely to have a total meltdown, but overall my ability to cope with ANYTHING is so diminished during the summer.

I get that I am not normal. There are so many people for whom this is their favorite time of the year. Others, who may not like the heat, might think they understand, but they don’t. Heat can be alleviated, but the overwhelming feeling of being trapped, of having nothing to look forward to, of just being stuck in misery until fall, that, they don’t have. A cold drink, and a nice breeze and they are enjoying their summer activities. The meaning of the word enjoy is almost beyond my grasp for the season.

I try. I try to stay cooler. I try to schedule things in small doses so I can keep on having minimal functionality and don’t have a total collapse, which just upsets me further. I like to get things done. That may be strongly worded. I HATE to not get things done. It really bothers me when I feel my productivity slipping for whatever reason. Truthfully, even vacationing is difficult for me because I am not “getting anything done.” If I go to long without getting enough done, it depresses me. The summer season depresses me. The only thing that alleviates some of the worst symptoms of the summer depression is scaling back my activities, and yet, accomplishing less depresses me. Is anybody able to see the problem here?

My antisocial nature increases, my ability to handle any sort of annoyance decreases. I could cry over drank milk, because it means I need to go to the grocery store to get more, and the grocery store is located outside of my house. It is expensive too. Our electric bills are astronomical because what small grip I have on something resembling normalcy depends on the AC working and working HARD. It cannot be just taking the edge off the heat outside, it needs to be cold, to battle against the looming oppressive heat and light that chip away at my will to breathe. I hate to go to other people’s homes because they will not keep it cool enough. If they come to my home they need a sweater. Not that there is a lot of inviting or accepting invitations. I am not in the mood for interaction and I have no social graces.

The problem has increased with age, and of course our move to SoCal amplified it and lengthened it. Summer here lasts much longer, and when I am the midst of it, I can see no end.

I am living in an endless summer.
If you can call it living.

Here are a couple of articles.
a few years old – Seasonal Depression Can Accompany Summer Sun
a recent one – Too much sunshine can bring on the blues

I don’t have the lack of appetite aspect, but my eating patterns, choices, cravings and ability to be satisfied by or really enjoy food is very different during the summer and they also bother me a lot. Any condition that messes with my enjoyment of food does a lot of damage to my overall mood.

Text of articles here, in case the links break.  – all copyright belongs to the original authors and/or publications.

Seasonal Depression Can Accompany Summer Sun

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By SARA IVRY
Published: August 13, 2002

No one looks forward to spring more than people with seasonal affective disorder, who grow depressed in the waning light of winter. A smaller group of people, however, suffer on the opposite side of the calendar.

Consider Violet Adair, a 39-year-old artist in Oakland, Calif., who gets ready for summer by filling plastic bottles with water. ”I’ll put them in my freezer and I’ll sleep with them,” she said. ”I’ll sleep hugging a two-liter Pepsi bottle filled with ice.”

These makeshift cooling devices help her cope with the distress that has come upon her each summer for roughly a decade. This year, she is going a step further.

Many of the rooms in Ms. Adair’s loft are windowless, and she plans to paint the walls blue and aqua. She will hide out in these darkened chambers, equipped with a fan, avoiding the outdoors as much as possible until the nights again grow long.

At least Ms. Adair knows what she has: summer SAD, also known as reverse seasonal affective disorder. About 5 percent of adult Americans are thought to have winter seasonal affective disorder; researchers estimate that fewer than 1 percent have its summer variant.

Because it is a fairly esoteric condition whose origins are unknown, many people who become depressed in the summer may not realize they have SAD. They may simply think of their bouts of depression as new events rather than parts of a pattern.

”We’ve kind of de-seasonalized ourselves as much as possible,” said Dr. Thomas Wehr, a research psychiatrist at the National Institute of Mental Health and an expert on seasonal affective disorder. ”You know, we turn the lights on after dark, we turn the heat on in winter, we turn the air-conditioning on in summer, and you could almost not notice. We tend to think more in a linear way rather than in a cyclic way.”

As with depression generally, more women than men appear to suffer from this condition, at a ratio some estimates put as high as two to one. It is most common among women in their reproductive years, but its onset sometimes comes as early as childhood. Researchers think it may also have a genetic component; more than two-thirds of patients with SAD have a relative with a major mood disorder.

The symptoms of the two forms of the disorder often vary, heightening the confusion. People with the more common variety typically feel lethargic in the colder months, crave carbohydrates, gain weight and sleep excessively. Those afflicted during the summer often experience agitation, loss of appetite, insomnia and, in extreme cases, increased suicidal fantasies.

The cause may differ, as well. Seasonal depression in the winter seems linked to increases in the production of melatonin, a chemical that helps set the brain’s daily rhythm, set off by the decrease in light.

But ”the seasonal trigger for the summer depression is less clear-cut,” said Dr. Norman E. Rosenthal, a Washington psychiatrist and the author of ”Winter Blues.” ”Conventionally, the thought has been that they are more sensitive to the heat. The question of whether it’s too much heat or too much light has yet to be resolved.”

Reports of summer seasonal affective disorder are often more frequent in hotter regions. A study published in the journal Comprehensive Psychiatry two years ago found that the rate of summer SAD among a group of students in Jining, 200 miles northwest of Beijing, exceeded that of students with the winter disorder. Epidemiological data in the United States have shown a higher proportion of people in the South depressed in the summer. The proportion rises as the latitude diminishes.

When moods deviate, Dr. Rosenthal said, the systems geared toward normalizing them generally take action. In seasonal affective disorder, he said, ”The challenges encountered with changing seasons seem to overwhelm those internal regulating mechanisms.”

Dr. Rosenthal and Dr. Wehr first identified winter SAD in 1984. Their findings prompted queries from many people who said they also felt depression, but in the summer.

To explore the summer disorder, Dr. Wehr manipulated patients’ body temperatures. People with severe depression, he said, tend to have higher temperatures at night; among healthy people, temperatures tend to drop. Antidepressants have been shown to lower brain and body temperature.

Dr. Wehr tried to cool down patients with a kind of reverse thermal blanket, carefully making sure the environmental drop in temperature would not cause shivering as a defense against the cold. After the treatment was over, however, the patients walked out of the building into summer heat, their body temperatures rose, and the symptoms of their depression returned. The effect of re-entering a hot summer environment undid whatever effect the treatment might have had.

Like Ms. Adair, many summer SAD patients have developed strategies for combating symptoms. Air-conditioning seems to help some but not others, the doctors say. One man is meticulous about spending his time in air-conditioned environments, going from apartment to parking lot to office and back again. Another person takes frequent cold showers. A woman reportedly swam daily in the English Channel where the cold water gave her respite.

For many, the only reliable defense against summer is pharmacological.

A designer in Northern California in her early 50’s takes a combination of mood stabilizers and a small dose of antidepressants throughout the year. Before summer begins, she increases the dosage as needed in consultation with her doctor.

She also is careful about staying inside, a frustrating challenge, she says, because she considers herself an outdoors person. She first suspected a seasonal link to her depression in her 30’s and became more attuned to it after she learned that she had a bipolar disorder around age 40. She said that she thought that it was the light more than the heat that affected her and that she felt frantic and depressed as spring ended.

”I actually feel kind of attacked by the sun,” the designer said. ”I feel like it’s piercing into me, and I start to feel more and more desperate to escape it. I have a hard time organizing and managing daily life. By August, I’m barely able to function and don’t really recover until autumn.

”October is reliably a good month. I’m waking up, and I feel like I’m being released from my summer, what I would call, jail cell.”

Too much sunshine can bring on the blues Those hit by depression in warmer weather complain of insomnia, anxiety and appetite loss.
By Victoria Clayton, Special to The Times
May 28, 2007

SUNSHINE and warm weather aren’t for everyone.

Take 30-year-old Saskia Smith, an illustrator who works part time in the billing department of a legal firm. She spent most of last summer’s dog days prone in bed with the velvet drapes in her Mid-City apartment pulled tightly shut.

“Other times of year, I’m basically an upbeat person,” Smith says. “But when summer hits, it’s like I’m operating on a low battery. Last summer, I had no desire to eat, I lost 15 pounds, I had anxiety attacks and I stopped seeing any of my friends. Even going to the grocery store felt like an impossible task.”

Smith, who grew up in Seattle and has lived in New York City and Germany (all areas with notably moody skies), is convinced she has seasonal affective disorder, or SAD. The condition first surfaced after she and her husband moved to Los Angeles almost three years ago. “It’s the unrelenting sun day after day after day,” she says. “I feel like I’m trapped and there’s no relief from it. At my lowest point [last summer] I just wanted to die.”

Although most people consider seasonal affective disorder to be a winter ailment brought on by waning sunlight, Smith and others say there’s a summer version — and it packs a wallop as well.

Researchers estimate that about 1% of the population suffer from summer depression, compared with 5% for the winter variety. Although summer depression has been mentioned in ancient writings, as well as in scientific journals sporadically for the last 20 years, the relatively low prevalence in the U.S. has meant it hasn’t gotten much serious consideration, says Dr. Thomas Wehr, a Bethesda, Md., psychiatrist and former National Institutes of Mental Health researcher.

“The closer you get to the equator — countries like India, China and Brazil — it turns out the condition is quite common. But here a lot of people with summer depression feel isolated,” says Wehr, an expert on seasonal affective disorder.

Role of the thyroid

Wehr and NIMH colleagues first became aware of summer SAD when they were studying winter depression in the 1980s. “In the course of our research, we’d regularly get letters from people saying winter depression was interesting but they seemed to have the opposite problem. However, the symptoms were different.”

People with winter depression tend to sleep more, have less energy, gain weight and have carbohydrate cravings. Summer depressives tend to be plagued with decreased sleep, weight loss and anxiety.

Researchers say that some people may be especially sensitive to heat, which could influence their production of various hormones. “We know thyroid hormone is suppressed by heat and growth hormone and prolactin are stimulated by heat,” Wehr says.

Lack of thyroid hormone can cause energy drain, and too much growth hormone and prolactin can lead to lethargy and lack of libido. In addition, prolactin is known to repress the effects of dopamine, a brain chemical linked to feelings of enjoyment and pleasure. Light on the skin can also influence the production of hormones, but preliminary NIMH research points to heat more than light as the culprit in summer depression.

Typical to depression in general, researchers say, more women than men appear to suffer from summer SAD. The condition generally crops up in childbearing years and studies point to a genetic link; more than two-thirds of SAD patients have a first-degree relative with a mood disorder.

“The problem is that right now we just don’t know enough about summer depression to say it gives us prognosis and treatment,” says Dr. Daniel F. Kripke, professor of psychiatry at UC San Diego. “Until we do, it’s not very useful.”

Winter blues responds well to light therapy, and because researchers think the summer version is a condition of heat, reducing heat should work as a treatment for summer depressives.

That doesn’t seem to be the case. A pilot study by Wehr and colleagues at NIMH found that manipulating temperature for a period of time was salutary but didn’t have lasting effects on summer SAD patients.

“In our study, people would improve [with cooling] and then very quickly the symptoms would come back,” Wehr says.

Antidepressants help

Some researchers take issue with associating winter depression with summer depression or labeling it “reverse SAD.”

“Calling it ‘reverse SAD’ only confuses the issue,” says Michael Terman, director of the Center for Light Treatment and Biological Rhythms at New York-Presbyterian Hospital. “It is not a light-related phenomenon and should not be considered the flip side of winter depression.” Standard antidepressants are the only medical intervention that’s been shown to be effective, he says.

Wehr agrees medication tends to work, but says the drugs may vary. “Some respond to Prozac-like drugs, some people respond to Wellbutrin. I’ve even had people respond to lithium and only lithium. They only take it during the summer,” Wehr says.

Some people respond well to lifestyle changes, he says. Some of his patients take daily swims in cold lakes; one built a refrigerated room and several avoid summer daylight and heat. “One patient,” he says, “was known to his friends and co-workers as ‘the mole’ because he literally never went outside in the summer daylight.”

Smith doesn’t want antidepressants, so she’s working harder on the temporary fixes.

“Last year I ordered a Cape Cod rain-sounds CD,” she says. “Whenever there was a heat wave, I would crank up my humidifier and air conditioner, close the blinds and meditate listening to the rain sounds. It really did the trick to put me, momentarily, in a different space.”

This year she plans to paint the bedroom walls pale blue with faint undertones of gray and purple, a color called rainy day, and she’s launched a website (www.seasonalsad.com) to reach out to others suffering from summer SAD.

In this perpetually sunny city, she says she hopes to form a support group for people who thrive in June gloom. If none of this works, she’ll work on persuading her husband to move.

For now, however, she still has a sense of humor about it all.

“I realize this all has a slightly psychotic tone, but I’m not crazy, I’m not into goth and I don’t want to be a vampire,” she says. “I would actually like L.A. if it just didn’t have so much sun.”

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