Coping with Shiftwork

 
 

As if you didn’t already have enough to be depressed about, consider the fact that we are now entering the dreaded portion of the winter months, when our time outdoors is limited, and the time of light is limited as well. 

 

For many, this is a time of great depression.  Not the kind of depression experienced on a spontaneous timetable, but one that begins as the cold winter months approach and may not leave until the onslaught of Spring.  This depression has a specific name, and you may have heard of it:  Seasonal Adjustment Disorder, or (appropriately initialed, SAD.   It was identified approximately twenty years ago.  Dr. Norman Rosenthal at the National Institute of Mental Health did much of the pioneering work on SAD.

 

About 6% of the population is afflicted with SAD and it occurs in all age groups.  Women, however, are four times more likely to suffer from SAD.  SAD is often more common in the northern latitudes.  For instance approximately 10% of the Maine population will experience SAD while only 1% in Florida.

 

Shiftworkers who already experience a loss of light exposure due to their jobs may be even more affected.  Consider the night worker who must sleep through a large portion of the day, only to wake up to a dusky evening before getting ready to go to work. 

 

Scientists believe that SAD is related to the biological clock, and that our old friend melatonin is highly responsible for the development of SAD.  In other words, when we get too much of it, we get more depressed.  And the reason we get too much melatonin, is that … once again … (you should know this by now) … less light means the pineal gland secretes more melatonin (which is supposed to make us sleepy).  In fact, one of the classis symptoms of SAD is sleepiness and lack of energy.

 

Some of the other symptoms of SAD are:

 

1. Intense cravings for carbohydrates and sweet, usually resulting in weight gain.
2. At least one major depressive episode each winter with feelings of extreme hopelessness and failure.
3. Difficulty in focusing and concentrating on work.
4. Heavy feeling in the arms and legs
5. Irritability
6. Withdrawal from social situations
7. Loss of interest in activities you once enjoyed

 

Doctors also believe that serotonin and changes in the brain cortex may be involved in SAD, but the effectiveness of light therapy and the resulting changes in the production of melatonin strongly suggests the fundamental relationship between SAD and melatonin (and the workings of the biological clock and circadian system.)  They also find much more melatonin in patients suffering from SAD.

 

Light is the therapy of choice for SAD patients.  After a number of studies that considered the intensity, time of day, and duration of artificial light exposure, the conventional wisdom is to expose the patient to approximately 10,000 lux of light intensity (which is about twice as bright as normally lit office).  The best time of day to administer the light is mornings as opposed to evenings, and the duration is usually 30 minutes to one hour.  The additional light that this provides depresses the production of melatonin in the pineal gland. 

 

Other therapies such as low light exposure while sleeping and negative ion generators may help in certain situations, but the jury is still out on much of this.

 

If you believe you may be suffering from SAD, there are some things you can do on your own before you result to light therapy (which by the way should only be done under doctors’ orders).  Also, your symptoms may be not as severe as you think, and you may be experiencing a case of the winter blues.

 

1. Spend as much time as possible outside.  Even an overcast day is brighter than an office or well lit home.
2. Exercise, preferably outside.  It helps combat lethargy and weight gain, too.
3. When indoors, spend as much time as possible near windows.
4. Eat a balanced diet and don’t overdo the carbohydrates
5. If you live in a northern location, plan winter vacations to sunny destinations.
6. Avoid using dark drapes and curtains in your rooms, and if possible install skylights.

 

Of course, if you’re a shiftworker, these tips have to be modified.  For instance, dark rooms are still best for sleeping.  But lightly colored walls with black-out shades will still provide the darkness you need, and opening them up during your “awake” time will give you maximum exposure to light.

 

In the days ahead, remember that your exposure to light is reduced by mother nature, so do everything you can to make up for it and in the process improve your mental and emotional health.

 

 

Sources:  

 

Abramovitz, Melissa,  “A Sad State of Mind”, Current Health, January, 2001.

Colllins, Geneva, “Light at the End of the Tunnel”, Female Patient, 2000.

Dess, Nancy, “Shedding Light on Moods”, Psychology Today, Nov/Dec 2000.