Suicide Prevention/Depression?


Hi, all through the winter I have been feeling sad. Sad to the point that I refused to go to school for a while, that I hid in my bedroom and cried. I can't sleep and have further been diagnosed with insomnia. I would break down in crying for no reason and started to hate my friends. It got to the point where I started to plan my suicide and cut myself. Then came summer and I didn't feel like that at all anymore. I was talking with my friend and she mentioned a type of depression called S.A.D. Do you think that is what I have? If so how can I prevent it?

winter blues?
winter blues?  
Seasonal Affective Disorder is the condition that you speak of. Thankfully it is now recognised and accepted as a real disorder, and not 'all in the mind' as once was thought!  I did a little research, and the most interesting and informative article I could find on this phenomenon is an excerpt from wikipedia:

I have condensed it to include on this page, but you can locate the full version via this link below. Interestingly there are some specific formulations in some health food shops and naturopath stockists, that treat the symptoms of S.A.D. The 'difficult to treat' cases will respond to a change of location, or even taking a trip away during the darkest of the winter months. When sufferers do not respond to these measures, it's likely that the depression that they suffer from is not only seasonal in origin, but may be more widespread, generalised depression. These people need more intensive help to cope with the debilitating symptoms of depression. Sometimes people can start out suffering from the "winter blues", and progress to more serious depression. Therefore it's important that their condition is monitored by their doctor, in case it worsens.

Anyway, do have a look at the information below, which cover the subject very well. Once you have a better understanding of the condition, you can approach your doctor with a view to working together to finding a solution that works for you, Adi.

Good luck with this, and let me know how you get on!  xoRachel

Seasonal affective disorder (SAD), also known as winter depression, winter blues, summer depression, summer blues, or seasonal depression, was considered a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or summer.[1]

In the Diagnostic and Statistical Manual of Mental Disorderss DSM-IV and DSM-5, its status was changed. It is no longer classified as a unique mood disorder, but is a specifier for recurrent major depressive disorder called With seasonal pattern that occurs at a specific time of the year and fully remits otherwise.[2] Although experts were initially skeptical, this condition is now recognized as a common disorder, with its prevalence in the U.S. ranging from 1.4% in Florida to 9.7% in New Hampshire.[3]

The U.S. National Library of Medicine notes that "some people experience a serious mood change when the seasons change. They may sleep too much, have little energy, and may also feel depressed. Though symptoms can be severe, they usually clear up."[4] The condition in the summer can include heightened anxiety.[5]

SAD was formally described and named in 1984 by Norman E. Rosenthal and colleagues at the National Institute of Mental Health.[6][7]

There are many different treatments for classic (winter-based) seasonal affective disorder, including light therapy with sunlight or bright lights, antidepressant medication, cognitive-behavioral therapy, ionized-air administration,[8] and carefully timed supplementation of the hormone melatonin.[9]

   1 Signs and symptoms
       1.1 Bipolar disorder
   2 Cause
   3 Diagnosis
   4 Pathophysiology
   5 Management
   6 Epidemiology
       6.1 Nordic countries
       6.2 Other countries
   7 History
   8 See also
   9 References
   10 External links

Signs and symptoms

Symptoms of SAD may consist of difficulty waking up in the morning, morning sickness, tendency to oversleep and over eat, especially a craving for carbohydrates, which leads to weight gain. Other symptoms include a lack of energy, difficulty concentrating on or completing tasks, withdrawal from friends, family, and social activities, decreased sex drive, and suicide.[citation needed] All of this leads to depression, pessimistic feelings of hopelessness, and lack of pleasure which characterize a person suffering from this disorder.[citation needed] People who experience spring and summer depression show symptoms of classic depression including insomnia, anxiety, irritability, decreased appetite, weight loss, social withdrawal, and decreased sex drive.[5]
Bipolar disorder

With seasonal pattern is a specifier for Bipolar and related disorders, including Bipolar I disorder and Bipolar II disorder.[2] Most people with SAD experience major depressive disorder, but as many as 20% may have a bipolar disorder. It is important to discriminate between diagnoses because there are important treatment differences.[10] In these cases, people with the With seasonal pattern specifier may experience a major depression or bipolar disorder during the winter and remit in the summer.[2] Around 25% of patients with bipolar disorder may present with a depressive seasonal pattern, which is associated with Bipolar II disorder, rapid cycling, eating disorders, and more depressive episodes.[11] Gender displays distinct clinical characteristics associated to seasonal pattern: males present with more Bipolar II disorder and a higher number of depressive episodes, and females with rapid cycling and eating disorders.[11]

In many species, activity is diminished during the winter months in response to the reduction in available food and the difficulties of surviving in cold weather. Hibernation is an extreme example, but even species that do not hibernate often exhibit changes in behavior during the winter. It has been argued that SAD is an evolved adaptation in humans that is a variant or remnant of a hibernation response in some remote ancestor.[12] Presumably, food was scarce during most of human prehistory, and a tendency toward low mood during the winter months would have been adaptive by reducing the need for calorie intake. The preponderance of women with SAD suggests that the response may also somehow regulate reproduction.[12]

According to the American Psychiatric Association DSM-IV criteria,[13] Seasonal Affective Disorder is not regarded as a separate disorder. It is called a "course specifier" and may be applied as an added description to the pattern of major depressive episodes in patients with major depressive disorder or patients with bipolar disorder.

The "Seasonal Pattern Specifier" must meet four criteria: depressive episodes at a particular time of the year; remissions or mania/hypomania at a characteristic time of year; these patterns must have lasted two years with no nonseasonal major depressive episodes during that same period; and these seasonal depressive episodes outnumber other depressive episodes throughout the patient's lifetime. The Mayo Clinic[5] describes three types of SAD, each with its own set of symptoms.

In the popular culture, sometimes the term "seasonal affective disorder" is applied inaccurately to the normal shift to lower energy levels in winter, leading people to believe they have a physical problem that should be addressed with various therapies or drugs.[14]

Seasonal mood variations are believed to be related to light. An argument for this view is the effectiveness of bright-light therapy.[15] SAD is measurably present at latitudes in the Arctic region, such as Northern Finland (64°00′N) where the rate of SAD is 9.5%.[16] Cloud cover may contribute to the negative effects of SAD.[17] There is evidence that many patients with SAD have a delay in their circadian rhythm, and that bright light treatment corrects these delays which may be responsible for the improvement in patients [18]

The symptoms of SAD mimic those of dysthymia or even major depressive disorder. There is also potential risk of suicide in some patients experiencing SAD. One study reports 6–35% of sufferers required hospitalization during one period of illness.[17] At times, patients may not feel depressed, but rather lack energy to perform everyday activities.[15]

Various proximate causes have been proposed. One possibility is that SAD is related to a lack of serotonin, and serotonin polymorphisms could play a role in SAD,[19] although this has been disputed.[20] Mice incapable of turning serotonin into N-acetylserotonin (by serotonin N-acetyltransferase) appear to express "depression-like" behavior, and antidepressants such as fluoxetine increase the amount of the enzyme serotonin N-acetyltransferase, resulting in an antidepressant-like effect.[21] Another theory is that the cause may be related to melatonin which is produced in dim light and darkness by the pineal gland,[18] since there are direct connections, via the retinohypothalamic tract and the suprachiasmatic nucleus, between the retina and the pineal gland.[citation needed] Melatonin secretion is controlled by the endogenous circadian clock, but can also be suppressed by bright light.[18]

Subsyndromal Seasonal Affective Disorder is a milder form of SAD experienced by an estimated 14.3% (vs. 6.1% SAD) of the U.S. population.[22] The blue feeling experienced by both SAD and SSAD sufferers can usually be dampened or extinguished by exercise and increased outdoor activity, particularly on sunny days, resulting in increased solar exposure.[23] Connections between human mood, as well as energy levels, and the seasons are well documented, even in healthy individuals.[citation needed]
One type of light therapy lamp
See also: Occupational therapy in the management of seasonal affective disorder

There are many different treatments for classic (winter-based) seasonal affective disorder, including light therapy, medication, ionized-air administration, cognitive-behavioral therapy and carefully timed supplementation[24] of the hormone melatonin.

Photoperiod-related alterations of the duration of melatonin secretion may affect the seasonal mood cycles of SAD. This suggests that light therapy may be an effective treatment for SAD.[25] Light therapy uses a lightbox which emits far more lumens than a customary incandescent lamp. Bright white "full spectrum" light at 10,000 lux, blue light at a wavelength of 480 nm at 2,500 lux or green (actually cyan or blue-green[26]) light at a wavelength of 500 nm at 350 lux are used, with the first-mentioned historically preferred.[27][28]

Bright light therapy is effective[22] with the patient sitting a prescribed distance, commonly 30–60 cm, in front of the box with her/his eyes open but not staring at the light source[16] for 30–60 minutes. A 1995 study showed that 500-nm cyan-light therapy at doses of 350 lux produces melatonin suppression and phase shifts equivalent to 10,000 lux bright light therapy in winter depressives.[27] However, in this study, the improvement in depression ratings did not reach statistical significance. A study published in May 2010 suggests that the blue light often used for SAD treatment should perhaps be replaced by green or white illumination.[29] Discovering the best schedule is essential. One study has shown that up to 69% of patients find lightbox treatment inconvenient and as many as 19% stop use because of this.[16]

Dawn simulation has also proven to be effective; in some studies, there is an 83% better response when compared to other bright light therapy.[16] When compared in a study to negative air ionization, bright light was shown to be 57% effective vs. dawn simulation 50%.[8] Patients using light therapy can experience improvement during the first week, but increased results are evident when continued throughout several weeks.[16] Most studies have found it effective without use year round but rather as a seasonal treatment lasting for several weeks until frequent light exposure is naturally obtained.[15]

Light therapy can also consist of exposure to sunlight, either by spending more time outside[30] or using a computer-controlled heliostat to reflect sunlight into the windows of a home or office.[31][32]

SSRI (selective serotonin reuptake inhibitor) antidepressants have proven effective in treating SAD. Bupropion is also effective as a prophylactic.[17] Effective antidepressants are fluoxetine, sertraline, or paroxetine.[15][33] Both fluoxetine and light therapy are 67% effective in treating SAD according to direct head-to-head trials conducted during the 2006 Can-SAD study.[34] Subjects using the light therapy protocol showed earlier clinical improvement, generally within one week of beginning the clinical treatment.[15]

Negative air ionization, which involves releasing charged particles into the sleep environment, has been found effective with a 47.9% improvement if the negative ions are in sufficient density (quantity).[8][35][36]

Depending upon the patient, one treatment (e.g., lightbox) may be used in conjunction with another (e.g., medication).[15]

Modafinil may be an effective and well-tolerated treatment in patients with seasonal affective disorder/winter depression.[37]

Another explanation is that vitamin D levels are too low when people do not get enough Ultraviolet-B on their skin. An alternative to using bright lights is to take vitamin D supplements.[38][39][40][41] However, one study did not show a link between vitamin D levels and depressive symptoms in elderly Chinese.[42]

Physical exercise has shown to be an effective form of depression therapy, particularly when added on in addition to another form of treatment for SAD.[43] One particular study noted marked effectiveness for treatment of depressive symptoms when combining regular exercise to bright light therapy.[44] Patients exposed to exercise which had been added to their treatments in 20 minutes intervals on the aerobic bike during the day along with the same amount of time underneath the UV light were seen to make quick recovery.[45]
Nordic countries

Winter depression is a common slump in the mood of some inhabitants of most of the Nordic countries. It was first described by the 6th century Goth scholar Jordanes in his Getica wherein he described the inhabitants of Scandza (Scandinavia).[46] Iceland, however, seems to be an exception. A study of more than 2000 people there found the prevalence of seasonal affective disorder and seasonal changes in anxiety and depression to be unexpectedly low in both sexes.[47] The study's authors suggested that propensity for SAD may differ due to some genetic factor within the Icelandic population. A study of Canadians of wholly Icelandic descent also showed low levels of SAD.[48] It has more recently been suggested that this may be attributed to the large amount of fish traditionally eaten by Icelandic people, in 2007 about 90 kilograms per person per year as opposed to about 24 kg in the US and Canada,[49] rather than to genetic predisposition; a similar anomaly is noted in Japan, where annual fish consumption in recent years averages about 60 kg per capita.[50] Fish are high in vitamin D. Fish also contain docosahexaenoic acid (DHA), which has been shown to help with a variety of neurological dysfunctions.[51]
Other countries

In the United States, a diagnosis of seasonal affective disorder was first proposed by Norman E. Rosenthal, MD in 1984. Rosenthal wondered why he became sluggish during the winter after moving from sunny South Africa to New York. He started experimenting increasing exposure to artificial light, and found this made a difference. In Alaska it has been established that there is a SAD rate of 8.9%, and an even greater rate of 24.9%[52] for subsyndromal SAD.

Around 20% of Irish people are affected by SAD, according to a survey conducted in 2007. The survey also shows women are more likely to be affected by SAD than men.[53] An estimated 10% of the population in the Netherlands suffer from SAD.[54]

SAD was first systematically reported and named in the early 1980s by Norman E. Rosenthal, M.D., and his associates at the National Institute of Mental Health (NIMH). Rosenthal was initially motivated by his desire to discover the cause of his own experience of depression during the dark days of the northern US winter. He theorized that the lesser amount of light in winter was the cause. Rosenthal and his colleagues then documented the phenomenon of SAD in a placebo-controlled study utilizing light therapy.[6][7] A paper based on this research was published in 1984. Although Rosenthal's ideas were initially greeted with skepticism, SAD has become well recognized, and his 1993 book, Winter Blues[55] has become the standard introduction to the subject.[56]

Research on SAD in the United States began in 1970 when Herb Kern, a research engineer, had also noticed that he felt depressed during the winter months. Kern suspected that scarcer light in winter was the cause and discussed the idea with scientists at the NIMH who were working on bodily rhythms. They were intrigued, and responded by devising a lightbox to treat Kern’s depression. Kern felt much better within a few days of treatments, as did other patients treated in the same way.[7]

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Rachel Hurst


All questions sent to me will receive a warm and caring response. I'll do my utmost to address a persons particular problem, but in most cases will also attempt to supply that individual with additional resources which might be of further benefit. There are many helpful online support groups where readers can benefit from the ongoing support of others who have suffered similar problems. These groups offer invaluable peer support from others who have 'been there'. As well as responding to your initial letter, I'll attempt to provide ongoing encouragement when this is needed. Advice will be focused on addressing the writers individual needs, and providing related information and resources. I would try to ensure that any person seeking advice has accurate and up-to-date information on the signs and symptoms of depression, and importantly, is made aware that help is available through many different avenues. Where I feel that it's relative and helpful I would mention my own life experiences with depression and coping with a loved one's suicide (however, only in context.) I would be on the lookout for warning signs that the person is in crisis and may require immediate intervention. As such I would arm myself with as much information as possible in order to refer them to the help they need. In cases where I believed the persons life to be in imminent danger I would contact authorities in their area, or if unknown, I would call the emergency services in my area in order for the person to be located through tracking.


I am by no means a trained professional. My knowledge comes mainly through life experience, having endured the devastating loss of my best friend through suicide, as well as my own subsequent battle with depression following his death. I found that my own experience of losing a loved one to suicide put me in a strong position to help others, due to my ability to empathize (as opposed to sympathizing). I became knowledgeable on the topic of grief, and the extensive repertoire of depressive illnesses, signs, symptoms, and treatment options available to people in crisis.

S.O.L.O.S. Survivors of Loved Ones Suicide - Active member since 2003.

'Marie Claire' Australian, 'Cleo' (Australian), Online discussion forums (in which my submissions have stimulated discussion and generated much feedback).

I am a professional writer. I was trained in journalism. Please see my profile in Linked In. I have studied related subjects during training as a registered nurse. Both of my parents are mental health professionals. However most of reading widely and life experience has been my greatest teacher.

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I have helped a number of individuals who have sought my take on a particular problem, or whom I have felt concern for, for various reasons.

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