talkpsych Podcast Episode 2: Seasonal Affective Disorder

September 28th, 2007 by Dr. Stacey

 
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Seasonal Affective Disorder

September 28th, 2007 by Dr. Stacey

Are you having difficulty getting up in the morning, especially after switching to Daylight Savings Time? Cutting down on their exercise and feeling the need for pasta, mashed potatoes and bagels? Decreased energy or feeling “blah”? Is the same thing happening every year at this time? Is it depression, or are you just SAD?

Seasonal affective disorder (SAD) is different from major depression. Both include sleep disturbances and lethargy, but seasonal affective disorder may include craving for carbohydrates and accompanying weight gain. There are two types of SAD; winter and summer. Winter depression, usually beginning around November and ending in March, is thought to be caused by light deficiency in the environment. Those with SAD have less suicidal ideation and negative moods in the morning when compared with nonseasonal depressives.

The currently accepted treatment for SAD, particularly winter depression, is bright light exposure or phototherapy. In this case, light is believed to synchronize the activity of the biological clock to the day-night cycle.

One inexpensive yet effective method to  combat SAD is a walk outside, which might work best when done in the early morning, the time when light therapy is most effective. Even an overcast winter sky provides more light than normal indoor lighting. But leave your sunglasses at home.  Your eyes must be exposed to the light. The walk has an added benefit – it’s good exercise and can bring about an overall improvement in mood.

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Body Dysmorphic Disorder

September 23rd, 2007 by Dr. Denise

Body Dysmorphic Disorder (BDD) is an official diagnosis from the DSM-IV, the Diagnostic and Statistical Manual. Research has shown that between 1 and 2 % of all Americans suffer with BDD symptoms, and that men and women struggle equally, which is not the case for those with only body image concerns. There is obsessive worry and pre-occupation about one’s appearance, and compulsive mirror-checking (or avoidance) to the extent that it causes occupational problems such as unemployment, absenteeism, and lost productivity; social problems such as avoiding the public or even remaining housebound; and relational or marital problems. If a person has severe BDD symptoms and doesn’t obtain treatment, they can become hospitalized or even commit suicide.

Although facial concerns are typically the MOST perceived deficit in someone with BDD, the pre-occupation with many other aspects of appearance also exist, including the look of one’s skin, stomach, eyes, lips, face size, buttocks, nose, genitals, hair, thighs, teeth, breast size, muscle strength, and weight.

Symptoms can vary according to which body part (or parts) are targeted, but general symptoms of BDD include:

  • Preoccupation with a perceived defect for at least one hour every day, with a lack of control and significant distress about their mental and physical preoccupation
  • Worrying that they are ugly compared to models and celebrities, or even other people in general
  • Constantly asking trusted friends or family members for reassurance about their looks, but not believing the answer
  • Constantly looking at their reflection, or else taking pains to avoid catching their reflection
  • Constant dieting and over-exercising
  • Grooming to excess – for example, shaving the same patch of skin over and over
  • Avoiding any situation they feel will call attention to their defect. In extreme cases this can mean never leaving home
  • Taking great pains to hide or camouflage the defect, sometimes with clothes, makeup, a hat…or sometimes focusing on how they sit so that others won’t see the perceived defect
  • Squeezing or picking at skin blemishes for hours on end
  • Consistent seeking of dermatological treatment or cosmetic surgery, even when physicians believe the treatment is unnecessary
  • Depression and anxiety, including suicidal thoughts

The cause of BDD has not been officially determined. Some evidence shows there might be a neurobiological basis to BDD, and there might be some abnormal functioning of the neurotransmitter known as serotonin, which is a chemical in the brain that relays signals from on brain cell to another. In addition, there might be a genetic basis, since it tends to run in families. According to the Los Angeles Body Dysmorphic Disorder Clinic, BDD is considered an Obsessive Compulsive Spectrum Disorder. Treatment with a professional who is trained in dealing with obsessive compulsive features such as BDD has been proven to be tremendously helpful.

Here are some helpful links:

www.bddcentral.com
www.bddhelp.com
www.massgeneral.org/bdd/pages/bddinfo.htm
www.bddclinic.com
www.mayoclinic.com/health/body-dysmorphic-disorder/DS00559

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