JUNE PAGE 2 | Today's Patient

Why Do I Feel Better in the Summer Than I Do the

Rest of the Year?

It Could Be

Seasonal Affect Disorder

by Liya Moges

Folks ask a very common question at this time of the year. Why do I feel so good and motivated once the summer arrives and throughout the summer months into the early fall, and then when Thanksgiving rolls around, why do I then begin to notice a pattern of feeling tired, unmotivated, irrationally sad, or a lack of enjoyment of things I usually love?

Perhaps, you’ve noticed your mood sours once November hits, and you find yourself struggling to finish tasks or find the energy to complete your work, but you just can’t figure out why. If you’ve felt this way before, don’t worry, you’re not alone! Data collected on adults in the United States reveal that about 5% of adult individuals share these symptoms during the fall/winter months each year. These symptoms, considering their relationship with the seasonal changes year-round, could be attributed to a condition called Seasonal Affective Disorder.

What is Seasonal Affective Disorder (SAD)?

Seasonal Affective disorder or the abbreviated term known as SAD, defined by the Mayo Clinic, is a type of depression in relation to the seasons. Most of the time, SAD begins and ends near the same time of year, and often occurs during the fall and winter months, though there have been a few cases in which individuals have developed these symptoms during the spring/summer months. Due to the subjective nature of this disorder, it’s important to keep track of your symptoms in order to best understand which time of year tends to prompt such feelings.

During the fall/winter months (or even sometimes during the spring/summer months), an individual may present the following symptoms:

Feeling sad and/or demotivated
Lack energy for daily activities
Feel drowsy and/or fatigued
Have difficulties concentrating on tasks
And in some severe cases, may have suicidal thoughts
How to identify your symptoms

Sometimes, these symptoms can become very overwhelming, so it’s important to recognize and understand when it is time to seek professional help. More often than not, adult individuals tend to either under react or overreact to symptoms they may present over time. This sliding subjective scale of extremes can make it difficult to receive help if your symptoms are left untreated over time. Luckily, there are some self-evaluative actions you can take in order to self-identify your symptoms and provide your healthcare provider with background information when seeking professional help.

Here are some ways you can self-identify SAD

1.) Keep a diary or journal to record any changes or continuation in moods. This will help you identify some triggers or patterns in your daily life that may contribute to your symptoms. An example would be to note an entry such as:

Entry 1: Today’s date is November 22nd, and I woke up at 8 am feeling content today. On a scale from 1-10 (1 being very sad and de-energized and 10 being happy and energized) I feel like a 7 today. At 6 pm however, I started to feel a bit sadder and drowsy, and the only change thus far is that it has gotten darker outside.

**Note: Make sure to be as detailed and inclusive as possible because it is key to identifying the patterns or triggers in your life that contribute to the symptoms mentioned above.

2.) Engage in activities you normally enjoy. It is common to have some days when you feel down, but one way to check if you may need to seek help is by trying to do some activities you normally enjoy. If you find yourself feeling down for more than a few days at a time and cannot motivate or energize yourself to do activities you usually enjoy, you should see your healthcare provider.

3.) Record and analyze your sleeping and eating habits. There are plenty of apps on your phone these days that can help analyze and organize your health habits. By downloading some apps, like Reflectly or Daylio Journal, you can easily collect data on things like sleep, appetite changes, and even your mental health. With its journaling properties, it can also be helpful to show your healthcare provider your weekly stats when visiting so they can see how your health has progressed in between visits!

What are some causes and risk factors to look out for?

Some risk factors that can contribute to developing SAD can include previous family history or previous diagnosis of depression or bipolar disorder. Having blood relatives who struggle with SAD or other forms of depression, such as bipolar disorder, are 15%-40% more likely to pass down genetic vulnerabilities and can be a leading risk factor to an individual’s susceptibility to SAD.

Other risk factors for SAD can include the location that you live in, in accordance with the equator. Depending on if you live farther north or further south from the equator, SAD appears to be more common among individuals who have decreased exposure to sunlight according to their geographical area of living.

In relation to lack of sunlight exposure, other risks such as low Vitamin D levels can also contribute to SAD in individuals. With low levels of vitamin D in the body, other things like serotonin and melatonin levels drop as well, which contribute to symptoms such as tiredness and mood changes associated with Seasonal Affective Disorder.

Is there a way to prevent SAD?

Unfortunately, there are no current preventative methods for Seasonal Affective Disorder, however there are some preventative measures you can take in order to manage the symptoms from worsening. By recording and analyzing your symptoms from home, you will be able to offset any mood changes, appetite loss, or dips in energy levels since you will be able to predict the time of year in which these symptoms start.

Receiving treatment from a healthcare provider can also help prevent any further complications, in the case that SAD is diagnosed and treated in time. It may be beneficial to receive treatment a month or two before your symptoms start, to and continue treatment for a month or so after the symptoms would normally end. Or in the case that your symptoms are longer lasting, you can receive treatment all-year round.

Liya Moges is a passionate and dedicated junior studying Biomedical Science, Business, and Law at Georgia State University. She works at Emory University Hospital supporting nurses and physicians on a Complex Medicine floor and uses this opportunity to shadow different physicians in different specialties. She has an interest in health equity which plays a role in Liya’s desire to spread awareness on diversity/inclusion and health equity within healthcare.

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Sudden Infant Death
Syndrome (SIDS)
What We Actually Know

by Nikita Amin

Recent News

This past month, a breakthrough study was released exploring a biological component to Sudden Infant Death Syndrome (SIDS). This news was widely celebrated as a miracle study finally figuring out the cause of SIDS, which is known for being an unexplainable and heartbreaking death that occurs in infants under the age of one year. It often occurs during sleep, and is unpredictable, happening to infants no matter how healthy they may seem. SIDS has baffled the scientific community for years, as it is the foremost cause of infant death in Western countries, yet no clear cause has ever been found.

The cause of SIDS is still not known, despite the headlines that came from the publishing of the May 2022 study. The explicit purpose of this study was “to evaluate BChE activity in infants and young children who had died from [SIDS],” (Harrington, Hafid, & Waters, 2022). Butyrylcholinesterase (BChE) is an enzyme in the brain that plays a major role in the nervous system and brain function. BChE plays its main role in the parasympathetic system, which is known as the “resting and digesting” part of our nervous system, responsible for regulating the body’s resting cycles. It is also cholinergic, meaning it acts on the neurotransmitter acetylcholine, which is the most important neurotransmitter in the parasympathetic nervous system.

Scientific Relevance

In this new study, the researchers were successfully able to show that there is a correlation between lower levels of BChE activity to SIDS deaths, where there was no such relationship found in non-SIDS related deaths. The study does not claim that BChE levels, however, is the cause for SIDS. In a case of over-extrapolation, internet discussions embellished these new findings, citing this as the end of SIDS.

Unfortunately, while the study has a lot of promise for future investigations, it can make no certain conclusions. One of the most important particulars of the article is that it extolls the importance of further research, especially because BChE was not directly measured in brain tissue, but instead in blood: “It will be important to identify whether the decreased BChEsa we observed in the peripheral blood of our SIDS cases is also evident in the brain,” (Harrington, Hafid, & Waters, 2022).

While the connection between BChE and SIDS is a significant breakthrough, with important implications for further study, it cannot yet be definitively lauded as a preventative method for SIDS. It is possible that if proven to be a precursor, BChE could be used as a biomarker to prevent SIDS. However, for right now, it can at best be added to the already long list of factors that are known to contribute to an infant’s susceptibility to the awful phenomenon.

Nikita Amin is a third year undergraduate student at the University of Virginia double majoring in Biology and English. She hopes to go into the biological research sciences, and is passionate about making the academia she is passionate about more accessible. This is one of her main focuses as a Senior Contributor at Today's Patient, writing articles that make scientific news more readily available to the general public.