It is definitely the heart of winter, mid-February, and we would be lucky if we had a week that didn’t have frigid temperatures, snowfall and blizzard-type winds, and long nights. Compared to the spring and summer seasons, winter in the northeastern hemisphere of the United States challenge even the happiest of people — weather conditions force us to stay indoors as much as possible, unless we emancipate ourselves from the city during these times into a cabin in the woods with hot cocoa and recreational activities meant for the season.
I am willing to bet however we aren’t all as lucky; city life and the responsibilities that come with it keep us close to it even in the harshest winter weather conditions. Compound that feeling of being trapped with heavy layered clothing, dangerous walking and commuting conditions, and gray, dreary short days that at 5 pm remind you it is wintertime with it’s pitch black quick nightfall.
Understandably this time of year, after the holidays have passed, depression sets in full force. There are those of us, however, who suffer a more consistent, cyclical type of depression this time of year called Season Affective Disorder or SAD. SAD has been recognized and included in the diagnostic classification system of the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition as major depressive disorder with seasonal pattern. In most cases, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. However, for those people with the opposite pattern, meaning have symptoms that begin in spring or summer may be suffering from a major depressive disorder.
Let’s look at this table below, courtesy of information from the Mayo Clinic:
There is a clear difference identified between Major Depression affected by SAD, Fall and Winter SAD stand alone, and then a category that actually has a Spring and Summer SAD! Obviously, the most popular kind is in the fall and winter, however there are those who have difficulties thriving in the Spring and Summer and display the symptoms listed above.
After serving a distinguished career at the National Institute of Mental Health researching cyclical mood patterns, Norman E. Rosenthal, MD, currently a Clinical Professor of Psychiatry at Georgetown University Medical School and Medical Director of the Capital Clinical Research Associates, in Rockville, Maryland, sheds light on the topic in an interview with Psychiatry (As published in NICH website).
Dr. Rosenthal claims, “Every year, as the days become short and dark, people with SAD develop a predictable set of symptoms. They slow down and have a hard time waking up in the morning. Their energy level decreases, they tend to eat more, especially sweets and starches, and they gain weight. Their concentration suffers, and they withdraw from friends and family. As you can imagine, their work and relationships suffer, and they can become quite depressed. This symptom cluster often lasts for four or five months until the days become longer again. Since the syndrome is linked to a lack of light, people with SAD may become depressed during cloudy weather at any time of year, or if they are confined to windowless offices or basement apartments.”
He also says that SAD in its full form affects productivity in work or school, affect interpersonal relationships, and causes a marked loss of interest or pleasure in most activities. There is a milder form of seasonal disorder which is called the winter blues and yields similar symptoms of decreased energy and increased appetite. This can also affect enthusiasm and productivity. For instance, people with SAD report sleeping an average of 2.5 hours more in winter than in the summer, whereas people with winter blues sleep 1.7 hours more (the general population sleeps 0.7 hours more in the winter).
So how do we combat depression, SAD or otherwise?
Typical Major Depression that is not directly affected by SAD are affected by Dopamine and Serotonin levels. A Study in the International Journal of Neuroscience in 2005 by TIFFANY FIELD, MARIA HERNANDEZ-REIF, MIGUEL DIEGO, SAUL SCHANBERG, and CYNTHIA KUHN determined that in studies cortisol was assayed either in saliva or in urine, significant decreases were noted in cortisol levels (averaging decreases 31%). In studies in which the activating neurotransmitters (serotonin and dopamine) were assayed in urine, an average increase of 28% was noted for serotonin and an average increase of 31% was noted for dopamine. These studies combined suggest the stress-alleviating effects (decreased cortisol) and the activating effects (increased serotonin and dopamine) of massage therapy on a variety of medical conditions and stressful experiences. They suggest that massage therapy improves overall wellness that can be utilized as an external source of increasing the happy neurotransmitters.
In some cases, Norepinephrine was also tagged to be part of the major depression cycle. See the image below:
The three neurotransmitters combine to maintain mood, focus and learning. Interestingly enough however, the serotonin-norepinephrine connection is what mostly determines the increase in depression, while dopamine-serotonin here is claimed to be highly involved in learning. Would it be safe to say then if the focus was on new learning and equipping one with new skills, that this may also offset major depression with chemical intervention to stabilize the serotonin-norepinephrine channels? New learning has been related to initially boosting dopamine which attracts wellness and confidence, and in turn effects the serotonin levels and pulls away from the norepinephrine pull to depression.
However, learning something new is only a small part of the solution. There are many more complex factors in major depression such as genetics, environmental situations, lifestyle choices which includes work-rest-exercise balance, diet and sleep.
For those with SAD on either the Fall-Winter Seasons or the Spring-Summer Seasons, Dr. Rosenthal says commonly used therapies include Light therapy, psychotherapy, and medications are the main treatments for SAD. Also, stress management and exercise programs can be helpful. Although the first controlled studies of light therapy were conducted only 25 years ago, this treatment has subsequently become the mainstay of SAD therapy throughout the world.
Mayo clinic also indicates that one’s biological clock (circadian rhythm) is part of what is affected by SAD sufferers. The reduced level of sunlight in fall and winter may cause winter-onset SAD.The changes in the season can disrupt the balance of the body’s level of melatonin, which plays a role in sleep patterns and mood. Reduced sunlight can cause a drop in serotonin that may trigger depression.
Dr. Rosenthal agrees with the need for therapeutic sunlight. He says, “Sixty to 80 percent of SAD sufferers benefit from light therapy. The amount of light varies from person to person. The best light therapy units are about 1ft by 1.5ft in surface areas and use white fluorescent lights behind a plastic diffusing screen, which filter out ultraviolet rays. Mornings seem the best time for light therapy to work, although the treatments can be divided during the day. Most people respond to light therapy within 2 to 4 days of initiating treatment. Although the amount of time needed varies, most people need between 30 and 90 minutes (10,000lux) of light therapy per day.”
In the New York Times article by Roni Rabin in 2011, “A Portable Glow to Help Those Winter Blues,” it quotes a 2006 multicenter double-blind randomized controlled trial that compared bright-light therapy head to head with the popular antidepressant Prozac (fluoxetine) in 96 subjects found the two treatments equally effective for alleviating winter depression, though light produced results faster, usually within a week, and with fewer side effects.
Presently, popular companies like Verilux, Nature Bright, and Northern Light Technologies have come up with consumer based light boxes that can be used all year round at home and in other locations with lack of light. Dr. Andrew Weil, a doctor and author who focuses on holistic health recommends SAD sufferers must sit in front of the light for about a half an hour per day. Light therapy is reputed to work in 80 percent of all cases of SAD. This treatment can relieve symptoms within a few days, but sometimes takes as long as two weeks or more. He cautions that while light boxes can be purchased without a prescription, a physician or other mental health professional can provide guidelines as to how to use a light therapy box for maximum effectiveness and may recommend a particular light box (you may need a doctor’s prescription if you’re seeking insurance coverage for the cost of a light therapy box).
Exposure to natural sunlight as well during the long winter months is recommended as well as a walk outside during the morning hours, however that is dependent on lifestyle and weather conditions unfortunately. The bottomline is this: whether it is major depression or SAD that causes you to be frozen in your own life, aiming for the serotonin-dopamine increase will ultimately be the key to off-setting the symptoms and hopefully improve the quality of living in the long run.
Your hand swings up from your side to grab your phone and shut off the music. It was your favorite song, now you hate it. “What was I thinking? A good song isn’t going to miraculously give me the energy to get up and out of this bed.” It’s 7:00; time to wake up. Actually already later than the time you should be getting up. Yet, you simply just can’t. You set the timer on your phone. 3 minutes. Because maybe in three minutes you’ll have the motivation to rise up and face the day. You roll back over, knowing full well it is wishful thinking. Hey… at least it’s 3 more minutes of delaying the inevitable.
Neuroplasticity, for all its positive attributes, has a dark side in the form of bad habits, monotonous routines, and personal, professional ruts to name a few. Maybe it’s motivation to get up in the morning and go to work, or spend time with friends, or go to the gym. Perhaps you feel stuck in a bad habit like an unhealthy relationship or smoking or drinking more than you should. Often times when these dark forms take over your life, they do so at such a slow, sneaky pace, you fail to notice until a friend makes a comment about your mood, behavior, health, or weight. You immediately jump to your own defense; however, later you take a long hard look into a literal or figurative mirror and a wave of panic and self-realization washes over you: she was right. Your mind flips and begins scanning for solutions to this problem. You select the only answer that could possible explain how you have landed in this inexcusable place: You have NO motivation. Obviously this is the problem.
But, what is motivation? Why is it not always the answer?
Motivation can be defined as “the act or process of giving someone a reason for doing something” Merriam-Webster Dictionary. Therefore, it is easy to assume that people need motivation in order to make a change, since typically people don’t change without a reason. Reasons may include a health scare, vanity, sick or being sick and tired of being sick and tired. Why even with reasons pushing people to change, is change still so difficult? Let’s take a look at what is happening in the brain when people are motivated. A study conducted by Mathias Pessiglione and a team of researchers at INSERM, found that the ventral striatum was a general motivational system in the depths of the brain. The ventral striatum was activated during both physical and cognitive activities when participants were incentivized or motivated with money. Additionally, the level of activation showed a positive correlation with increased incentives. This essentially means the more motivating the reward, the more the ventral striatum was activated. However, further studies have shown the involvement of dopamine in motivation is quite complex. Dopamine is released into the nucleus accumbens when people have near-successes as well as when they are successful–this occurrence plays a role in addiction. Additionally, the nucleus accumbens is activated when people are motivated to avoid unpleasant experiences as well. Now let’s add one more blockade to our motivation to change. Researchers at CalTech and UCLA learned that different areas in the brain are activated when people are thinking about how to do something than when they are thinking about why they are doing something. Additionally, the areas in the brain do no appear to fire simultaneously and actually have shown a negative correlation in activity. In short, you need more than motivation to make a change.
Not having motivation and knowing this, is one step closer to change, however; relying on the factors that supposedly will motivate you to change may lead you nowhere except down the same path. If you focus too much on the how, the brain cannot move onto the why; if you focus too much on the why, the brain cannot plan the how. Furthermore, the mere talking, thinking or move towards change may be enough change for dopamine release and an activated nucleus accumbens, which in your brain is enough to lead to a sense of satisfaction.
“If someone is going down the wrong road, he doesn’t need motivation to speed him up. What he needs is education to turn him around.” Jim Rohn
How can you use motivation to change?
The answer is unglamorous and gruesome: you can’t. Change takes more than motivation. It takes work–cumbersome, agonizing work. You will be miserable, hate your life, those around you and pretty much everything related to the change you are trying to make. In addition, you will begin being haunted by reminders of change. All of this a direct result of the very comfortable habit loop you have essentially disrupted. In other words, the dark side of neuroplasticity.
But here’s the lesson: If you push through and put in the work, motivation will come. It will also sustain the new healthy habit you developed because once the change occurs, dopamine as a reward system will kick in when you engage in that new behavior. Your brain, body and mind will begin craving the new healthy habits because the synaptic connections are now wiring and firing together in addition to the other positive outcomes gained from the change in behavior. Motivation alone won’t change your behaviors. Instead, educate yourself on how to change and use those motivating factors to help you persevere to see that change through.
Your hand swings up from your side to grab your phone and shut off the music. It was your favorite song, now you hate it. “What was I thinking? A good song isn’t going to miraculously give me the energy to get up and out of this bed.” It’s 6:00; time to wake up. I really don’t want to, but unless I do, I never will. Change is hard, but I know now it won’t always be this difficult to wake up in the morning. I just need to push through one day at a time and the motivation will come.
As there is the promise still of a new beginning, a do-over in the resetting of the previous year, that uplifting feeling and positivity can collectively be described as Hope. Hope is not necessarily the same for everyone; however, at some point every person in the world has experienced the internal dialogue and introspection and pushed the positive thoughts out into the universe hoping on hope. And maybe a mantra some of us call prayer.
From a brain perspective, hope is activated and is influenced from the neurotransmitter Dopamine.
The two specific receptors we will focus on here are D1 and D2 receptors. These receptors assist in the faciitation of the sense of well-being, which we label as hope. These have been implicated, along with oxytocin receptors, in both the maintenance and formation of social pair bonds, respectively. The density of these receptors in an area of the brain called the nucleus accumbens plays an important role in both mating and social bonds. The D2 type receptor is necessary to initially form the pair bond between two monogamous animals.
Hope then based on this study is not only a singular experience, or a personal experience. Rather, it’s a collective biological, mindful collective unconscious that connects from the youngest child to the oldest human.
A study that supports the social aspect of hope was one on primates conducted by Morgan et. al., 2002, Nature Neuroscience. They had singly housed monkey brains scanned for D2 binding capacity (n = 20). Then, the primates were allowed out of their individual cages for the first time so all the animals were now together, which meant there was an opportunity to create a social hierarchy.
After a stable hierarchy was formed the researchers re-scanned the primates brains. The high ranking animals D2 binding capacity increased by approximately 20% (the authors believe based on rat studies that singly housed animals have a lower than normal D2 levels at baseline, and therefore suggests that falling lower in the social hierarchy would cause a reduction in D2 levels if the animals start at a ‘normal’ baseline), however D2 levels in the low ranking individuals did not change.
In order too see if the changes in D2 levels had a functional effect in these animals, they offered the addictive drug cocaine to the animals.
The high ranking animals with high D2 levels were resistant to addiction while the low ranking animals with low D2 levels were more susceptible to addiction. These results are consistent with a large body of additional research that find low D2 levels is related with higher addiction rate.
Can one then be addicted to the feeling of hope or the idea of it? Can it be strong enough to actually influence the consciousness of one’s mind?
Not directly seems to be the response from the scientific community. Without an external supplement to the dopamine such as cocaine, maintaining the sense of hope to a point of addiction is controlled by the D1-D2 synaptic dance. The brains ability of course to regulate and maintain biological boundaries.
Efforts to investigate dopamine’s role in addiction and normal biological processes have been complicated by the fact that the nervous system contains multiple kinds of receptor molecules for dopamine as well as different types of nerve cells that use dopamine.
“Research in humans and other species has shown that increased vulnerability to drug addiction correlates with reduced availability of D2 dopamine receptors in a brain region called the striatum,” explains David M. Lovinger, Ph.D., chief of NIAAA’s Laboratory for Integrative Neuroscience. “Furthermore, healthy non-drug-abusing humans that have low levels of the D2 dopamine receptor report more pleasant experiences when taking drugs of abuse.”
On another front, Quantum mechanics has determined that if you think it, it is. The thought of hope and the end product of hope are one and the same.
Quantum physics specifically states in the act of observing an object (events, conditions and circumstances) the cause for the thought to be there and the outcome is based only on how we observe it. An object or thought cannot and does not exist independently of its observer.
The Quantum Field is an “Infinite” field of potential. Anything and everything that has, does or will exist, begins as a wave in this field and is transformed into the physical realm, limited only by what can be conceived as truth by the observer.
Following this line of thinking, one can only hope for an experience that is being craved or an object that has not yet been retrieved. All within the realm of the subjective experience of what hope looks like to one person: from positive to negative hopes. Antithetical as this may sound, there’s a reality out there for negative hopes.
That would be best explained with a philosophy of thought called the Theory of Mind.
This theory has roots in philosophy, particularly in the groundwork for a science of the mind laid down by René Descartes (1596–1650). The Swiss psychologist Jean Piaget (1896– 1980) suggested that before the age of 3 or 4 egocentrism prevents children from understanding that other people’s thoughts and viewpoints may differ from their own. And in 1978 Nicholas Humphrey proposed that introspective consciousness has a specific function as it enables social animals to predict each other’s behavior.
Theory of mind is a theory as it is believed one’s mind is not directly observable. The presumption that others have a mind is because each human can only intuit the existence of his/her own mind through introspection, and no one has direct access to the mind of another. It is typically assumed that others have minds by analogy with one’s own, and this assumption is based on the reciprocal nature of social interaction, as observed in joint attention, the functional use of language, and understanding of others’ emotions and actions. Having a theory of mind allows one to attribute thoughts, desires, and intentions to others, to predict or explain their actions, and to posit their intentions.
Without a mind, one would either have negative or no hopes. Someone with a theory of mind (ToM) impairment would be someone having difficulty with perspective taking. This is also sometimes referred to as mind-blindness. This means that individuals with a ToM impairment would have a hard time seeing things from any other perspective than their own. Individuals who experience a theory of mind deficit have difficulty determining the intentions of others, lack understanding of how their behavior affects others, and have a difficult time with social reciprocity.
In the end, no matter which of these you adhere to, the ability to hope is a truly human faculty. Hopefully if will be one hopeful year for those of you with priceless hope.