The night was cold and dreary. That about sums up some of the recent weather in my hometown. After a mild winter that nudged tulips and daffodils through last year's mulch of leaves earlier than expected, we are paying the price in the Pacific Northwest.

Once again, thanks to a mutual agreement with a good friend who exchanges the hospitality of her Arizona home for pet-sitting responsibilities I had the opportunity to escape. After I spent several days in the bright sun and higher altitude I was stunned to discover how much my mood had lifted. I thought I'd avoided SAD this year. (You read correctly. It's not "being SAD" it's SAD.) I realized I hadn't.

For those of you who live in predominately sunny or high altitude climates, you may be unfamiliar with SAD. SAD is an acronym for seasonal affective disorder, a form of depression caused by a biochemical imbalance in the hypothalamus, It's precipitated by shortened daylight hours and a lack of sunlight in winter. It's also known by the more common name, "winter blues." For some people SAD is a mild but debilitating condition that causes discomfort but not suffering. For others it is a seriously disabling illness that requires medical treatment. Regardless, it tends to recur regularly each winter with an early onset that begins between September and November and continues until well into April.

There are many symptoms for this medical syndrome including disturbed sleep, lethargy, overeating (usually craving of carbohydrates which changes brain serotonin levels and elicits a temporary lift of mood), irritability and withdrawal, tension and inability to tolerate stress, decreased interest in sex and the misery, guilt and loss of self-esteem that is a hallmark of depression. Most people who suffer with SAD also have a weakened immune system during winter when they are more vulnerable to infections and other illnesses. In late spring, symptoms disappear-sometimes quickly with a brief period of hyperactivity or hypomania.

People who suffer from depression often treat themselves unfairly by comparing their situation to someone whose life situation seems worse. If they don't hear it from others they tell themselves, "Pick yourself up by the bootstraps," The tragedy is that this is a biochemically based syndrome. Although cognitive coping strategies help, they don't change the underlying biochemistry that is the hallmark of the syndrome that can be relieved somewhat with healthy eating and regular exercise. However, when you are down in the dumps taking care of yourself is often the last thing that appeals to you.

If you have had the blues lately you need to be proactive about how you will take care of yourself next year since there's a very good chance the syndrome will recur. The downside is that when you are down in the dumps, taking care of yourself is often the last thing that appeals to you. Daily exercise and good nutrition bring some relief but the most successful treatment is the use of light therapy. This is exposure, for up to four hours a day, to very bright light that is at least ten times the intensity of ordinary domestic lighting. Readers of this newsletter will discover that the internet is the best source for these products which still aren't mainstreamed into stores although some hardware stores carry less intense full spectrum lights that can help brighten a room. Some of the newer anti-depressants are helpful when combined with the light therapy and counseling or other complementary therapies which promote relaxation, an ability to accept illness and cope with its limitations. Some people get relief from the herb, St. John's Wort, but before you use it remember that despite it's availability without a prescription it is a drug that not only interacts with other drugs but also makes you susceptible to sunburn when you do find some sun.

My trip to Arizona reminded me of another interesting facet of illness. We often don't know how bad off we were until we feel better. Happily I do (feel better). And, armed with the experience I've already penciled "begin light therapy" on my calendar for September and some earlier in the winter trips to sunny climes. Life is good.