Depression seasonal

Melatonin [73-31-4] C 2H N202 (31) has marked effects on circadian rhythm (11). Novel ligands for melatonin receptors such as (32) (12), C2yH2gN202, have affinities in the range of 10 Af, and have potential use as therapeutic agents in the treatment of the sleep disorders associated with jet lag. Such agents may also be usehil in the treatment of seasonal affective disorder (SAD), the depression associated with the winter months. Histamine (see Histamine and histamine antagonists), adenosine (see Nucleic acids), and neuropeptides such as corticotropin-like intermediate lobe peptide (CLIP) and vasoactive intestinal polypeptide (VIP) have also been reported to have sedative—hypnotic activities (7). 

Varieties which were intermediate in hardiness either had no significant yield depressions, or had a lighter crop than usual. In these varieties there was significant leaf death which will have delayed development in the growing season. 

Light therapy is an alternative treatment for depression associated with seasonal (e.g., winter) exacerbations. Possible side effects include eye strain, headache, insomnia, and hypo-mania.16,17 Also, potentially vulnerable patients, such as those with photosensitivity or a history of skin cancer, should be evaluated carefully prior to therapy.16... 

In clinical psychiatric terms, the affective disorders can be subdivided into unipolar and bipolar disorders. Unipolar depression is also known as psychotic depression, endogenous depression, idiopathic depression and major depressive disorder. Bipolar disorder is now recognised as being heterogeneous bipolar disorder I is equivalent to classical manic depressive psychosis, or manic depression, while bipolar disorder II is depression with hypomania (Dean, 2002). Unipolar mania is where periods of mania alternate with periods of more normal moods. Seasonal affective disorder (SAD) refers to depression with its onset most commonly in winter, followed by a gradual remission in spring. Some milder forms of severe depression, often those with an identifiable cause, may be referred to as reactive or neurotic depression. Secondary depression is associated with other illnesses, such as neuro-degenerative or cardiovascular diseases, and is relatively common. 

Disturbances of sleep are typical of mood disorders, and belong to the core symptoms of major depression. More than 90% of depressed patients complain of impaired sleep quality [60], Typically, patients suffer from difficulties in falling asleep, frequent nocturnal awakenings, and early morning awakening. Not only is insomnia a typical symptom of depression but, studies suggest, conversely, insomnia may be an independent risk factor for depression. In bipolar disorders sleep loss may also be a risk factor for the development of mania. Hypersomnia is less typical for depression [61] and, in contrast to insomnia, may be related to certain subtypes of depression, such as seasonal affective disorder (SAD). 

The length and severity of a mood episode and the interval between episodes vary from patient to patient. Manic episodes are usually briefer and end more abruptly than major depressive episodes. The average length of untreated manic episodes ranges from 4 to 13 months. Episodes can occur regularly (at the same time or season of theyear) and often cluster at 12-month intervals. Women have more depressive episodes than manic episodes, whereas men have a more even distribution of episodes. 

Bright light therapy (i.e., the patient looking into a 10,000-lux intensity light box for about 30 min/day) may be used for patients with seasonal affective disorder and as adjunctive use for major depression. 

However, the microbial activity is depressed during long and severe wintertime, and this leads to an accumulation of semi-mineralizable plant residues on the soil surface. With the increasing duration of cold season from south to north, the mass of these half-destroyed remains enlarges from 15 ton/ha of dry organic matter in Broad-Leaved Sub-Boreal Forest ecosystems to 80-85 ton/ha in Northern Taiga Forest ecosystems. 

To mimic melatonin action and increase the half-life is the goal of melatonin receptor agonists, which are the more recent addition to the insomnia therapeutic armamentarium. These compounds, in addition to use for insomnia, may have potential application in the synchronization of disturbed circadian rhythms, sleep disturbances in the elderly, seasonal depression and jet lag, to name a few. Furthermore, studies have shown that melatonin receptor agonists do not induce any of the hypothermic, hypotensive or bradycardic effects caused by melatonin in humans [27,28]. 

Uniabeied Uses Treatment of attention-deficit/hyperactivity disorder, brain injury-re-lafed underarousal, depression, endozepine stupor, multiple sclerosis-related fatigue, parkinson-related fatigue, seasonal affective disorder... 

The initial choice of therapy is also dictated by the severity of the depression (e.g., the severity of depressive symptoms impedes an adequate trial of psychotherapy), subtype of depression (e.g., presence of psychosis, seasonal depression, or treatment-resistant depressions) presence of comorbid disorders, prior treatment history, child and parent motivation toward treatment, and the clinician s motivation and expertise in implementing any specific intervention. 

With seasonal pattern (applies only to the pattern of major depressive episodes)... 

A typical example of diagnostic splintering provides the group of mood disorders. One reads about major depression, minor depression, double depression, dysthymia, unipolar and bipolar depression, depressive personality, depression not otherwise specified, brief recurrent depression, subsyndromal symptomatic depression, mixed anxiety depression disorder, seasonal depression, and adjustment disorder with depressive mood. 

Kupfer 1987 Soldatos et al. 1987). However, despite these intergroup differences, a subgroup of depressed patients may actually sleep more than the control subjects (Garvey et al. 1984 Kupfer 1984 Michaelis and Hofmann 1973) this subgroup includes mainly patients with seasonal affective disorder (Rosenthal et al. 1984) and those with anergic depression of the bipolar type (Detre et al. 1972 Kupfer et al. 1972). 

A number of epidemiological studies [including several reviewed in May and Lichterman 1993] have shown that panic disorder and unipolar depression occur more commonly together than could be explained by chance. Some 50%-70% of patients with panic disorder also have major depression [J. Johnson et al. 1990 Volrath and Angst 1989]. The association also holds true for seasonal depression [Halle and Dilsaver 1993] and to some extent for bipolar disorders [Savino et al. 1993]. 

Oppenheim G Estrogen in the treatment of depression neuropharmacological mechanisms. Arch Gen Psychiatry 43 569-573, 1986 Oren DA, Moul DE, Schwartz PJ, et al A controlled trial of levodopa plus carbidopa in the treatment of winter seasonal affective disorders a test of the dopamine hypothesis. J Chn Psychopharmacol 14 196-200, 1994 Ormandy G, Jope RS Analysis of the convulsant-potentiating effects of lithium in rats. Exp Neurol 111 356-361, 1991... 

Lindquist (34) and his associates have applied Diesel oil containing DDT or other chlorinated hydrocarbons as a prehatching treatment for controlling snow-water mosquitoes. Late in the fail Lindquist applied several oil formulations containing chlorinated hydrocarbon insecticides to swales and depressions that had produced mosquitoes in season. These oil formulations remained on the ground during the winter and when flooded with snow water proved toxic to the newly hatched mosquito larvae. A dosage of 2 pounds of DDT per acre (10 quarts of a 5% DDT-oil solution) prevented mosquito development in some instances for 2 years. 

Reports vary as to the predominant picture, which ranges from one quite similar to melancholia to one more consistent with an atypical depressive disorder or a bipolar II disorder (Table 6-5). Complaints usually involve a diminution in energy, followed by an increased need for sleep, increased appetite and weight, and a lack of involvement or interest in one s activities. Only toward the end of the episode onset does the patient become aware of the depressed mood and such classic symptoms as poor concentration, feelings of self-worthlessness, and multiple somatic complaints. Insomnia often develops over the next 1 to 2 months. Whereas this atypical picture is more characteristic of the early phases of the illness, reminiscent of certain bipolar subtypes, the affective episode appears to evolve toward a more classic depressive syndrome as it progresses over multiple seasons. 

Neumeister A, Praschak-Rieder N, Hebelmann B, et al. Rapid tryptophan depletion in drug-free depressed patients with seasonal affective disorder. Am J Psychiatry 1997 154 1153-1155. 

Lacoste V, Wirz-Justice A. Seasonal variation in normal subjects an update of variables current in depression research. In Rosenthal NE, Blehar MC, eds. Seasonai affective disorders and phototherapy. New York Guilford Press, 1989. 

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