Licensed books on medicine
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How does the brain know that it is time to fall into seasonal depression?
But the victims of seasonal affective disorder also synthesize melatonin in the winter over nine night hours, but in the summer less than eight and a half. This, in general, does not negate the main conclusion that those people whose internal hormonal rhythms are especially sensitive to lighting changes are susceptible to seasonal depression, but emphasizes that it’s not the melatonin concentration per se, but rather the fact that its level changes. Distortions of the normal daily rhythm of melatonin secretion, by the way, are found not only in seasonal affective disorder, but also in other forms of depression, and in some cases they are even trying to be treated with the additional intake of this substance - with varying success, however.
If we are not talking about depression as a whole, namely about seasonal affective disorder, then yes, it is precisely associated with changes in the level of illumination, but the brain reacts to it not only through melatonin synthesis, but also through a number of other biochemical pathways. The main center of control of daily rhythms (it is usually called the biological clock) is located in the suprachiasmatic nucleus of the hypothalamus. A real molecular pendulum works there: several proteins activate and suppress the synthesis of each other (and themselves) in such a way that their concentration in neurons changes cyclically during the day: one momentary combination corresponds to the dark time of day, the other means that morning has come, in the afternoon all changing again, and in the evening everything comes to its former state, and the brain understands this in the spirit that night comes and it is time to sleep. This molecular machine makes a cycle approximately equal to days, and it depends on the genetic characteristics of an individual whether these clocks tend to hurry or fall behind (owls and larks seem to determine) - but, in addition, the suprachiasmatic nucleus of the hypothalamus receives nerve impulses from retina and all the time tightening up their internal clocks, adjusting them to the real solar rhythm (otherwise we could not change the time zones and adjust to the new change of day and night). Today it is known that some genes involved in molecular hours (for example, Per2, Bmall, Npas2) are present in different people in different ways, and this genetic diversity allows us to predict with a high degree of certainty whether a given person is prone to seasonal depression. In any case, when comparing the DNA of people suffering from and not suffering from seasonal affective disorder, it turns out that the frequency of occurrence of different variants of these genes in these two groups differs significantly.
Naturally, as with any other type of depression, with seasonal affective disorder, changes in the activity of serotonin and dopamine are observed, and some genetic differences associated with the work of these molecules in the brain are found20. Classical antidepressants, such as selective serotonin reuptake inhibitors, help against seasonal depression, respectively. But the main method of treating seasonal affective disorder is the banal effect of bright light. People come to the medical office (usually in the morning, although there are studies that evening light is also effective) and sit there for two hours around a bright light bulb, specially designed so that its radiation imitates sunlight. The retina receives a signal that there is a lot of light, nerve impulses are transmitted to the epiphysis, where melatonin is produced, and to the suprachiasmatic nucleus, where molecular biological clocks work, and the brain decides that, judging by the light intensity, we have a spring here rather than autumn, so that depression can be stopped.
In this story of seasonal depression, it seems to me that it is important to understand that this is a real illness, like the flu or a fracture of the radius. As with any illness, with depression, there are completely material changes, some molecules become larger, others smaller, the brain does not want something, but rather cannot work as it should. Our beautiful subtle psyche is a product of the work of neurons, and if their biochemical state changes, so does the perception of the world and its place in it. Despite the fact that a complete and comprehensive understanding of the mechanisms of seasonal depression still does not exist, it is still sufficiently studied so that doctors can help with it. And therefore, no one is obliged to desperately suffer every November - everyone has the right to go to the doctor and do something about it.
A real severe seasonal depression — such that it really poses a threat to a full life and work — happens only to people who have a genetic predisposition toward it, and even in the most terrible northern city, less than 20% of its inhabitants suffer from it. But even mild forms of seasonal affective disorder, such as are not worth the fuss with a light bulb or, especially, with medications, but still reduce mood, are not necessarily heroically tolerated without any struggle at all. It makes sense to remember that the bad mood in November is directly related to the lack of light, and consciously pay attention to the fact that there is more light. Ordinary light bulbs are not very similar to the sun, but still slightly deceive the retina, so in the fall it makes sense to light all the lights in the room and screw the brightest light bulbs found in the store into the chandelier. And most importantly - even the autumn sun is better than no sun at all, and therefore, if you are suffering, then you need to force yourself to go for a walk in the daytime. I understand that in November this bright time is too little and it is fully occupied with work, but work will be done faster and more efficiently if employees don’t get depressed, and it’s better to lose half an hour for a walk than half the working day for office procrastination. By the way, in the United States alone, depressed employees cost employers $ 44 billion in lost profit per year - this figure has nothing to do with medical expenses, it is only a matter of decreasing labor productivity. People who are depressed tend to think slowly and cannot concentrate on anything normally. Of course, we are talking about all depressions, not only the mild form of seasonal affective disorder, but it does not contribute to productive work. Therefore, if you are overwhelmed by autumn despondency and you don’t want anything, then rehabilitation should be started by going for a walk more often, especially in sunny weather. This is not negligence, it is applied science.
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How does the brain know that it is time to fall into seasonal depression?
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