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Winter Blues: Seasonal Affective Disorder, What it is and how to overcome it. (Revised and updated)
By Norman E. Rosenthal. New York: The Guilford Press, 1998, 354pp., $14.95
In which months do you gain the most weight? Are they the same months when you sleep the most, east the most and socialize the least? Do your mood and energy level change with the seasons? If so, you might be one of the six percent of the U.S. population who suffer from seasonal difficulties, such as Seasonal Affective Disorder (SAD). A Senior Researcher at the National Institute of Mental Health, Dr. Norman E. Rosenthal is one of the eminent practitioners responsible for advancement in the understanding and treatment of seasonal depression. This revised and updated version of his book aims to address the new cultural perspective in which the debate no longer centers around if seasons affect mood, but how; and more importantly, what is the best treatment.
Dr. Rosenthal’s book is incredibly informative; it is not only written by an expert in the field, but it is crafted in a comprehensive, yet comprehendible, style. The text includes explanations and definitions of seasonal disorders, questionnaires to test the reader, and charts to map the reader’s seasonality. It also addresses SAD in children and adolescents, including signs to look for and which treatment strategies are most effective. Although the majority of the book focuses on clients with winter difficulties, Rosenthal does include a section devoted to clients afflicted with summer SAD, in which productivity and mood are decreased during the summer.
In addition to the clear definitions and explanations about the disorders, another advantage of this book is its extensive exploration of treatment options. Dr. Rosenthal addresses options ranging from the pedestrian, such as merely spending more time outdoors, to the involved, such as entirely relocating residence. He thoroughly examines the pros and cons of using light therapy including boxes, visors, and dawn simulators. The greatest strength of the treatment section is Dr. Rosenthal’s inclusion of the forty most frequently asked questions about light therapy. True to his style, his answers are clear, concise and informative, and provide readers with a knowledge base so they can play a more active role in treatment method decisions.
The treatment section is not limited to an either-or approach, as Dr. Rosenthal explores combination plans, in which psychotherapy or medication can be used in combination or in conjunction with light therapy. This section could be especially invaluable to the reader because it describes different psychotherapeutic orientations as well as the different classes and types of medication. Again, this adds to the reader’s knowledge and increases comfort and confidence regarding treatment decisions.
In addition to treatment options for SAD, Dr. Rosenthal also acknowledges those symptoms which often are associated with the disorder. For instance, SAD sufferers often are ‘carbohydrate addicts’ and crave comfort food such as bread, cake, cookies, cereal, fruit or fruit juice. Some SAD clients are trapped in a cycle in which they gain up to 15 pounds in the winter and shed that weight in the summer. This cycle is dangerous to one’s health and adds to their winter depression. Dr. Rosenthal includes the ‘Carb Addicts’ Diet discovered by Drs. Rachael and Richard Heller as a tool for those SAD clients who suffer from the associated craving for comfort foods.
This book is an asset to a SAD client because it is incredibly informative, has an extensive exploration of treatment options, and also addresses treatment plans for those symptoms associated with SAD. While all of these factors lead to a more informed SAD client, the greatest emotional assets to the SAD client are the examples and case studies. Often SAD sufferers feel withdrawn and isolated in the winter, and these examples help illustrate that those feelings are a result of the disorder, not of the individual. Dr. Rosenthal combines the informative and emotional when he discusses his battle with SAD, as well the treatment plan that works best for him. Winter Blues is a wonderful tool for SAD sufferers because they can read it independently, providing them the space and distance they at times desire, while allowing them to learn and understand that they are not alone.
In addition to the above strengths, Dr. Rosenthal’s book includes a resources section to provide information about where to purchase light fixtures, how to find a qualified practitioner who can treat SAD, support groups and informative web pages. The resources all reflect Dr. Rosenthal’s experience and expertise in the field as he includes only light companies and support groups which are well established and which he has personally been impressed with their quality. In response to reader feedback, Dr. Rosenthal has made some adjustments from the last edition of this book regarding his advice on how to find a psychotherapist. He also updated the web site list in accordance with the expanding web based literature.
A unique feature is the inclusion of dietary advice menus and recipes which endorse a carbohydrate and protein balanced diet. Dr. Rosenthal includes the complete menu for seven days, including snacks, recipes, and his own success story. This step by step approach makes understanding a new diet much more manageable and less intimidating to the SAD client.
Winter Blues is appropriate for any adult suffering from SAD as well as any friend or relative of someone with seasonal difficulties. While complex topics are discussed, such as the psychological, biological and neurological factors of SAD, this discussion is straightforward, well explained, and does not require any previous knowledge.
This book could be extremely beneficial to clients with SAD since many individuals lack understanding about the disorder. Often people feel isolated from friends and can provide no explanation for their change in behavior. Likewise, SAD clients are likely to become frustrated when they are repeatedly told by their physician that nothing is wrong with them. This book could serve as an excellent educational tool for better understanding, as well as a source of comfort that shows that others feel the same way and struggle with similar issues. The psychotherapist might find it most beneficial not only to have the client read this book, but to encourage the client’s spouse, or family members to read it as well. Seasonal difficulties can put a tremendous strain on a marriage. Family members often report that they feel they live with two different people, a summer and winter person. This book might serve as an excellent tool for the psychotherapist to reach out and instruct others in how to understand and be supportive of a SAD client.
It might be advised that a psychotherapist not assign the entire book to a client. Rather, clients should read sections of particular personal relevance that may then be discussed in subsequent psychotherapy sessions. Assigning the book by chapters is recommended for two reasons. First, a good part of the book addresses preparation for psychotherapy, including the difference between the orientations and how to select a psychotherapist. While Rosenthal provides good tips, much of this information will come too late to benefit your client. Second, in what is perhaps the only weakness of this book, much of the pertinent information is repeated in several sections of the text. For a SAD patient during their down season, any task can seen daunting, so assigning smaller sections may be less intimidating, but due to the repetitive writing style, they will still receive all the crucial information.
Overall, this is a solid book that is highly recommended to sufferers of SAD. A clear, concise read, this book could be incorporated into psychotherapy as an educational tool and could be incredibly beneficial to both clients and their families.