Dark Days, Darker Spirits

By Anastasia Toufexis

Nell Krabacher lived happily with her husband in Anchorage throughout the spring and summer of 1986. Then came the fall. As the days grew shorter, her spirits darkened. The ex-aerobics instructor, then 30, began gorging on carbohydrates, became increasingly lethargic, and would burst into tears for no apparent reason. By November, when daylight lasted only seven hours, Krabacher had gained 20 lbs. "There were some days," she recalls, "when all I could do was get out of bed and get on the couch and stare until the sun came up." Miserable and panicked, Krabacher fled to her former home in Southern California. Her symptoms soon disappeared.

She returned to Anchorage in the spring, and once more everything was fine. Until this fall, that is, when her mystifying gloomy feelings resurfaced. "All of a sudden I found myself obsessed with getting out of here," says Krabacher. "I didn't want that." Instead, she sought help at a local clinic, where she received a novel prescription: sit in front of a bank of bright lights for several hours a day. Within a week she was back to her normal sunny self. Says Krabacher, who now basks in fake sunlight each day at the desk in her office: "I'm finally having a good winter up here."

Krabacher suffers from SAD, short for seasonal affective disorder, a syndrome characterized by severe seasonal mood swings. "This is more than the winter blahs," says Psychiatrist Carla Hellekson of Fairbanks. "This is something that needs to be taken care of." Researchers at the National Institute of Mental Health began studying and defining the syndrome in the early 1980s; it received formal acceptance this spring, when it was included for the first time in the American Psychiatric Association's bible, the Diagnostic and Statistical Manual of Mental Disorders (Third Edition). Says NIMH Research Psychiatrist Norman Rosenthal, a pioneer in SAD studies: "People who suffer from depression are less able to cope with stresses that knock them out of equilibrium; they can't roll with the punches. We have now expanded that idea from psychological stresses to the physical environment."

Typically, SAD sufferers become clinically depressed with the approach of winter. Besides gaining weight, oversleeping and being listless, they withdraw socially, lose interest in sex and feel anxious and irritable. As spring approaches, depression subsides and behavior returns to normal. In fact, some people become downright euphoric during the long days of July and August. Carl Harris, 37, of Takoma Park, Md., whose winter plaint is "If I were a bear, I'd hibernate," finds in summer that he needs only four hours of sleep a night and can work two or three jobs at once. Latitude appears to be as important as season: the incidence and severity of SAD increase with distance ; from the equator, peaking at around 40 degrees north. "It's as if there's a 'biological equator,' " explains Psychiatrist Thomas Wehr, head of NIMH's psychobiology branch.

With research in its infancy, investigators can only guess at the number of SAD victims -- in the U.S., the figure is estimated at anywhere from 450,000 to 5 million -- and they caution against making SAD the new fad disorder. Experts say the syndrome, which afflicts about four times as many women as men, usually appears in the early 20s. But the malady has been diagnosed in children as young as nine. Child Psychiatrist William Sonis of the University of Pennsylvania, who in a 1985 survey found that 6.5% of 1,000 students at a suburban Minnesota high school had SAD, says that too often "the symptoms are attributed to school-related issues, like the seventh- or tenth-grade slump." Or they are ascribed to behavior problems. "The most prevalent symptom among children is irritability," says Sonis. "Kids said they picked fights and they didn't know why." The clue that their problems are due to SAD: depression recurs year after year.

What causes SAD is a mystery. Experts suspect there is a genetic factor, because more than two-thirds of those with the syndrome have a close relative with a mood disorder. Also baffling is the exact role that the absence or presence of light plays in seasonal mood shifts. Among the theories: a disturbance in the body's natural clock and abnormal production of melatonin, a hormone manufactured in the brain, and serotonin, a chemical that helps transmit nerve impulses.

The only certainty so far is that light therapy relieves SAD. Sufferers readily pay around $400 for a sun-box, a device containing several fluorescent light tubes that emit the full spectrum of natural light at five to ten times the intensity of indoor lighting. Says Hellekson: "The light you get is about equivalent to standing one inch away from a window on a sunny spring day." Because light seems to affect the body through the eyes and not the skin, tanning therapy doesn't work, Rosenthal points out. Some patients spend from 30 minutes to five hours daily soaking up the sun-box rays. For Dalene Barry, 44, of Washington, who each winter used to endure near suicidal depressions and weight gains of up to 40 lbs., light therapy has been liberating. "It's like a gift someone's given me," she declares. "I get four months a year back that I never had."

With reporting by Glenn Garelik/Washington and David Postman/Anchorage