Winter Blues: Seasonal Affective Disorder: What It Is and How to Overcome It

Rosenthal, Norman E. M.D. New York: Guilford Publications, Inc., 1993. Paperback, 325 pages.

Norman Rosenthal, M.D., is a pioneer in the study of seasonal affective disorder (SAD) and director of the light studies at the National Institute of Mental Health. His expertise and his own sensitivity to seasonal variations first resulted in his 1989 classic, Seasons of the Mind. The revised edition, renamed Winter Blues, is a “must read” book for anyone interested in SAD. Dr. Rosenthal invites the reader to see what SAD is, how it affects people, and what can be done about it. The reader feels as if he or she has the benefit of expert, cutting-edge medical information along with the common-sense help and caring of a support group.

Winter Blues is written at a level useful to both the novice and the informed SAD patient. It also has practical information for family members and friends; family physicians; and the clergy, school personnel, and other helping professionals. Further, this book is an excellent introduction to affective disorders for the layperson whose interest has been piqued by the recent media focus on SDA, Prozac, and depression in general.

The first section of the book gives a detailed clinical profile that addresses the central features of SAD along with individual variations. Dr. Rosenthal presents an appealing case for placing SAD along a continuum of seasonal responses experienced by many people, a model which aids understanding of the illness and may act to lessen stigma. Particularly well explored are the somatic (bodily) complaints of fatigue/low energy, difficult morning rising, carbohydrate craving, and weight loss/gain. Also discussed is the “just leave me alone” symptom which can be so distressing to family members and friends.

Part 2, “Treatments,” explores light therapy in detail, focusing on recent developments in implementation and refinements of light-box technology. Psychotherapy and medication are discussed in a manner helpful even to treatment veterans. Most interesting to me were the chapters “Beyond Light Therapy: Other Ways to Help Yourself” and “Combining Different Types of Treatment.” These issue frequently come up in support groups and informational meetings; addressing them encourages people to work with their mental-health professionals on a personalized treatment plan for attaining the highest possible degree of functioning.

There is also a comprehensive resource section providing information ranging from where to purchase a light box; to dietary advice, menus, and recipes; to support groups. Depression self-rating scales are also included, but be careful to make sure, if you’re buying, that a browser has not already filled them in.

Winter Blues is one the best books I’ve read about mood disorders and will be a well-thumbed volume on my bookshelf.

By Lissa Falk

Book Reviews

Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families and Providers, Torrey, E. Fuller, M.D., and Knable, Michael B., M.D. New York: Basic Books, 2002. Hardback, 395 pages.

A comprehensive, clearly written book examining many aspects of manic-depression (a term the authors prefer over the DSM III designation, “bipolar disorder”). In defining the illness, the authors review the various states of the disorder and explore the differences and similarities among manic-depression, depression, and schizophrenia. A chapter is devoted to the important distinction between manic-depressive illnesses and conditions that might be confused with it, such as mania caused by drugs, head injuries, and other illnesses. There is a thorough discussion on medications, including drug interactions, treatment strategies for different phases of the illness, and frequently asked questions. “Ten Special Problems” examines social and compliance issues associated with the disease, including suicide, homelessness, and the difficult problem of “the seduction of mania”-patients’ enjoyment of manic states, which often causes them to resist treatment.

Although the book provides much useful information on manic-depressive illness and dispels some myths, it also perpetuates a few myths. The authors cite reports claiming that most successful Wall Street stock traders have a form of manic-depressive illness called the “CEO disease.” They mention high-publicity, violent criminal cases in the 1990s that involved individuals with manic-depression. However, if one were to compare those with the total prevalence of violent crimes committed throughout the United States, any difference in percentage is probably minuscule. The authors also claim that psychotherapy is not necessary for many patients with the illness, and that the treating physician can be an internist or family practitioner.

Keeping in mind the aforementioned short-comings, Surviving Manic Depression is a well-written guide to help the reader understand a difficult illness.

By Marion Ehrlich