Alcohol Abuse In A Sad Patient example essay topic

Growing up in Alaska certainly taught me how to live peacefully with the bear minimum in life. Hauling water from a creek in the back of my house, using an outhouse in fifty below zero weather, and above all, living for almost nine months with an extreme lack of sunlight. When I lived in Alaska I treasured the beautiful yet short summer months that seemed to come and go with such swiftness. The difference in weather and amount of sunlight that I got to enjoy was just as drastic as my mood in the wintertime compared to the summer.

In the summer life seemed remarkably pleasurable, I was happier with my appearance, and I worried much less about petty obstacles that I was confronted with. Unlike in the wintertime when every little thing annoyed me, all I wanted to do was sleep and eat, nothing really had importance, and I was in a constant state of anxiety. These mood swings seemed characteristic of the change in seasons and it became such a reoccurring experience that I simply learned to live with my seasonally mixed emotions. Until at age fourteen I moved from Alaska to California, Arizona, and then finally to Virginia, that during that time of travel I realized my moods were not as drastic compared to the change in seasons. This was when I learned of Seasonal Affective Disorder (SAD), a psychological disorder marked by the change in seasons.

It McClain 2 seemed simple to me at first, yet when I learned more about the disorder and the people who it affected, I began to believe that SAD was a disorder that had a greater influence on a person who has a family history of depression and alcohol abuse. Which in my case my family had both, in addition to living in an area where the sun really only comes out three months out of the entire year. As a result I maintain the belief that SAD is a psychological disorder that can be found in people with a family history of depression and alcohol abuse when they are experiencing conditions of environmental isolation, rather than a psychological disorder stemming mainly from a change in seasons. The research that can be found about SAD is in some ways very limited because it is a very recent diagnostic discovery. There really have only been studies conducted on people with possible SAD since 1984 when a man named Norman E. Rosenthal actually defined the psychological disorder (Lam). Since Rosenthal defined SAD as a syndrome characterized by recurrent depressions that occur annually at the same time each year characterized by hypersomnia, overeating, and carbohydrate craving (Newsome), there have been several studies conducted and published on people with possible SAD.

Many of the studies that have been published for the general public focus mainly on the different forms of treatment for SAD, such as light therapy and different forms of Phototherapy, rather than focusing on the cause. Discovering the main causes of SAD would help to clearly identify who is actually in need of treatment related to light therapy compared to anti depressants. In my situation I had symptoms that were both characteristic of what identified SAD patients and patients suffering from mild forms of depression. When symptoms of one disorder are so closely related to symptoms of McClain 3 another type of disorder it is very important to identify a key differentiation, which I believe could be found in a person's family history. Understanding the universality of SAD symptoms is just as important, for example, there have been reports of a sense of sadness, weight gain, loss and lethargy described by poets and seen in cultures and religions through ceremonial festivities marked by the change from summer to winter throughout the centuries (Watkins). Reports like these are still not reason alone to conclude that the seasons affect a person's psychological well being though.

Some people love the winter months with the cold weather and decreased sunlight, while others, who are the typical candidates for light therapy because of a simplified diagnosis of SAD, thrive in the heat and pounding rays of sunlight. This difference with a person's seasonal preference and change in mood demonstrates why the cause could be deeper and rooted in the person's medical family history. It is also the reason why a deeper analysis of symptoms and diagnosis needs to be in place when treating someone for SAD. In my situation, I had seen several different doctors in order to find a cause or a cure for my mood and appetite disorders. Doctors had a different diagnosis, even though I stated the same symptoms to all of them. The relative similarity between some of the many documented psychological disorders is a reason why different case studies have been conducted.

For example, a case-control study conducted by JM Allen and others established that SAD patients demonstrated more atypical symptoms of depression compared to nonseasonal patients, both having similar genetic loading for mood disorders. In addition SAD patients were also determined to have family psychiatric history in first-degree relatives, as well as McClain 4 being more likely to have alcoholism in their families (Lam). Thus signifying the importance for investigating a person's family history before diagnosing them with the typical SAD associated with deprivation of light. When a person is treated with light or Phototherapy and their disorder stems deeper than lack of light no true cure and treatment has been accomplished, witnessed, or documented (Lam).

Due to the number of people that have been misdiagnosed with SAD, several studies have been conducted in order to determine if anti depressants have greater affects on curing symptoms associated with SAD patients compared to the treatment of light therapy. As a result case studies have suggested that such prescriptions as citalopram", a selective serotonin reuptake inhibitor", where just as effective as light therapy (Wirz). This study and reports that another prescription called Fluoxetine are shown to be just as effective for SAD as compared to light therapy (Ruhrmann). Accordingly a question remains whether inhibitors, which are used for patients dealing with depression, are more effective than light therapy or if in combination they would work better than alone (Lam). A question that could be answered by deep investigation of a patient's individual and family history, which would show if depression is evident alone or along side feelings of deprivation of sunlight due to seasonal changes. Other factors need to be considered in the diagnosis of SAD patients in order to determine the key difference between psychological disorders that have very similar symptoms.

A person's geographic location has been the key factor in many of the studies recently conducted. The studies examining different geographic populations demonstrated that SAD is much more complicated than it originally appeared to former McClain 5 researchers. These case studies have been conducted in different parts of the world such as Alaska, Switzerland, Italy, and Canada. One of the statistical results are as follows, in "Canada, 20% of people diagnosed with clinical depression also displayed symptoms of SAD", showing that there might be a correlation between SAD and other forms of depression (Williams). Varying forms of depression on the diagnosis of SAD makes treatment much more complicated and in dire need of further investigation of family history especially if involving alcohol abuse. In Alaska there are several people who suffer from alcoholism, and many claim that it is due to the wintertime blues.

Ignoring the fact that alcohol abuse can be traced through your family history and linked very closely with depression and cases of SAD. For example, my family has a history of alcohol abuse and depression, which both my mother and father suffered mild forms of in their youth living on the east coast. When they moved to Alaska they both began to suffer stronger forms of their individual disorders, thus demonstrating how different geographic locations with harsher seasonal changes can enhance psychological disorders, rather than cause them. There have been recent studies suggesting the importance of this relationship between Seasonal Affective Disorder and alcohol abuse both of which are very common throughout the population. These studies also examined the importance of family history and found through family studies and using the family history method that, "41% of SAD patients had first-degree relatives with alcoholism compared with only 18% of non-SAD patients", which demonstrates the high occurrence of people diagnosed with SAD also having other disorders (Alien). In addition to this finding, it was also found that the McClain 6"incidence of alcoholism among first-degree relatives of patients with SAD (even those without a personal history of alcohol abuse) is greater than the incidence among blood relatives of controls (20% vs. 7.2%) " (Alien).

This discovery proves that the diagnosis of SAD is rooted deeper than a lack of sunlight and that the importance of knowing a person's family history of depression or alcohol abuse is growing even stronger because SAD patients with alcoholism may be self-medicating an underlying depression with alcohol, especially given the carbohydrate craving associated with SAD, or manifesting a seasonal pattern to alcohol-induced depression (Alien). That is why it is very critical for a doctor to know a person's previous disorders or family history before making a final diagnosis. For instance, alcohol abuse in the individual or his or her family is a very important aspect to consider when diagnosing someone with SAD because alcohol abuse alone cannot be treated by the typical light or Phototherapy. A person could spend hundreds of dollars and hours on light therapy being exposed to possible risks and undefined benefits if alcohol abuse in a SAD patient is disregarded.

Phototherapy has received negative press because of the possible side effects one might experience (Lindner). The reported side effects include, photophobia, headaches, fatigue, irritability, hypomania, insomnia, and the possibility of retinal damage (Lindner). Some of these side effects are the actual symptoms that signaled a doctor to diagnose light therapy for SAD in the first instance, creating a cycle of untreated psychoses. In the medicinal and scientific communities a cycle such as the one described previously is a great indication that further investigation and discovery is needed. One McClain 7 reason why it is so hard to diagnose a patient with a specific disorder is because every person is very unique, with different experiences in their lives as well as vast differences in their medical family history.

Even when one case study indicates a specific key factor in the diagnosis of a disorder there still needs to be further investigation due to the fact that not every person will be affected by the same factors. The main reason why I have argued that knowing a person's family history is vital in the diagnosis and cause of any disorder is because the more a doctor or researcher knows about their patient the better they can pinpoint the main cause. Which is also why I have a firm belief that persons diagnosed with SAD should be further examined in order to make a concise decision on whether their symptoms of SAD are stemming from a family or personal history of alcohol abuse and or depression. This knowledge would increase the accuracy of doctors' diagnoses as well as help to more clearly identify symptoms of different disorders in the future. McClain 8

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