Seasonal affective disorder (SAD) is a type of serious depression that appears at the same time each year, starting in the fall or winter and symptoms goes away in the spring. Some people also suffer from less common type of SAD known as summer onset depression, which usually starts in the late spring and feel much better in winter.

What are the risk factors for SAD?

1. women
2. People of young age and old age.
3. People who have a close relatives with Seasonal affective disorder
4. People who live in very cold or very hot area.

What causes the Seasonal affective disorder?

Exact mechanism of SAD is still unknown but believed that SAD has been linked to an imbalance in the brain due to lack of sunlight in the winter. Other specific factors that may come into play include:

Serotonin levels: serotonin is chemical that affect mood which is produced and act by sunlight .Reduced sunlight can cause a drop in serotonin, perhaps leading to SAD.

Melatonin level: As same as serotonin.

What are the symptoms of Seasonal affective disorder?

Different people do not experience the same symptoms but the common symptoms of winter-onset SAD include:

1. Depressed mood
2. Lost of interest in usually enjoyable activities
3. Fatigue
4. Poor concentration
5. Thoughts of death or suicide
6. Sleeping more
7. Weight gain
8. Irritability
9. Behavior disturbance
10. Loss of sex drive

Symptoms of summer-onset Seasonal affective disorder include:

1. Loss of appetite
2. Insomnia
3. Weight loss
4. Irritability and anxiety
5. Agitation
6. Increased sex drive

The symptoms of SAD come back every year, and for any specific person, they tend to come and go at about the same time each year.

How to diagnosed SAD?

Diagnosis mainly relies on taking complete history; some lab test may be needed to rule out an underlying problem.

Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnosis SAD. The following criteria must be needed for a diagnosis of seasonal affective disorder:

1. Patients experienced depression and other symptoms of Sad for at least two consecutive years, during the same season each year.
2. The periods of depression have been followed by periods without depression
3. There are no other explanations for the changes in your mood or behavior.

How Seasonal affective disorder managed?

Treatment for SAD includes lifestyle modification, light therapy, antidepressant medication and psychotherapy.

• Life style modification includes:
  1. make home and environment sunnier and bright
  2. Take sun bath
  3. Exercise regularly

• Light therapy: This is the most effective treatment option for seasonal affective disorder. Generally, light therapy takes about 30 minutes each day throughout the fall and winter, in severe depressed patient if light therapy helps, continue it until enough sunlight is available, typically in the springtime. Stopping light therapy too soon can allow the symptoms to come back.
• antidepressant medication include:

1. Bupropion (extended-release antidepressant)
2. paroxetine, sertraline
3. fluoxetine and venlafaxine

• Psychotherapy: Psychotherapy can help identify and change negative thoughts and behaviors that may be making feel worse.

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1. Exploding head syndrome

Exploding head syndrome is a rare and is an unusual condition characterized by a loud noise that is suddenly imagine just before fall asleep which is generally described as parasomnia. It is originally described as “snapping of the brain”. 1989 exploding head syndrome was detailed described.

The cause of exploding head syndrome is still unknown but some researcher reported a correlation with stress or extreme fatigue.

People over the age of 50 and women are most likely to experience exploding head syndrome but it has been reported in people as young as 10 years old.

People who suffered from this disease experience a tremendously loud noise as originating form within his or her own head, usually described as the sound of an bomb explosion, gunshot, door slamming, roar, waves crashing against rocks, loud voices, a ringing noise , those who experiencing exploding head syndrome do not experience pain, when they hear the loud noise. Few people have described as flashes of light occurring along with the explosion. Some have such symptoms even during the day. Some people gaining a fear of sleeping or resting which lead to development of insomnia.

If the condition isn’t disrupting sleep or hampers daily life no treatment may be required. If stress triggers the syndrome relaxation may required. Alcohol, smoking, caffeine, large meals and heavy exercise should be restricted during the evening. If symptoms are severe and frequent use of tricyclic anti-depressants like Clomipramine, imipramine or calcium antagonists like nifedipine or flunarizine may help in some patients.

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Male Menopause (also called viropause or andropause) involves the hormonal, physiological, and chemical changes that occur in all men generally between the ages of 40 and 55, though it can occur as early as 35 or as late as 65. These changes effect all aspects of a man’s life.
The male menopause is used to refer to the condition in which men experience a decrease in their hormone levels but unlike women whose hormone levels drop dramatically, male menopause takes place with a gradual fall in hormone testosterone. Medical reports have shown that many men in their 70′s have almost the same testosterone levels as those in their 20′s.

Men with menopause manifest symptoms such as irritability, sweating, memory problems, concentration difficulties, and hot flushing.

Other common complaints of men with menopause consist of low sex drive, hair loss, fatigue, generalized pains, and body shape changes as they tend to become more rounded and less brawny.

When you analyze these symptoms, it becomes clear why male menopause is compared with that of women. Women may show some or all of the symptoms listed.

It is important to note, however, that the symptoms listed may be caused by other physical illnesses other than menopause and thyroid gland dysfunction, depression, or anemia could be the underlying causes.

Some doctors, however, claim that male menopause is caused not by the hormonal changes but by psychological reasons. The realization that they are ageing is underlined by the signs of physical changes such as the occurrence of wrinkles, fat and waning hairline.

Men in their middle age usually weaken their self-esteem as they begin to question themselves as to whether they still have a role in their homes and the society. An example is when their children mature and leave home; they start to feel empty and futile in the family.

Other possible psychological triggers of menopause in men include financial problems, job dissatisfaction, and marital conflicts.

It is important to note, however, that the symptoms listed may be caused by other physical illnesses other than menopause. Again, thyroid gland dysfunction, depression, or anemia may be the underlying causes.

The diagnosis of male menopause is done by running a physical exam, the doctor will inquire about the symptoms the male is experiencing. He may conduct necessary diagnostic tests to discard other medical problems which may be affecting the condition. Series of blood tests will then be carried out to analyze the patient’s hormone levels, as well as the blood testosterone status.

Testosterone replacement therapy is applied if the testosterone levels are found to be low. This process also helps to minimize the symptoms such as fatigue, depression, and low libido, or poor sex drive.

Hormone replacement therapy has as well been tied to the development in the brain functions, bone density and night sweats.

Testosterone replacement comes in oral medication, implants, or injections.

The oral drugs are given to those who cannot bear implants or injections.

On the other hand, implants are placed in the lower hip or abdomen. This method provides cure that keeps going for up to six months.

The testosterone injections are typically given about once every two weeks.

If you are considering testosterone replacement therapy, it is important that you talk to a doctor to learn more about it. Your physician may also advise some changes in your lifestyle, such as an exercise program, proper diet, and medications to help alleviate the symptoms caused by male menopause.

References:

1. men.webmd.com
2. www.medicinenet.com
3. www.mayoclinic.com
4. www.andrology.com
5. health.discovery.com

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