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Parenting with SAD, Part 2: Treatment

Last week, I was late to the holiday party at my son’s daycare because I had to sit in front of a special therapy light before heading to the party. I debated skipping the afternoon session of light therapy so I could make it to the beginning of the party, but I had missed my afternoon session the day before and barely made it through the evening, falling asleep while putting my daughter to bed at 8:00. It’s better for my kids (as well as myself and my husband) if I am late to the party instead of missing a session of light.

Treatment for my Seasonal Affective Disorder (SAD) that will truly work for me within the constraints of my life is critical to my health, my children’s well-being and Londo’s sanity. It has taken me years to figure out what the right treatment is for me, and unfortunately the constraints of my life seem to change every year since having kids. At least every year I learn something from the year prior, and each year I’m getting better and better at staying on top of my treatments.

Before I had children, I started doing light therapy sessions once I realized I had SAD. I bought a couple of special therapy lights, which are bright lights that mimic the sunlight minus the harmful (and tanning) UV rays. Light therapy sessions involve sitting in front of the light at a certain distance with eyes open so as to “receive” the light through the eyes, the only truly proven way that the light therapy works. So I don’t get a nice tan, I can’t just sleep through the light therapy session, and I can’t move around because I have to stay that certain distance. It’s bright, which makes it hard for me to do certain thing like watch TV and makes it very obvious to anyone nearby that it’s not a normal light. The amount of light therapy I need increases the later into the winter it gets. Also, since the light helps reset the body’s circadian rhythm/internal wake-sleep clock, people with SAD are supposed to do the light first thing in the morning, and certain people (me included) also need a shorter session in the afternoon for a late-day boost.

When it’s late winter, I need the most light therapy, which would end up being almost 2 hours in the morning and another hour in the afternoon. That is 3 hours a day sitting in front of this bright light. That was manageable before kids and when I had an office with a door I could shut at work.

But now? I don’t have 3 hours to spend sitting around, except when I’m at work—but I sit in a cubicle now and am not going to have a light bright enough to land airplanes shining in my eyes while people are walking around me. I am not going to wake up at 4:00 in the morning to make sure I get 2 hours of light therapy in before my toddler wakes up—I don’t get enough sleep as it is!

And even with 3 hours of light therapy a day, I would just barely get by. I was still exhausted all the time, and only slightly depressed, which at least was an improvement to being so depressed that I couldn’t get off the couch to take basic care of myself. The 3 hours of light therapy and a dawn simulator (my alarm clock that starts to light up gradually 30 minutes prior to the alarm going off) was just enough to get me out of bed, to work, and back home. Once home, maybe I’d eat a dinner and watch TV with Londo, or maybe I’d curl up on the couch and stare off into space until Londo made me eat something and go to bed. (I could go on about how bad it would get, but I don’t think I need to. If you’ve ever been depressed or if you remember the exhaustion you felt in the first trimester of pregnancy, you’ve got an idea of what I would go through.) Though the light therapy kept me from being unable to function, it just hasn’t been enough for me to truly feel like myself all year round.

Thank goodness for medication!

Going on Zoloft in the winters, combined with (shorter amounts of) light therapy, has made such a huge difference in my life. It was a hard decision for me to make, but once I did I wondered why I ever hesitated! What made me decide to try the medication was knowing I was going to be pregnant during the winter, and time for and effect from the light therapy was just not going to cut it.

This winter is my third on medication, and I can’t tell you what a difference it has made! I am able to care for myself, my children, my house, my husband, my pets without feeling overwhelmed or exhausted. I have good days and bad, good weeks and bad--but who doesn’t? Granted my bad weeks really suck, but that usually means that I’ve not kept on top of the medication or my light or or my vitamins (multivitamin, vitamin D supplements and fish oil) or getting enough sleep, all of which I have to be very cognizant of upping dose or time as needed.

I’ll be honest, I wish I didn’t have to spend any time in front of the therapy light. But I tried going with just medication as treatment this fall, and that did not work out so well. At least with the medication, I don’t have to spend as much time in front of my light.

And that’s the toughest part about treating SAD as a parent. The time it takes. My kids are still to young to be right in front of the light (this is my opinion, as I’ve not found any age-specific recommendations for safety), and if they are in the same room as me, they often want to see what I’m doing or I need to get up to figure out what they are into. It’s not the relaxing time I need to settle down in front of my light. And the time I spend in front of my light takes away from my time with the kids, either playing with them or getting them ready for pre-school/daycare, or it takes time away from sleep, of which I need more in the winter than in the summer with a minimum average of 8 hours a night. Making sure I get that sleep and the time for my light therapy in the morning takes away spending time with Londo in the evenings or having time to myself or watching TV shows or reading or blogging. Or it means that Londo has to take more night-shift duty with the kids, which gets hard on him.

SAD seems like it’s easy to treat: medication, light therapy, dawn simulator alarm, vitamins and supplements, getting enough sleep or whichever combination of these that works for a person. And exercising and eating right would totally help! But it really is a struggle and a trade-off for each treatment, especially with young kids in the house. There are side effects of medication. The light therapy takes time away from other things. The dawn simulator might wake my daughter who comes into bed with us every night, so I haven’t been using it. Missing dosages of vitamins or supplements causes immediate reactions. Getting enough good-quality sleep is something I dream of when I’m trying to sleep (see previous sentence about daughter in bed, plus night-wakings with toddler during teething episodes like last night).

Fortunately, I know that the trade-offs are worth it considering what going without treatment does to me. And as I said earlier, each year I’m able to learn more about how to stay on top of my treatments and how to better incorporate what I need to get through the winter within the constraints of my life with young children. I have high hopes that each year will continue to get better.

Comments

paola said…
I have a 24 hour day. How many hours are in yours????

You manage to do so much in a day, despite your condition. I really admire that! Blogging, work, child-care, family and in bed by 8. Way to get the most out of every day!

I therefore can imagine how difficult it was for you to find those 3 hours a dya for your light therapy. I had no idea it took so long and so much concentration either.

Thanks for all this information. You are doing someone out there an invaluable serviec.
geeks in rome said…
wow! that is such a big commitment, and it's wonderful to see someone be so disciplined to manage the time and the effort!! it's inspiring! and it's so good you're getting this info out there for people.

of course the preferable option is move to new zealand for the US winter months and get summer-time sun the natural way !!

hope you have a wonderful new year!
mom2boy said…
I had no idea it took so long either. I had imagined it like a 15 minute tanning bed zap. Thanks for sharing how you've worked on figuring out what you need and how it's a continuous process. Very happy you are feeling better theses days!
Cloud said…
I'm glad the medication and the light therapy help. And I'm glad you tried the medication!

I'd never heard about a dawn simulator alarm clock. What a cool idea.
hush said…
Amen to all of the above comments, and good for you for being so proactive about self-care!!
nej said…
CaraMama, I love you. Thanks for writing about this.

When we lived in Arlington, I spent winter after winter on the couch, immobilized and totally clueless as to why.

What a difference living in CO has made! So much sunshine and mild winters where we can get outside almost every day. Not to mention the handful of supplements my naturopath has me on. I still struggle a little bit (why is February, the shortest month, sooooo freakin' long!) but now that I know what SAD is and what helps curb it, I can see it coming from a mile away and I can get myself through it.

I can't imagine being a parent with SAD back East, or really anywhere where the sun don't shine. Good for you for having the self-awareness and the strength to soldier on. You are a good role-model for your children.
caramama said…
Thanks, all!

@paola - There in lies the problem, right? There are only 24 hours in the day. It's very frustrating, and something constantly has to give.

@geeks in rome - New Zealand is just a smidgen too far away. I do hope to eventually have a winter place in Florida. And though it's hard to keep the discipline to do the therapy sessions and take the meds and supplements, the alternative is MUCH harder on everyone.

@mom2boy - Some people might only need 15 minutes, but that is no where near enough for me. But we do what we have to for our health, right?

@Cloud - The dawn simulator is actually a good idea for anyone who hates getting up when it's dark out. There is no special light to it, and some people even use regular bedside lamps on a timer. They are really cool.

@hush - I've tried the non-proactive route, and it sucked. So even slacker me has to be proactive about something. ;-)

@nej - Love you too! Immobilized is the perfect word for it! Glad that things are so much better in CO. I do hope to move somewhere more southern in the not-too-distant future. When I lived in Georgia, I had only 1-2 months of difficulty. In North Carolina, it was maybe 4 months. Up here, it's really 6 months of managing the disorder. That a large portion of my life. So at some point, we will move to NC or GA again.

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