Fibromyalgia
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Some people, and this number may be actually more than once supposed, do not do well in winter. They developed a severe mood disorder which was referred to as seasonal affective disorder. SAD may be more common in patients who already suffer from fibromyalgia.
Modell and colleagues studied 226 patients with SAD and found that it was actually a syndrome consisting of multiple symptoms (Modell, JG, et al. Biol Psychiatry. 2005; 58: 658-667.) It was the depression, fatigue, social withdrawal, anxiety, feelings of guilt, carbohydrates thirst, insomnia, increased appetite, weight gain, and gastrointestinal symptoms. The appearance these symptoms may simulate a failure of fibromyalgia. And in fact, there is very little difference from a clinical point of view. Symptoms begin Late in the fall and continue until the end of March to January and February is the worst month for the symptoms.
SAD is judged due to abnormal functioning of the pineal gland at the base of the brain. The circadian rhythm is regulated by the pineal gland. The pineal gland secretes melatonin in the evening and off during the daylight hours, melatonin. Dysregulation of the secretion of melatonin, both in the amount and the time seems to be the major glitch. Srinivasan proposed that the non-morning fatigue restorative sleep that occurs with SAD may be due to the secretion Prolonged melatonin in the morning (Srinivasan V, et al. J Biol Psychiatry. 2006; 7: 138-151.)
Treatments for SAD should be familiar to fibromyalgia patients. The first is to use a light box for 30 minutes in the morning. Theoretically, this should stop the secretion pineal melatonin because of exposure to light eyes. A light box should be of high intensity emitting less than 10,000 lux. A variety of these "sun boxes" are available. They cost about $ 400-600. The light box should be used after consultation with your specialist. strict compliance of instructions will help prevent eyestrain and headaches.
Moreover, selective serotonin reuptake inhibitor drugs (SSRIs) may also be used. The drug has been studied most, is Prozac. Although generally well tolerated, but it has the potential side effects, including palpitations, insomnia, and loss libido.
Melatonin taken in small doses (0.1 mg) in the afternoon can also be effective for SAD. This dose is small enough to not cause drowsiness, but enough to make the pineal gland biological body clock reset. Since the usual dose of OTC is 3 mgs, a patient may need the help of a chemist mixing in order to get the tiny dose of 0.1 mg.
The combination of low dose melatonin with a light box also appears to be effective.
Exercise is another treatment that is useful. No impact aerobic exercise helps stimulate blood circulation, increases energy and stimulates production of endorphins in the brain. All these initiatives contribute to fatigue and mood disorders that occur with both sad and FM.
Finally, cognitive-behavioral therapy should not be overlooked. There is a cornerstone of treatment of FM and is also beneficial for SAD.
Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland (http://www.aocm.org). He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to:Fiber-myalgia
Fibromyalgia