As the winter hours fall upon the city, many people may find their moods hang low. Yasmine El-Rashidi finds that SAD is not sad As the Cairo winter approaches, and the days get shorter, colder and greyer, we may find ourselves feeling slightly down. We get slower, and emotionally lower, and in many cases we huddle up at home, watching our waistlines grow and spirits sink. We dismiss the funk, and bash ourselves for feeling somewhat sad; ashamed at this feeling that we associate with lack of control. The feelings are normal. It is what specialists call SAD: Seasonal Affective Disorder, and even in Egypt, the slightly lessened sunshine hours do take their toll. "When I tell people that I feel a bit 'blah' in winter, they get surprised," says Emma Oscarson, a three-year Swedish resident of Cairo. "Everyone says, 'but you're Swedish, you're used to this!' But it does affect my mood. Suddenly it gets dark so much earlier!" Lethargy is what she feels, and it is a mood change common in winter. But like much else in this society driven by what is the so-called social norm, the feeling of down -- or depression, to be more precise -- are quickly pushed aside, and down. Denied, in short. That too is considered a norm. "For many, the stigma of depression is a serious problem," writes Lewis Wolpert, in his memoir Malignant Sadness: The Anatomy of Depression. "My wife, Jill Neville, was embarrassed by my being depressed, and told colleagues and friends instead that I was exhausted from a minor heart condition." If Neville had been in Egypt, chances are she would not have even known that her husband was depressed. And he, himself, may not have been willing to acknowledge the fact. "Depression is becoming more openly talked about, and much more widespread," says Nancy Abdullah, a psychologist who has dealt intensely with depression. "We are beginning to appreciate how overpowering it can be, and how serious it is. But compared to the West, we still have a long way to go. Society as a whole is not yet aware of the gravity. We still dismiss mild depression." Mild depression is not appreciated for how overwhelming it can be. "Why do you look like you're carrying the concerns of the world on your shoulders," people frequently joke. "Lighten up, smile, nothing is worth it." As the cliché goes, it is unfortunately much easier said than done. "No one I know really understands," says one 27-year-old woman, who wanted her name withheld. "They don't understand what it feels to wake up in the morning and not want to wake up, or have a list of a few things to do and not be able to do them," she continues. "Everyone thinks, 'oh you're so young, what problems could you possibly have.' They just don't understand. They're not even willing to try to understand." There are days, this slim, well-groomed, striking-looking young woman says, when the process of moving from the sofa to the kitchen to throw something away, or to the bedroom to get a paper, or phone number, or book, becomes an unattainable task. "It's like there's a weight at your core pulling you down. You want to get up and do something, and you tell yourself you will, but you don't. And you can't. You just sit there." In an article for the New Yorker, writer Andrew Solomon refers to a serious case of depression, "It seemed that it had been easier to make his way toward the tip of a plane's wing against a powerful wind at 6,000 feet than it was now to get out of bed and take a shower." While such a state may not be specifically caused by SAD, chances are, in the coming months, the incidences of feeling down will be up. The chances of the downward spiral are greater in winter than at any other point in the year. "SAD is caused by a biochemical imbalance in the hypothalamus [part of the brain involved in processing sensory information] due to the shortening of daylight hours and the lack of sunlight in winter," the Association of SAD states in its literature. "It's a type of winter depression that affects millions of people around the world; an estimated half a million people every winter in almost every country in the world," it continues. "For many people SAD is a seriously disabling illness, preventing them from functioning normally without continuous medical treatment. For others, it is a mild but debilitating condition causing discomfort but not severe suffering. We call this [syndrome] SAD or 'winter blues'." While SADness may not hit as hard in Egypt or the Middle East as in other parts of the world, it is the relative diminishing in sunlit hours that plays into effect. The symptoms, include: Sleep problems: Usually desire to oversleep and difficulty staying awake but, in some cases, disturbed sleep and early morning wakening. Lethargy: Feeling of fatigue and inability to carry out normal routine. Overeating: Craving for carbohydrates and sweet foods, usually resulting in weight gain. Depression: Feelings of misery, guilt and loss of self-esteem, sometimes hopelessness and despair, sometimes apathy and loss of feelings. Social problems: Irritability and desire to avoid social contact. Anxiety: Tension and inability to tolerate stress. Mood changes: In some sufferers, extremes of mood and short periods of hypomania (over-activity) in spring and autumn. "People don't often recognise that they are suffering from a chemically-founded imbalance," Abdullah says. "Sometimes it's not even a matter of dismissing it," she continues, "They simply just live it, never really attending to their moods or feelings." They do it with SAD, and they do it with depression too. "On the one hand, I am tempted to say that depression has become less of a socially stereotyped taboo. On the other, it saddens me that we are so unaware of its reality," she says. In his classic paper Moods and Melancholia, Freud wrote, "The distinguishing mental features of melancholia are a profoundly painful dejection, cessation of interest in the outside world, loss of capacity to love, inhibition of all activity, and a lowering of the self regarding feelings to a degree that finds utterance in self-reproaches and self-revilings, and culminates in a delusional expectation of punishment." For anyone that has experienced the perils, or even just stepped into a milder state of it, Freud's description hits home hard. Nevertheless, the societal stigma still stands solid for the most part. "The stigma associated with depression, and the sense of shame and guilt in the patients that they are depressed," writes Lewis, "are still strong. In relation to postnatal depression, for example, many women feel it is a shameful and humiliating experience and want to forget it; they feel guilty for having had a depression for which they feel they were responsible." Abdullah agrees. "People really take it onto themselves, as a responsibility. They're not willing to succumb to the reality that it is a chemical imbalance," she says. "If they did, the social regard to it would be much less severe," she continues, explaining that if society would look at depression for what it really is, it would be regarded in much the same way other illnesses are; as just another illnesses that needs treatment. But that, too, is easy to say. "I was very reluctant to take anti-depressants at first," says the 27-year-old marketing manager. "It felt like failure to me. I felt I should have been able to just get myself out of it." That would have been nice, but illness is not a simple thing, and upon looking into the mechanics of what makes this illness, she recognised that it was really not in her hands. "I read about it quite a lot, and saw that it was chemical," she says. "I was still a bit resistant, but I realised that anti- depressants were the best, and only, way to deal with it." The thoughts of Prozac dance in people's minds when one talks of depression and feeling down, but it doesn't have to reach such a chemically controlled extreme. "In many cases," Abdullah says. "St John's Wort will do." St John's Wort -- a natural, mood-elevating, herbal remedy -- has skyrocketed in popularity. And rightly so. "It works wonders," says 29-year-old Shaden Hussein. "You feel your head suddenly go quiet. Peaceful, sort-of." The slight alleviation of milder cases of depression can also come through exercise and a balanced, healthy diet, but sometimes, the facts have to be faced. Sometimes, some of us must take the time to acknowledge and accept that we are slightly ill. And while medication and pills may not be favourites, at the end of the day, we all usually give in to reality, and kill the viruses and bugs with a dose of drugs. Depression, in its varying degrees, is no different.
