University students often find themselves in positions where downtime is scarce and sleep is merely a myth. With full-time classes, part-time jobs, and extracurriculars designed to make résumés pop, life often feels like a train careening down stretch after stretch of track, as far as the eye can see. Often, we might wonder if any of it is really worth it — if our exhausting routines will pay off in the end.In the real world — a world not modelled by academia and APA citations — rewards are not given simply because you are the hardest working or the most qualified. In Forbes magazine, Cindy Wahler writes about how she was always an exemplary student and advocate of hard work, shaped by her parents’ efforts. However, she also discusses how in the workplace, those who did not go above and beyond in their efforts were promoted before she was, and how this was incongruent with her previous conceptions of what it meant to succeed.What we find when escaping the university atmosphere is that success is not necessarily directly connected to work ethic. One cannot assume that perfectionism, integrity, and perseverance will inherently result in reward. There are a number of factors upon which success hinges: workplace politics, sexism, and racism must be taken into account. There are also times when hard work just goes unnoticed.These barriers undoubtedly take a toll on individuals in the workforce, and it can be frustrating to feel as if they cannot be broken down. This does not require an abandonment of our goals, but a shift in perspective with respect to the things we cannot change.In Psychology Today, Diane Barth discusses how hard work is not enough to overcome issues such as mental health concerns. There are many situations that are so beyond an individual’s control that they simply cannot be worked out. The difficulty is when these instances come into conflict with the workaholic mentality that any obstacle can be thwarted, any mountain climbed.I know from experience how much my mental illness has acted as a detriment within my daily life. Not only has it put me into difficult situations, it has aggravated feelings of failure when I could not resolve the issues I was faced with. Never mind the fact that expecting an individual to thwart forces beyond their control is like swimming upstream — the mental battles I fight with myself are draining and often difficult to win.This does not mean that hard work has no merit. The issue lies not in effort itself, but in our attempts to go beyond what we are physically capable of until we make ourselves sick with anxiety. Obsession with being the perfect version of ourselves means that we often forget to treat ourselves as humans, and it is widely acknowledged that a lack of self-care only makes stress worse.It can be tempting to pick up that extra shift at work or volunteer for an extra commitment. It can be tempting — as I’ve learned this year — to write a column, choreograph a musical, and work three jobs. But it is not sustainable, and if your schedule does not crumble in on itself, your body or your mind will.To be hardworking is arguably one of the noblest traits a person can possess, but there comes a point at which it threatens to destroy you. Personal achievement should not come at the expense of your welfare, and self-created stresses only hinder your progress. Sometimes the real work lies in respecting your limitations.Jenisse Minott is a second-year student at UTM studying Communications, Culture, Information and Technology.
Does hard work pay off?
Reflections on mental health and barriers to achievement
Giving up the Grind(r)
On dating apps and the mental health crisis in the gay community
Growing up in the suburbs with a traditional Desi family and coming to terms with my sexual orientation, I had hope that one day I would fit into a tangible gay community. I placed high expectations on dating apps like Grindr to provide that sense of community.
The result is that now, rather than having anxieties about coming out anxieties arise for me when one of my white gay friends says that they find Grindr a useful tool to make connections. Though I’ve experienced some success using Grindr on and off for almost two years, it has also been the source of many problems. Grindr fails to foster community for individuals who do not fit in the cis, white, able-bodied, fit, masculine mould — in this way, it is reflective of the mainstream gay community in general.
Hook-up apps such as Grindr and Scruff — not to mention the omnipresent Tinder — have now become ubiquitous. In 2000, 20 per cent of gay couples met online, a figure that skyrocketed to 70 per cent in 2010. Grindr is a prominent feature of gay culture, and installing it has become a rite of passage for young gay men.
At the same time, many members of the gay community are experiencing a mental health crisis, one that is not significantly improving despite parallel strides toward representation and legal equality. The use of hook-up and dating apps can aggravate these concerns, especially along intersectional lines.
Coming out is not a single effort, but rather a process that all members of the LGBTQ community endure throughout their lives.
Globally, gay men are still more likely to experience mental illness than straight men. A recent Huffington Post article by Michael Hobbes brings attention to an international “epidemic of gay loneliness.” In the Netherlands, gay men are three times more likely to suffer from a mood disorder. In Sweden, the suicide rate for men married to other men is triple that for men married to women. In Canada, more gay men in recent years have died from suicide than HIV-related causes.
Hobbes also starts a discussion on minority stress, which is caused by the additional effort required in various situations if one is also a member of a minority group. For example, if a gay couple wishes to avoid homophobic aggression while travelling, they are more conscious of their body language and actions, avoiding any public displays of affection.
This is a reality for gay men who are open about their sexual orientation, in spite of the common misconception that coming out of the closet signals the end of a struggle. Coming out is not a single effort, but rather a process that all members of the LGBTQ community endure throughout their lives.
While Grindr is a wonderful way to meet other gay men, its ubiquity has normalized problematic behaviours toward minorities. The ‘no strings attached’ hook-up culture associated with apps like Grindr often pressures younger gay men into using hook-up apps to pursue casual sex instead of seeking meaningful, long-term relationships — adding an element of fetishization on the basis of skin colour and ethnicity for racialized gay men.
In this vein, Hobbes notes the alternative prejudices that exist within the gay community along intersectional lines: “All of a sudden it’s not your gayness that gets you rejected. It’s your weight, or your income, or your race.” Hook-up apps play a role in placing this prejudice front and centre. A 2015 study conducted by William Elder suggests that 90 per cent of gay men on the app wanted a partner who was tall, young, white, muscular, and masculine.
There is also a personal inner dialogue that takes place when interacting with Grindr and trying to fit into the mould. I’ve constantly asked myself whether I should be looking for meaningless hook-ups, if I should subscribe to a specific ‘tribe’ based on my body type, or if I should overlook the casual racism that is ubiquitous in the gay community.
Throughout their lives, gay men are burdened with the idea that they do not belong. And though many gay men find a community in which to feel at home, the rejection of gay men who do not fit pre-established criteria only fuels depression and anxiety.
Though I am confident in my own personal identity and understand that the mould created by dating apps is not one I necessarily want to fit into, there is some grief for the community I envisioned as a teenager. It is the expectation that the gay community will be welcoming that may further aggravate mental health concerns for gay men when this expectation is not fulfilled.
Ultimately, a shift in attitudes toward gay men who do not fit into the cisgender, white, able-bodied, fit, masculine mould is necessary. This kind of change is systemic and will take time. Meanwhile, however, we ought to acknowledge that apps like Grindr cater to a very specific niche and should not be considered rites of passage insofar as they fail to be inclusive to entire segments of the gay community.
Avneet Sharma is a second-year student at Trinity College studying English and Cinema Studies. His column appears every three weeks.
Why I quit a job I love
A fourth-year finally puts mental health first
In the fall, U of T will welcome hoards of eager frosh waiting for the university experience to turn their lives upside down. This summer series of personal essays delves into the minds of seasoned upper-year students, and everything they never expected to learn.When I entered university, I was determined to do it all: soccer, archery, dancing — it did not matter that I was barely flexible enough to touch my toes. I ran a café. I blogged and I copy edited. I volunteered left, right, and centre. I even took up crocheting again.By late November, I was having nightly breakdowns.The drive to do everything was largely motivated by observing the lives of the people around me. Everyone, it seemed, was doing amazing things. News articles would broadcast their achievements: world-famous activists, successful entrepreneurs, ‘Top 20 Under 20′ students — all my age or younger. Even my friends were somehow making it to the gym five times a week. I was racing to keep up. After all, university meant a fresh start, a chance to finally be the perfect student ready to take on the world.Besides, U of T was bursting with opportunities — free fitness classes, a thousand clubs, and dozens of engaging courses. Newly freed from the confines of a grade school schedule, I was eager to take advantage of it all. Nothing was more satisfying than coming home at the end of a full productive day — days when my Google calendar was devoid of white space. No time wasted.However, as the cold rolled in, I suddenly found myself incapable of dealing with the smallest stressors. A 68 per cent on my first university essay sent me into days of tears. Not getting a position I’d applied for unleashed a floodgate of self-doubt. What was it about me that was insufficient? Did my personality rub people the wrong way? Would I ever succeed at anything in life?Once those seeds of doubt were planted, fear and anxiety quickly rose to the surface. Almost overnight, the loneliness of being a first-year commuter at U of T hit me so hard that every bit of energy evaporated. I felt tired all the time. I was crying every night, alone in my bed while Facebook photos of laughing friends constantly reminded me of my shortcomings.Yet, despite the severe deterioration of my mental health, I continued to prioritize other activities over self-care for the following two years. It felt impossible to justify giving up amazing opportunities for some extra sleep, a hot bath, or a night of YouTube videos. How exactly would extra sleep advance my personal and professional skills? I was busy. I had a café to manage.
I had been relentlessly driven past my limits. Going into my final year, it felt like the last chance to get it right.
And then, in third year, I became a don. It was rewarding, exciting, and fulfilling in every way, but even as I preached the benefits of self-care, I was still seeing a counsellor. I was seeing the learning strategist. I was spending hours alone in my office crying. By February, one low mark would knock me out for a week.My self-esteem had become entirely dependent on my accomplishments and external praise, to the point where I couldn’t sustain myself without them. There was no time to watch a movie, to read for pleasure, or even to see my boyfriend without falling asleep or suffering overwhelming guilt. My schedule had been so tightly packed for years that I was constantly racing at breakneck speeds to meet deadlines.I applied when re-applications for donship opened in January, but I found myself wavering weeks later, unsure of my decision. Throughout the past few years, when faced with the choice between taking it easy and taking on another great learning experience, I had never hesitated to sign up for a new commitment.However, I had been relentlessly driven past my limits. Going into my final year, it felt like the last chance to get it right. Finally, after the most academically-challenging month of my degree, I withdrew my re-application.It had taken me years to admit, but I wanted my nights of frivolous YouTube videos. I wanted to go home before the sky turned pitch black. I wanted my heart to stop racing, and I wanted to stop feeling like I was constantly on the verge of drowning. For the first time, it didn’t matter what other people were doing around me. I was exhausted, and I was putting myself first.Writing, managing a café, being a don — these were the most valuable experiences of my time at U of T and I would certainly not retract them for anything. But I had spent too long refusing to acknowledge my needs, as many students do. I had put school over sleep. I had put work over play. Without a healthy mind and balanced schedule, each minor stress — a bad mark, a failed driving test, an argument at home — was enough to send me over the edge. At last, I was learning to listen to my limits. At last, I was reclaiming my health.
How expressive writing helps students combat mental health problems
For many students, life at university is fraught with uncertainty. The challenges they face evolve throughout their undergraduate careers: first-year students struggle with adjusting to a new academic environment, and upper-year students worry about job prospects in a bleak market or their chances of getting into graduate school. Some pressures, such as maintaining good grades or building a social network, concern all students.The Centre for Addiction and Mental Health (CAMH) defines stress as “a response to environmental pressures or demands (‘stressors’), in particular when we feel they are a threat to our coping strategies or well-being.”The higher stakes and greater time-management demands within academic environments only add to the stressors that students face. The fear of failure to achieve goal in an environment where competition is widespread limits a student’s ability to cope with stress.
Students practicing expressive writing become more in control of their academic life and more rewarded by their success; subsequently, their anxiety about facing challenges decreases over time.
Unfortunately, help on campus does not always reach all students. The Health and Wellness Centre, the Centre for International Experience, and the offices of college counsellors tend to have incredibly long waiting lists, which makes it difficult for students to receive support. Complex mental health problems, such as anxiety, depression, and substance abuse, may emerge when stress goes unaddressed.Expressive writing is one way to combat these difficulties. A practice identified by Dr. James Pennebaker from the University of Texas, expressive writing enables the writer to focus on emotions and events, without concerning themselves with grammar and form — a method likely to appeal to students, who are ordinarily constrained by grammatical rules. Research by Harvard professor Francesca Gino has indicated that the regular reflection which results from expressive writing can increase an individual’s efficiency at work. Students practicing expressive writing become more in control of their academic life and more rewarded by their success; subsequently, their anxiety about facing challenges decreases over time.Business Insider has indicated that expressive writing is also beneficial in forcing the writer to disclose or confront unpleasant parts of their life. Maintaining a journal allows students to express their deepest, perhaps darkest, emotions privately, without the fear of judgment or hurting another person. In a time where privacy is diminishing and social media makes oversharing problematic, this can be perceived as a luxury.
it is not the act of writing itself but the nature of what is being written that is crucial.
Students lead hectic lives in which they can rarely make time to reflect on their progress and plan for the future. However, putting their thoughts and emotions down on paper gives students a platform to re-examine and analyze past experiences, and to plan for better choices in the future. By encouraging introspection, expressive writing also discourages rash decisions.Simply putting pen to paper, however, is not enough. Bridget Murray, a journalist for the American Psychology Association’s publication Monitor on Psychology, argues that writing about emotional difficulties is only the first step towards healing. It may open up wounds that the writer is trying to avoid and needs to be followed with certain activities, like dialogue with a companion, that work towards resolving those wounds.The absence of reconciliation may cause the writer to become overwhelmed by the bottled up emotional weight of their problems, inadvertently increasing mental health problems in the process. This is especially important for students who may not have someone to regularly talk to, as they would be particularly susceptible.Susan Lutgendorf, a health psychology researcher at the University of Iowa, also notes that it is not the act of writing itself but the nature of what is being written that is crucial. Students can use optimally expressive writing to focus on their individual mental health problem. More broadly, CAMH advocates regular writing about mental health issues to identify methods that will help patients.Expressive writing is one effective way to start combatting mental health problems. While regular, written reflection should be essential for everyone, students may find it most beneficial if they utilize expressive writing to address their unique university experiences.Sonali Gill is a third-year student at St. Michael’s College studying International Relations and Criminology.
A world of worries
Why the university needs to prioritize the mental health of international students
According to the Faculty of Arts & Science’s website, “International students come from more than 140 different countries and make up nearly 25 per cent of U of T’s student population.” Given that international students comprise a significant portion of the university’s membership, it is important to recognize their unique concerns and the stressors that they face, specifically with respect to mental health. As an international student, I can understand the difficulties that come with adapting to, and becoming familiar with a new country.
There are certainly many benefits to being an international student, including receiving a better education, broadening perspectives on different issues, and developing new language skills. To travel to new countries is often to indulge in novel experiences that contribute not only to academic but personal growth.
Such learning, however, is often undertaken with greater risks and stresses than that of a domestic student, due to the learning curve of being in such a vastly different environment. Coping with such unfamiliar rules can take a toll on students, both physically and mentally.
Cultural norms and subjects of conversation, for instance, can put strains on even the most casual interactions between international and domestic students. Take the awkwardness of attempting to meet someone new, and compound that with a stark lack of similarity in background and values. In a similar vein, the language barriers international students face can hinder full participation in typical social meet and greet events.
These obstacles can often make it feel like international students must start from scratch with respect to both social and professional relationships. Lacking readily-available and long-established systems of support from family and friends back home, these students have to manage various challenges on their own. Such isolation makes it more likely for international students to spiral into negative health patterns.
If matters escalate, ongoing worries about academics and friendships can result in the development of anxiety, depression, or other psychological disorders. This, in turn, can impact the student’s study habits, diet, sleep, and other elements necessary for success at school and beyond.
Although the university provides psychological counselling and other beneficial services through the Health and Wellness Centre, improvements to these services can be made simply by increasing awareness of their availability within the international student community. Strategies for doing this include better promotion of events during mental health awareness month, as well as facilitating ongoing discussions and focus groups with relevant community members. Considering that international students may be particularly affected by stress, it is also important to ensure that these services provide culturally sensitive programming that is cognizant of the particular circumstances that international students must grapple with.
Promoting the well-being of international students at the university will ensure that these students have the best educational experience possible. It is important to send the message that international students are welcome at U of T, and an important part of our community. Working on mental health service awareness is an important first step in this regard.
A multi-headed beast
There's more to mental health support than just financial coverage
THE VARSITY recently reported that the University of Toronto Students’ Union is expanding its financial commitment to cover psychological care. As of September 2016, the revised health and dental plan will now provide students up to $100 of coverage per session with a registered psychologist, for up to 20 sessions a year.
These changes were met with overwhelmingly positive responses from many students, and the praise is arguably well-deserved. Certainly, the UTSU should be lauded for its efforts to provide increased financial support for students struggling with mental health issues.
That said, it is also important to recognize that this represents only a small step on an incredibly long road to full support for mental health on campus. If we want to tackle student mental health effectively, the financial and social contexts of the issue must be emphasized.
Although students under the UTSU’s health and dental plan can now subsidize their psychological care to a greater extent, the UTSU itself has admitted that per-session costs of appointments with health professionals exceed the coverage they are able to offer. This means that the majority of patients will still have to pay a significant amount of money for psychological treatment.
Furthermore, the UTSU will only cover the cost of up to 20 sessions a year, which is less than the support required by students with significant mental health concerns.
More troubling, however, is the fact that increasing financial coverage for mental health services may not suffice to help the students who need it the most. Stigma continues to surround most, if not all, mental illnesses. Affected students may live with their conditions for years without telling others, fearful of being labelled as unstable, attention-seeking, or even dangerous, if they choose to come forward.
Although wellness programs and awareness campaigns on campus are increasing, students’ concerns that they will be misunderstood or rejected continue to haunt many, often leading them to suffer in silence. These students are unlikely to extend their trust to a clinician, if they cannot even count on the support of those around them.
Some disorders inhibit the patient’s ability to determine that they are in need of treatment. It may be particularly difficult for an individual suffering from an eating or psychotic disorder to seek out treatment, therefore rendering them incapable of taking advantage of the UTSU’s offer for help.
In line with the idea of making it easier for students to come forward, it seems that mental health initiatives are increasing on campus. Earlier this year, it was announced that Trinity College would be launching its own mental wellness program, aided by a $1.75 million subsidy for these services. The UTSU has also pursued several mental health initiatives throughout the year, including offering phototherapy for students suffering from seasonal affective disorder.
It is these types of initiatives that must continue to supplement increases in financial coverage, so as to more effectively reach out to all students — even those who are hesitant to accept help. Although increased financial coverage for psychological treatment is a step in the right direction, work needs to continue in pursuit of more long-term, sustainable, and well-rounded solutions.
With the UTSU elections underway, it is my hope that the winning candidates will continue to fight for mental health support on campus. In the meantime, we must acknowledge that increases in coverage are noble but still just a small improvement to one part of an incredibly complex problem.
Teodora Pasca is a second-year student at Innis College studying ethics, society, and law and criminology. She is an associate comment editor for The Varsity. Her column appears every three weeks.
SAD for the season
How Health & Wellness helped me cope with seasonal affective disorder
Although this year’s winter has been unusually mild, it hasn’t disappointed when it comes to dreary mornings and very short days. With impending papers in November and exams in December, I began to feel as sluggish and uninspired as the view outside my window. At first, it was easy to dismiss my lack of motivation and productivity — after all, aren’t we a little prone to avoiding studying during finals season and taking extended naps whenever possible?
Soon enough, however, the problem became impossible to ignore. I found myself sleeping ten to twelve hours a day, and resorting to unhealthy eating habits to cope with the stress of classes and finals. Even more concerning was my lack of motivation for any activity at all, and my inability to concentrate on the tasks before me.
With a little research, I began to suspect that I was experiencing Seasonal Affective Disorder (SAD).
As defined by the Centre of Addiction and Mental Health (CAMH), SAD is the most severe manifestation of the seasonal mood changes that affect many people in late autumn and winter, when the daylight hours get significantly shorter.
While many of the given symptoms aligned with my experiences, doubts immediately occurred to me: was I overreacting? Many students often experience the “winter blues,” and my heavy course and workload was undoubtedly not helping the situation. When I began to fall behind on my schoolwork, however, I knew that it was time to look for some sort of help.
Although the Health and Wellness Centre was located just a short walk from my house and was accepting appointments from all U of T students, I also knew that the mental health services on campus do not have a very good reputation. Nevertheless, my family doctor was dozens of miles away, and, with important deadlines approaching, I figured I would give campus services a try.
At first, I was pleasantly surprised by my experience. The centre scheduled me for a next-day appointment, and the doctor listened attentively to my symptoms and concerns.
Although he immediately gave me a range of recommendations, such as increasing my physical activity and shifting to a more protein and complex carbohydrate packed diet, insistent on fully establishing the cause of my sluggishness and depression. He recommended a vitamin D supplement, prescribed several blood tests and a follow-up appointment.
Most importantly, the doctor expressed genuine concern about my health and well being. In fact, during my follow-up, the doctor continued to insist that, despite my improved condition, I continue to monitor the situation and return for a follow-up appointment wherever necessary.
My situation is just one of many, and does not negate the remaining problems of stigma and inadequate services that others continue to face. I want to highlight, however, that there are professionals on this campus who are caring and willing to help students struggling with mental health issues. It is unfortunate that the distribution of these professionals seems to be based on luck, and that is something the administration should strive to improve in the future.
In any case, however, I would encourage anyone struggling with feelings of depression, whether seasonal or otherwise, to seek help on campus. SAD is a legitimate illness and should be treated as such, no matter whether it feels like mere “winter blues.”
Daryna Kutsyna is a third-year student at Trinity College studying international relations and history. She is the co-president of U of T’s Equal Voice Chapter; the views expressed here are her own.
Chilly days, muted spirits
What we know about Seasonal Affective Disorder, and how students venture to cope
It is no secret that Torontonian winters can be hard. Short days, freezing dorm rooms, and long waits for the streetcar in the snow are all frustrating enough on their own. Dragging yourself away from the fire to get to the pub on a Friday night can be a Herculean task for anybody, especially when the thermometer reads -20C outside.It seems somehow counterintuitive that a drop in temperature, something that could be easily remedied by a hot chocolate or a warm blanket, causes so much turmoil that for some simple activities such as waking up for class or meeting a friend for coffee are rendered very difficult or even impossible. For some U of T students, this is a fact of life three months of the year. It is likely that you are starting to notice a prevalence of the words ‘seasonal affective disorder’ (SAD) come up increasingly in conversation. Although one third of Canadians report feeling worse off in the winter, for a small portion of the population the common experience of feeling ‘down’ when it’s cold outside turns into a full-blown and extremely debilitating disorder that shares some similarities with depression.SAD is diagnosed by a medical professional but it has also taken on a colloquial meaning for those who suffer through winter weather rather than enjoy it. In an environment that pressures people to go out and be productive in both your social and academic life, it is understandable when tired students turn to clinical terms with a self-explanatory name to make sense of their otherwise unexplained lack of motivation. According to the Canadian Mental Health Association (CMAH), only two to three per cent of Canadians experience SAD in their lifetimes. As with many mood disorders and mental illnesses, understandings of SAD differ between the public, the patients, and the medical community. We spoke to several SAD-suffering students and mental health professionals to work through the facts and myths surrounding this cryptic disorder.
The truth about SAD
As with depression and other mood disorders that can result in depressive episodes, simply feeling ‘down’ is not the same as having SAD. “[I]t’s characterized by a fairly distinct set of symptoms, and those symptoms include not necessarily a sad mood,” says Dr. Robert Levitan, Cameron Wilson Chair in Depression Studies, and professor in the departments of psychiatry and physiology at U of T.Although SAD and depression are similar, there are important differences between the two disorders.Levitan explains that while SAD is characterised by oversleeping and carbohydrate cravings, many people with non-seasonal depression will experience insomnia, loss of appetite and loss of weight. “[SAD] is somewhat of a different syndrome when you look at the overall number of symptoms and it doesn’t always necessarily involve sadness,” he adds, “so typically what we see is more that patients lose their motivation and energy. I would look at [SAD] almost as related to energy regulation as I would just a pure mood disorder.”Although Levitan gives a fairly clear definition, between SAD the disorder, and having sad feelings, the differences remain somewhat ambiguous. Students living with SAD report distinct and often debilitating symptoms. Polly*, a U of T undergraduate student, describes how her SAD causes lethargic symptoms that affect her schoolwork during the winter semester.“ …[N]o matter how important [my homework] is, it can be like a 20 page paper and I’m just like ok later. [Later] never comes.”For Polly, the disorder has led to problems with her social life and self-worth in addition to school work.“I think in second year and third year [my SAD] was the worst, because that’s when it got like the darkest. I was just never leaving the house and I didn’t fully understand why,” she says.“I tried to just like attribute [my symptoms] to other things, and there was all this imagined pressure. I was like ‘oh well it’s because I’m not succeeding that’s why I’m not happy’ or like ‘[I] haven’t done anything with my life yet, that’s why I’m not happy’ and it was just a lot of excuses.”Ali* is a fourth-year psychology student who describes similar difficulties: “I guess I’ve been experiencing the effects [of SAD] probably pretty much since I came to Canada,” he says, “I usually just experience a lot of lethargy, like it’s hard… for me to get going in the morning.” The lack of sunlight causes Ali particular difficulty. “It’s hard for me to get motivated and do anything throughout the day, and it can be really hard for me to [prevent] my sleep cycle [from going] out of whack very quickly when I just don’t get enough sunlight.” Lack of motivation left Ali confused and helpless prior to diagnosis. One result of this was devastating academic consequences.“Actually that’s how I sort of in retrospect realized that I was having problems with SAD,” Ali reflects, “in first-year… my motivation to get out of bed and go to school plummeted, and basically just wasn’t there anymore.” he explains.Ali nearly failed high school, and failed his first year of university as a result of his SAD.
An evolutionary process
It is not clear how the complicated relationship between the brain and the body affect the onset and treatment of mental illnesses — a puzzle which continues to challenge researchers and health care professionals. Thatsaid, most mental illnesses can be recognized from physical symptoms; mental states are heavily influenced by diet, exercise, and environment. Levitan believes that environmental factors may have a greater impact on SAD than other mood disorders. “If you think about your day-to-day biology and mood, it’s profoundly affected by light and dark cycles,” he says. “They’re a fundamental aspect of nature, of biology, and life on the planet.”Levitan explains that his research on SAD has led him to believe that the way our bodies have evolved is more connected to our geographical location than we may expect. According to Levitan “we all have body clocks within us, and those body clocks are very sensitive to changes in light.” Levitan believes that the root cause of SAD may lie in the body’s attempt to regulate energy given these natural ‘clocks.’ This could also explain why fatigue and carbohydrate cravings are a common symptom of SAD. “I think that when the fall [and] winter comes there are changes [in the body] to help us adapt to the winter time that perhaps during the ice age were very very helpful to us in terms of conserving energy and avoiding problems,” he adds, “and so I sort of see SAD as a natural process that has an evolutionary significance.”
A contentious disorder
As is often the case when it comes to mental illness physicians do not all agree on the definition — or indeed, the origin — of SAD.The overlap of SAD symptoms with regular depressive symptoms contributes to why there are disagreements surrounding this disorder. Dr. Edward Shorter, Jason A. Hannah professor of the history of medicine in the Faculty of Medicine at U of T, and a cross-appointed professor of psychiatry, goes so far as to say that SAD may not even exist.“Let me make a few little points: I don’t think SAD is a legitimate form of depression,” he says in a phone interview with The Varsity. “I think it’s a kind of construct that [has] been imposed on the world of affective [mood] disorders.” Shorter considers the depressive symptoms caused by SAD to be legitimate, but is not convinced that the disorder stands on it’s own. He believes that it is more likely that regular depression provoked by difficult experiences that some individuals undergo in the winter.“Depression can be profoundly biological experience, to be more likely trigger[ed] by your genes or some terrible personal crisis,” he says. “Or whether the sun is shining that particularly February day.”Levitan, however, sees SAD differently. “It definitely exists,” he states. “It’s just that you have to see a lot of patients with depression to understand the difference between somebody with a true seasonal depression versus somebody who says they’re seasonal but probably aren’t.” He goes on to emphasize that — despite the overlap in SAD symptoms with those of depression —he believes that SAD is distinguished by the measurable physical changes that it causes. “What we use clinically is not just the patient’s report,” he says, “but then we’ll get into the symptoms over a long period of time and consider other factors. In our research we’ll also do brain scans or we’ll look at actual measures of [patients’] biology and see whether there are changes that match our models.”Although the most effective way to categorize SAD still remains unclear, the medical community has agreed on a temporary classification outlined in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM). The DSM is the main standardized text that North American doctors use to diagnose all kinds of mental illnesses. ‘Seasonal affective disorder’ is coined in the fourth edition of the text, known as the DSM-IV. In the fifth edition of the DSM (the DSM-5), SAD is now classified as a sub-disorder under depressive disorders.SAD no longer stands alone in the DSM but researchers agree that the harm it could cause is real, and serious. “Real depression is characterized by anhedonia — the inability to experience pleasure,” Shorter says. “That means you don’t get pleasure from your children or grandchildren. You don’t get pleasure from working out. You don’t get pleasure from anything.”
Finding treatment, getting through
Antidepressive drugs such as Zoloft and Prozac are the general practitioner’s ‘go-to’ solution for many problems involving depressive symptoms; specialists, however, are beginning to believe that medication is not the only form of treatment for SAD.One type of non-chemical treatment for SAD gaining popularity is light treatment; the CAMH SAD clinic notably uses devices
called ‘SAD lamps’ to treat their patients. The lamps are specially designed to imitate the light of the sun; they do so by radiating light at the exact same wavelength. Shorter credits the effectiveness of SAD lamps, largely, to the placebo effect. Levitan, on the other hand, sees things differently.“The specific way it works is still not completely understood,” Levitan says, “[but] I see it very much as a stimulant… not unlike a psychostimulant drug that boost the levels of different systems in your brain so that they’re functioning normally.”Levitan again refers to the biological and environmental sources of SAD. “If you think about it, every day in the morning you wake up, that’s a profound change in your biology,” he explains. “You’re going from a state of sleep to a state of activity, and so light speeds that up…[and] that’s difficult to do on the short days of fall and winter.” “I think all of us to some extent are sensitive to light in our environment, and using very very bright lights… at just the right time of year in the right individuals, I think corrects essentially a tendency to be in a state of low arousal which leads to the sleep problem of fatigue and the overeating.”Support for this theory may be found in the usage of SAD lamps to treat jet lag, Levitan suggests. “Jet lag is, when you think about it, in some ways is similar to [SAD],” he says, “it’s just something that happens very quickly when your body is out of sync with respect to the day and night cycle.”Along with regular sunlight, or imitative sunlight, proper nutrition may also be key in combating SAD. There have been several studies in recent years indicating that SAD might be a consequence of not having enough vitamin D in the body — a deficiency from which many North Americans are believed to suffer.Some have even suggested that seasonal changes in sunlight affect the circulation of vitamin D3 — the chemical responsible for keeping us energetic and motivated — the lack of which results in the symptoms of fatigue and lethargy. One group of Danish researchers performed a double-blind trial in 2014, where one group of SAD patients were given vitamin D supplements and another group were given a placebo. The group that took the vitamin D scored higher on a standardized depression test known as the Hamilton Depression Rating Scale — a bleak result for supporters of vitamin D as a SAD treatment. The link, however, was only established after participants had taken the supplement for a period longer than 12 months. On top of that, only 34 participants completed the study. A 1999 study performed by the Union Memorial hospital in Baltimore indicated that vitamin D is a far more effective treatment for SAD than light therapy, with a 74 per cent and a 34 per cent positive result respectively. This study, however, was only conducted on 15 participants and used a ‘randomized control’ method but did not make use of a placebo. Despite turbulent evidence, the vitamin D SAD treatment idea has caused a large stir among the psychology as well as nutrition communities, and many SAD sufferers have already taken it upon themselves to self-medicate using this method. “I actually have a SAD lamp [at home]…but mostly these days I find that just taking large doses of vitamin D keeps me ‘up’,” says Ali.Ali says that he “stumbled onto” vitamin D when a doctor prescribed it to him, and he credits this discovery with immense improvement in his life. “It seems kind of weird that a couple of pills that you can get for a couple of dollars was one of the reasons I like failed my first year and you know lost thousands of dollars doing that,” Ali adds. “But yeah, shit happens.”Fourth-year English student Anya Zaporozhchenko, also cites vitamin D as a simple, cheap remedy for students with SAD. She also emphasizes the importance that students with SAD treat their disorder as they would any other illness. “I think it’s important to take time for self-care. Maybe schedule something indoors with your friends, even if you have work,” she says. “You know, you gotta pick a night to do something indoors and cheer yourself up a little bit.” Zaporozhchenko also discusses how important it is for U of T students to fight mental health stigma and treat SAD as a reality faced by many, rather than something we need to be ashamed of. For Zaporozhchenko, openness and understanding within the U of T community is integral to helping SAD sufferers manage their illness. “It’s nice to even be able to talk about things,” she says. “It sounds so silly, but it’s nice, even when I’m talking to my friends who also struggle with mental health issues. Even when you say ‘try this medication, I tried it. These are the side effects that I got’…[M]aybe, there’s a new hobby that keeps you motivated a little bit. It’s nice to be able to talk about that sort of thing.”Though antidepressive drugs, vitamin D supplements, morning light therapy, nutrition, and exercise have all been referenced by mental health professionals as effective treatments, it is clear that none are universal. Students have taken note, meanwhile, that SAD lamps and vitamin D supplements are both accessible to patients who may not have access to psychiatric health care and those without a diagnosis.
Students helping students
Due to the confusion within the medical mental health community surrounding SAD, the denial from many parents and educators about its existence, the extent to which it affects student lives, and the societal stigma that is still always present many students have found it necessary to take SAD treatment into their own hands. For example, last year Auni Ahsan, Victoria College Director at the UTSU, launched a SAD lamp campaign with funding from Vic Student Projects, a program where Victoria College student initiatives can obtain financial support.Ahsan successfully procured $785 dollars to purchase three SAD lamps, that students can borrow from the Victoria College Students’ Administrative Council (VUSAC) office for free at any time. He says he got the idea from a post on the U of T subreddit, in which a student noted that other universities had SAD lamps available on campus.“I think that something really prominent about seasonal affective disorder is that it’s both like underdiagnosed and underrepresented,” Ahsan says. “A lot of people suffer from symptoms of it or even the clinical diagnosis of it, but [are] not really … aware of it.”Ahsan believes that awareness of SAD and accessibility to treatment go hand in hand. “I think that a big part of the campaign, or a big part of getting SAD lamps, is you need to have the lamps here,” he explains. “And you need to start having a campaign about awareness for the fact that students might be suffering from this issue, so that they become more aware of it and more willing to use the resources that are here.”Ahsan explains the method behind SAD lamp use: “The basic idea is that you sit next to this lamps for thirty minutes every day…like 12 to 14 inches away, you can be like eating cereal or like doing homework at the same time, and you’re supposed to do it every day.”Levitan agrees that the free availability of SAD lamps is a great resource. “I think it’s a wonderful idea,” he says of the initiative. “The advice I have is that early [in the day] is better…you can still benefit later [in the day], but often the way it works is to reset your biological clock so that you’re waking up earlier, and that ability to wake up earlier is often what makes people feel a lot better.”He also explains the most effective way to use the lamps, “I would say a half an hour is good; [students] can study while they use the light…the light should be in front of them but they shouldn’t be staring right at it.”After realizing the simplicity and usefulness of the SAD lamp program, Ahsan decided to extend it to the greater St. George population, and brought the idea to the UTSU in 2015. He obtained funding for the UTSU to buy four additional SAD lamps, which are currently available for use in the basement of the UTSU office.Ryan Gomes, UTSU VP internal explains that a poster awareness campaign to advertise the lamps is underway. “I expect [the posters] to reach out all over campus, hopefully from as far as here at VUSAC to all the way down at Bahen,” says Gomes. “Because I think that this is a disorder that affects people all across campus.”Both Gomes and Ahsan recognize the importance of solidarity when it comes to mental illnesses within the community. Even for those who not diagnosed with SAD, there are many U of T students who may suffer from winter blues. “There’s no harmful side effects from the SAD lamps for the most part anyway,” Ahsan concludes. “But like my hope is that more people will become aware of the fact that these sorts of mental illnesses can affect you on a really small scale, affect your school performance, or affect your social life, and can take the steps to get better. And we hope we can help with that.”*Names changed at individuals’ requestWith files from Clara Osei-YeboahCorrection (February 10th, 2016): An earlier version of this article listed an incorrect acronym for the Canadian Mental Health Association.