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Haslam's view: SAD or just grumpy old man syndrome?

i'm not a great fan of this time of year. the mornings are too dark, the evenings are too dark and, for all too many people, the mood is too dark.

I have little doubt that there is a genuine biochemical condition that does affect a few people as seasonal affective disorder (SAD), which is possibly linked in some obtuse way with pineal gland activity. I'm equally certain that there is another condition, which affects far greater numbers of us, simply called ‘I don't like this time of year'.

At the very real risk of metamorphosing into a grumpy old man, I do frequently wonder why every emotion, sensation, mood and feeling has to be given a biological status and an attached syndrome. It wouldn't matter if these were simple labels. The problems arise when people with understandable moods or feelings try to look for an excuse rather than an explanation, and then use that excuse to avoid doing anything to sort the problem out themselves.

One of the genuine and beautifully logical benefits of cognitive behaviour therapy is the way that people are taught to spot their negative thoughts, accept that there might be a more positive interpretation of the way the world appears to them, and then to look deliberately at the world in a more positive way.

I often describe the logic of this in a very simple form with unhappy patients:

‘Imagine you are walking down the street and someone you know walks by without speaking to you.

If you are feeling down, you will probably interpret this as "what have I done?" and inevitably feel even worse. If you are feeling good about life, you are likely to think

"I wonder what's wrong with her?" It's the same event but two very different interpretations – and making a negative interpretation reinforces a low mood. It is the most vicious of vicious cycles.'

Many patients can understand this and begin to act on it. But when people decide that they have a syndrome, with a biochemical explanation for their mood, there is a risk of becoming a victim rather than tackling the feelings head on.

Indeed, I am slightly surprised that my self-declared "grumpy old man" status hasn't been picked up as a syndrome. Let's face it; it has all the necessary hallmarks. You can just imagine the press release: ‘Scientists today have identified the cause of grumpy old man (GOM) syndrome. It appears that reduced elasticity in the amygdala, falling testosterone levels and a combination of environmental factors likely to be triggered by the wave emissions of electronic gadgets, in particular TV remote controls, are all playing an increasing part in this scourge of the male population.'

There would be the inevitable demand for more research, the observation that the condition is less common in societies that use traditional herbal remedies and a recommendation that sufferers seek the advice of their GP. Today.

But far more effective for the treatment of this particular grumpy old doctor is regular exposure to students and doctors at the start of their careers. I always leave such encounters thoroughly inspired by the positivity, altruism and enthusiasm that they show.

Don't let anyone tell you that young people these days ‘aren't like we were when we were their age'. That's GOM syndrome activity. You don't need counselling to get over it, and you certainly don't need an appointment with your GP.

Author

Professor David Haslam CBE
FRCGP
GP, Ramsey, Cambridgeshire; President, Royal College of General Practitioners; national clinical adviser to the Healthcare Commission; and Visiting Professor at de Montfort University, Leicester

Haslam's view When people decide that they have a syndrome there is a risk of becoming a victim

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