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What steps can I take to ease the autumn blues? DR MARTIN SCURR answers your health questions

Why does autumn make me gloomy? I wish we could go straight to winter.

Sean Mackie, via email.

It sounds like you have some form of seasonal affective disorder (SAD). Most people with SAD find that their mood is affected in the winter, but it can also occur in the fall, spring, or summer.

The exact cause is not known, but it is thought to be related to the disruption of the circadian rhythm, the internal body clock that regulates our sleep-wake cycle, as well as changes in the retina, the light-sensitive cells at the back of the body. the eye.

These cells relay messages to areas of the brain involved in mood regulation and produce so-called happiness hormones such as serotonin.

One theory is that the retina of people with SAD is not as sensitive to light, leading to a deficiency of these hormones.

It sounds like you have some form of seasonal affective disorder (SAD).  Most people with SAD find that their mood is affected in the winter, but it can also occur in the fall, spring, or summer

It sounds like you have some form of seasonal affective disorder (SAD). Most people with SAD find that their mood is affected in the winter, but it can also occur in the fall, spring, or summer

It may also be related to the levels of melatonin, the hormone released in response to daylight.

While we don’t understand the exact link, we do know that people with SAD often have higher melatonin levels, which can make them feel sleepy and unmotivated.

When they strike, the symptoms of SAD are broadly similar and can include low mood and sleep disturbances.

The good news is that there are a number of treatments that can help.

Light therapy boxes generate artificial ‘natural’ levels of light (they are available in the High Street and cost around £90; you need a device that produces 10,000 lux) – stand in front of them for 30 to 60 minutes each morning.

I would suggest using this now as we are leaving the summer and will continue to use the box through the fall months.

The goal is to improve SAD by decreasing melatonin production and increasing serotonin.

Good sleep habits can also make a difference – for example, going to bed and waking up at the same time every day, as this helps regulate melatonin production.

Where these don't work, antidepressants and cognitive behavioral therapy (CBT), a talk therapy that tries to help change the way you think, can be helpful

Where these don't work, antidepressants and cognitive behavioral therapy (CBT), a talk therapy that tries to help change the way you think, can be helpful

Where these don’t work, antidepressants and cognitive behavioral therapy (CBT), a talk therapy that tries to help change the way you think, can be helpful

Finally, dawn simulation can help. This form of light therapy uses a less intense light than a light box. It is programmed to turn on at a low level during the last hours of sleep and then increase over 60 to 90 minutes.

Devices marketed as wake-up lights cost around £30. It may be more effective to use this alongside a light box than either alone.

Where these fail, antidepressants and cognitive behavioral therapy (CBT), a talk therapy that tries to help change the way you think, can be helpful.

I would advise self-help as the best first step. However, talk to your doctor as they can help you decide what to try first.

I am 78 and suffer from atrial fibrillation, where my heart rhythm is temporarily confused. When this happens, I also have an uncontrollable need to urinate every few minutes. It can be uncomfortable and embarrassing. Can you help?

Name and address provided.

This is a rare but recognized consequence of the changes that occur in the heart muscle in patients with atrial fibrillation – the most common form of abnormal heart rhythm.

In a healthy heart, the two upper chambers beat regularly and in coordination. But in people with atrial fibrillation, the muscle of the atrial wall occasionally vibrates and so the two chambers beat in an uncoordinated way.

Causes include heart disease, high blood pressure, and an overactive thyroid.

So what causes the urge to urinate? Some research blames high levels of a hormone called brain natriuretic peptide (BNP), which is secreted by muscle cells in the heart when it’s not pumping as much blood as normal.

This hormone sends the kidneys into overdrive, encouraging them to filter more fluid than usual. This in turn has the effect of filling the bladder quickly and thus the need to urinate frequently.

There is no easy solution. I would recommend that you speak with your cardiologist again to explore the options.

In my opinion: the queen was also a shining example for doctors

For so many of us, Her Majesty the Queen was an example of how we should behave.

But when we think about her life, it is striking how her example also resonates with us in the medical world.

In particular, her life and work embodied the four pillars of medical ethics: autonomy, benevolence, harmlessness and justice.

The pillars form the basis of good practice and should guide everything we do with our patients.

The first, autonomy: Her Majesty the Queen clearly respected our individual right to live our lives according to our own beliefs and culture.

She was also a model of benevolence – the duty to ‘do good’ – guided by kindness and selflessness; and of non-malice, meaning that it conspicuously never does any harm. Obviously, the queen was also an example of no malice.

And finally the fourth pillar: justice. Her Majesty treated all people equally and fairly. Could we all be remembered in medicine for being so faithful to these principles.

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