J

ill King falls into depression every year when the cold of winter
thaws into spring, a transitional time. Shes felt like this all of her
life but only became strongly aware of it in her post-college years.
Teres a commercial they show sometimes on TV of a per-
son with a cloud over their head, King said. It was like seeing
that and realizing I felt like that.
When Kings therapist noticed that her depression had a
pattern that had repeated for many years in a row, she diagnosed
King with reverse seasonal depression.
Melancholy is how King described the experience of sea-
sonal depression.
Its not really sad just down, King said. What I want to
do is go sleep.
Most people knowabout a kind of depression that gets worse in
the fall and winter. Tis is known as seasonal afective disorder, or
SAD. Te defning characteristic of this disorder, according to the
DSMIV, is the onset and remission of Major Depressive Episodes at
characteristic times of the year. Reverse seasonal depression has the
same recurring patters, but is works in the reverse, afecting people
in the spring and summer months. About 10 percent of people with
some kind of seasonal depression experience it in the reverse.
Barbara Melville is a freelance writer whohas writtenabout various
healthissues. She decidedtowrite about reverse seasonal depression
because of the apparent lackof informationandresearchonthe subject.
Tere were several articles out there onwinter depression, many of
whichmentionsummer depressioninpassing, andofenwithnosugges-
tionof where tofndout more, Melville saidinane-mail. Tis seemed
like lipservice, andI wantedtosee if I coulddig upsome information.
Inthe context of the article, I was surprisedby howmany people
were searching for terms suchas summer depression andreverse SAD. I
got somany e-mails frompeople whosaidthey were experiencing signs.
Regarding the disorder itself, Imsurprisedit hasnt hadmore coverage.
Its likely that many people dont notice that their depression has a
pattern or dont feel that what they experience counts as depression.
It took Chapel Hill resident Andrea Hale two years to notice
that things started going downhill in the spring and didnt get
better until fall.
I guess I just realized that I was feeling crappy all the time
and that it could be depression, Hale said. And then that it
generally happened during the spring and summer and I thought,
Maybe it is seasonal depression.
Hale said the realization was gradual. She started noticing that
some things were diferent.
Not enjoying things that I normally enjoy. Not having enough
energy. Feeling down or sad. Tat kind of thing, Hale said.
She saw a therapist, not specifcally for the seasonal depres-
sion, but for the accompanying psychological problems.
I was having a lot of irrational thoughts like thinking that people
didnt like me for some reason or I was a bad person, Hale said.
Although reverse seasonal depression is a recognized and ac-
cepted psychological disorder, there is no defnitive answer for what
causes it. According to WebMD, reverse seasonal depression can be
caused by a change in schedule because of summer plans; body im-
age issues; discomfort because of the heat; or even fnancial issues.
I think in the summer because theres always expectations of
how youre supposed to be, Hale said. Youre supposed to be do-
ing things that are fun and worthwhile and when I wasnt, it was
kind of a trigger for me to start going downhill.
Chapel Hill psychiatrist Dr. Cheryl Yanuck said that sometimes
feelings about a traumatic event that happened in the summer can
resurface every year and cause seasonal depression. In the same
way, a particularly stressful summer could create the feeling that a
person needs to live up to certain expectations every year.
Most of the people Melville interviewed during her research said
that the summer weather was the main contributor to their depression.
Tey all said feeling too warm was the biggest hindrance, and
2010
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2010
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Cbapel Hill can get SAD in tbe Summer
Maggie Tobias
Cbief Editors' Notes
I|oa||ng by Muud Cutevood (courtesy o Somerh Art Cuery,
Durhum, N.C.) Cutevood, born n Yunceyve, N.C., s one o the
Southeust's most revered und ercey ndependent urtsts. She
punted ths pcture o u rend yng n the poo o the lorest Home
estute n Cusve County. Cutevood receved nutonu und nter-
nutonu recognton or her vork beore pussng uvuy n 2004.
@iooer o( tbe )oo @ritiog ur
NC BioStart: Creat Start for Biomedical
Entrepreneursbip
Eric Emilio Butter
they shared concerns about feeling isolated and unheard, Melville
said in an e-mail.
Te physical discomfort of summer may stem from deeper
health problems, Yanuck said. One of the causes of seasonal de-
pression may be that the person has a negative body image.
Peoplewhoareoverweight tendnot tolikethesummer becausethey
get hot. Teymaynot want towalkaroundintank-tops, Yanucksaid.
None of the people Melville talked to mentioned their weight, but
according to Robert Lawson, another Chapel Hill psychiatrist, its not
uncommon for someone to dissociate their weight with the problem.
You cant tell a person that, Lawson said. You have to be gentle.
Besides issues of tact, there is no factual evidence that weight or a
negative viewof ones body is the only cause of seasonal depression.
People of all sizes and shapes can have body image issues; anyone may
have aversions to heat and wearing minimal clothing.
Along withthe psychological stress that may occur inthe summer,
these seasons may containcircumstances, like vacations, internships and
summer jobs, that isolate people fromtheir friends andsupport groups.
Hale spent two consecutive summers interning at a lab in More-
head City, N.C., where she was separated
fromfriends and lacked transportation
to help her meet newpeople and create a
community.
I tried to build a support system
when I was away, Hale said. And be ac-
tive and work on the irrational thinking.
Hale said her therapist focused on
cognitive therapy to combat her depression. Tis is a common
remedy that many psychiatrists say is the best because it attempts
to fnd the root reason for a psychological problem.
King also tried therapy at the suggestion of her therapist.
Sometimes if you give medication too early it takes away the
feelings and prevents you from working through the underlying
issues, King said.
In Kings case, cognitive therapy didnt seem to be helping her
depression so she decided with her therapist that the depression
was chemically based and began taking Efexor, an antidepressant.
Doctors, patients and supporters of the alternative medicine
movement difer greatly in their opinions about medication. In
some cases, the therapist may decide that medication is the best
option for a person experiencing seasonal depression.
I dont really like the idea of medication, Hale said.
She said shed rather work through the problem naturally than
rely on pills.
Many people try other possibly temporary remedies like staying
indoors to avoid the sun or taking cold showers to combat the heat.
Personally, I wouldnt necessarily advocate this to the ex-
treme, Melville said. Some people would fnd this very disrup-
tive and it may not be tackling the underlying causes.
A lack of research on reverse seasonal depression may be stop-
ping therapists and doctors from knowing what those underlying
causes are. Some may think its cognitive; others may see it as a
consequence of being overweight.
Psychiatrists say that a change in diet could help alleviate the
symptoms of reverse SAD. Consuming vitamin C and omega-3
fatty acids can also improve mental well-being. Yanuck suggests
consuming a spoon of fsh oil every morning. Tese changes can
improve the general health of the body and help a person lose
weight. If being overweight is indeed a cause of seasonal depres-
sion, these nutrients and dietary changes could help treat it.
But without further research, many people with reverse seasonal
depression must fnd their own ways to deal with the disorder.
Te symptoms of reverse SADare diferent for everyone, andnoone
methodworks as a universal treatment. Still, bothHale andKing found
that similar remedies workedtolightenthe loadof their depression.
I tried to build a support system when I was away [in Morehead
City], and be active and work on the irrational thinking, Hale said.
For Hale, as well as King its important to
reachout topeople andget out of the house.
Not just retreating into myself, Hale
said. Other people provide a foil for my
feelings and help me realize that things
arent as bad as they seem.
Bringing more light into her home
by opening drapes and windows helped
King deal with a more literal kind of darkness.
With or without medication, people with reverse seasonal
depression must learn how to live with their disorder in some way
or another. Te hopeful news is that sometimes this psychological
struggle can lead to a better understanding of the self, even if a
person has go through hard times.
It reminds me that I need to take care of myself mentally
as well as physically, Hale said. It also makes me want to think
more carefully about where Ill be in the spring and summer be-
cause I want to be able to deal with it if it happens again.
Because of its cyclic nature, it will happen again. But the good
news is that summer will always end. Lawson said that most
people with reverse seasonal depression will give you the same
answer if you ask for their favorite season.
Strangely enough, its the fall, King said. Its a nice time to be
outside, yet its not so hot. Although things are dying, the colors
are really beautiful. I cant explain that one either.
continued from page 3
2010
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MEDICAL INSICHTS:
P
erry Genova, Ph.D., trained in chaos theory, helped lead nu-
merous start-up companies, and patented more than twenty
inventions. Jetting with his family across the Atlantic Ocean in
2006 to vreux, France, seemed at the time like just another natu-
ral step in his exciting journey.
GlaxoSmithKline hired Genova to bring unique technical un-
derstanding and management experience to its metered dose inhaler
manufacturing teams near Paris. Meanwhile, back in N.C., Genovas
father was diagnosed with well-developed esophageal cancer.
Genova spent his free time studying everything he could about
the cancer, and soon realized a recurring theme: poor early-stage
diagnostics. Ultimately, I felt a longing to return to my entre-
preneurial roots. In 2008, shortly afer Genova lost his father to
esophageal cancer, the entire family returned to N.C.
Since then, Carolina graduate Genova has been working tirelessly
to develop and release a new point-of-care diagnostic for esophageal
cancer with his start-up company, Oncoscope. Tis diagnostic may
have saved my fathers life and I am certain, looking ahead, that we
can prevent other needless deaths from this aggressive cancer.
To stay motivated through the negative proft margins and
occasional self-doubt, entrepreneurs like Genova feed of passion
and ofen personal ties to their work. I really care about my job,
says Genova. At a 2009 Carolina Innovations Seminar, Genova ex-
plained that now, when he catches the bug to start up some new
venture, his wife is no more surprised than when he registers for
another opportunity to race his vintage BMW (Genova has raced
his custom-built BMWs for over 12 years).
Te latest bug to bite Genova is something new: education.
Genova is an entrepreneur-in-residence for Carolinas new bio-
tech business incubator, NC BioStart. Te program launched in
spring 2009 as part of the North Carolina Translational and Clini-
cal Sciences Institute (NC TraCS). Vice Chancellor Tony Waldrop
attributes the programs early success to Etta Pisano, M.D., vice
dean of the School of Medicine and 2008 inductee of the National
Academy of Sciences Institute of Medicine.
Pisano secured one of 46 prestigious Clinical and Translational
Science Awards fromthe National Institutes of Health to fund work at
TraCS and BioStart. Pisano, a professor of radiology and biomedical
engineering, struggled through the process of starting her own com-
pany to commercialize a safer formof X-ray imaging. Administrators
like Waldrop expressed confdence that Pisano would ease the process
of biomedical commercialization for UNCstudents and faculty.
Although Pisano just accepted a new position as dean of the
Medical University of South Carolinas College of Medicine, NC
BioStart will continue to thrive thanks to its early legacy of suc-
cess. Te three entrepreneurs-in-residence for BioStart Tom
Mercolino, Joel Shafer, and Perry Genova already advise some
seven university startups each.
Referring to a recent article in the Carolina Alumni Review,
Waldrop attributes the programs rapid takeof to Pisanos bril-
liant impatience. But such personal drive and motivation is not
restricted to biomedical researchers like Genova and Pisano.
Every year, applicants to the UNC School of Medicine detail
their personal motivations to the board of admissions. Accord-
ing to BioStart Director, Don Rose, Ph.D., medical doctors and
students are involved in about half of BioStarts start-up com-
panies. Students of law, medicine, science, and business also work
with BioStart through the Launching the Venture program and
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