She has to force herself to get out of bed every day, but not because she hasn't slept enough. Sleep is one thing she's had plenty of. She has no energy, no desire to get up and continue with daily routines.
When she finally gets up, in the pitch-darkness of a winter morning, she can't even concentrate on simple tasks. She's not indecisive, she just can't think.
She manages to get to school, a little late, but in class she can't focus on the teacher. No matter how hard she tries, she can't finish, let alone, begin her assignments.
This student, an 18-year-old senior, is one of the over 10 million Americans who suffer from a psychological disorder called Seasonal Affective Disorder (SAD).
The symptoms are easy to notice, and the solution is simple as well: sunlight.
Some mild cases, the so-called "winter blues," can cause feelings of boredom, fatigue and lack of energy. Symptoms of those plagued with extreme cases of SAD include weight gain, absence of concentration, extreme irritability, oversleeping and a drop in energy levels. These symptoms begin in October or November, but for some may start as early as late August or September.
SAD is caused when shorter days with less sun cause a decrease in the production of the hormone melatonin, which is stimulated by sunlight. The chemicals serotonin and dopamine also are affected, causing the sufferer's biological clocks to run slowly.
"Seasonal depression is in many respects the same as other depression," said Kalispell psychologist John Santa. "Some of the differences are that seasonal depressive disorders seem to be brought on by lack of light and (sufferers) seem to shut down, want to hibernate, like a bear. Some people adjust differently to the shorter days."
SAD can be misdiagnosed as clinical depression and it may not be correctly diagnosed for a year or more, until the psychologist or psychiatrist notices the pattern of the patient feeling better in spring and then relapsing the next winter. As more is learned about SAD it may become easier to diagnose, according to Norman E. Rosenthal, a New York psychiatrist.
"Depression is like fever in a sense," said Kalispell psychiatrist John McKinnon. "It's the sign of a problem, but it's not the complete diagnosis.
"People need to know that the depressed mood is completely normal, when some one dies or as you grow up," McKinnon added. "There are all kinds of reasons that people get depressed. Some people see an odd correlation between their changes in mood and the changing of the seasons. That is when (SAD) is diagnosed."
A major disagreement in studies is whether those living at different latitudes are more often plagued with the disorder. A study at the University of British Columbia in Canada showed that in Florida less than one percent of the population is affected, while far north in Alaska about 10 percent may suffer from SAD. Another study, conducted by R. J. Williams and G. G. Schmidt, of mental patients showed 20 percent of depression patients suffered from SAD, regardless of the latitude at which they lived.
Treatments such as Prozac or Zoloft, which are used to treat patients with clinical depression, are often effective in SAD patients. However, newer therapies use light, as well as exercise and a well-balanced diet, for treatment.
Patients "need to understand more about the depression and not to damage themselves," said Santa. "When people get depressed they can't concentrate and they get down on themselves for that. It's just a symptom that comes with depression."
For light therapy, the patient is told to sit in front of a "light box" for 30 minutes to two hours for three to seven days a week, according to the Mental Health Association of Colorado. This light emits 10,000 lux of light, which is the same light intensity as on the beach on a bright, summer day. The patients are also told to remove the blinds and curtains from windows and to install brighter light bulbs in lamps. Some patients also are helped by tanning sessions.
"Some circuits in the optic nerve affect brain chemistry," said McKinnon. "Light is the reason for (SAD), not snow or the temperature."
However, this is a new therapy and psychiatrists perscribe different solutions more often, according to McKinnon.
"Light therapy is not prescribed that often." said McKinnon. "It's rare to come across such a clear-cut case that we prescribe light therapy. Some people are helped by the light."