Dear Dr. Garner,
I feel like I am out of synch with everyone. All my friends look forward to summer. The kids are out of school. No more Sunday evening book reports.
The weather is great — no heavy clothing.
Why then do I dread the summer? It happens every June, when I start to panic. I don’t know why, but I have trouble sleeping, and I feel anxious. Why? I don’t know.
I become irritable and very hard to live with.
I have been to doctors and they are not sure what it is, and I am reluctant to take pills without knowing why I need them.
Do you have thoughts?
Summer Woes in Williamsburg

Dear Summer Woes,
Your problem is somewhat unusual, as most people do look forward to the summer and the wonderful times it can bring.
There is a small group of people who relate symptoms similar to yours. While depression and other mental disorders are difficult to evaluate without a careful exam, I would like to discuss a condition known as SAD, or seasonal affective disorder. Most people experience this in the fall and winter, as the daylight hours decrease. The chemicals of the brain become altered as a result.
There are a small percentage of people who have this problem in the summer.
There are many thoughts as to why it occurs and most believe it is due to a chemical imbalance of the brain, which is aggravated by the changing daylight hours of the summer, when it gets light as early as 5 a.m. and darkness may not occur until 9 p.m.
This interferes with the sleep cycle and the body’s internal clock.
The symptoms include:
• Anxiety, weight loss, irritability, trouble sleeping, and poor appetite.
• Some may experience a very excited state, in which the person becomes hyperactive.
The key part to the diagnosis is to establish that the condition occurs in cycles and occurs year after year at the same time. Females seem to be more prone to the condition and it may run in families.
Treatment options include anti-depressant pills and psychotherapy. As in many other diseases, improving one’s lifestyle with better diet and exercise is a key part to the success of the treatment.
Mind-body therapies may be useful such as yoga, meditation, and massage therapy.
In experimental treatment, some doctors advocate reducing the body temperature while sleeping. This can be accomplished with air conditioners, or even ice bags that people keep near them in bed while sleeping. There was some improvement noted as the body temperature was slightly lowered. The condition may be related to the heat, particularly in those who are overweight and obese. The heat becomes uncomfortable, and many people refuse to leave their house due to this.
Some think that the depression may be there all year, but only recognized in summer, when life is much less structured. The routine of car pooling, and working on a child’s homework provides structure. When it disappears, some people become anxious and depressed.
The kids are home, and if not at camp, have to be entertained. There are increased expenses for vacation, and pressure to have fun, which further compounds the situation.
While I cannot say with certainty what condition you have, I hope this is helpful to get a conversation started with your doctor to address the problem you are having.
I hope to hear from you regarding your progress.

I can’t believe it, but we have come to the end of another season of “Ask the Doctor” in The Tablet. As in the past, we will rerun previous columns until new ones appear in September.
My wife and I are looking forward to a trip to Barbados, at the end of June. We have heard such nice things about the island and its people.
We, of course, are looking forward to our annual trip to Manchester, Vt., with the Grisafis and Carneseccas. This is always fun, with shopping, summer stock plays, and clay shooting.
And perhaps our favorite part is staying in the city most of the time, when its beauty can be enjoyed without the usual crowds.
I hope you all have a wonderful summer and I look forward to meeting you on the streets of our beautiful city in the good old summertime.
Be well!