It is getting better with the Estonian soul

Photo: Liis Treimann / Postimees

With the men lost and not found lately, links have been drawn with troubled soul. Even so, heads of psychiatric clinics claim there's nothing out of the ordinary with receptions at their institutions this fall. Are mental problems popping up related to the seasons?

Regarding that – the seasons – even scientists till today don’t quite agree though the talk about autumn low and springtime depression is common. Not necessarily is suicide the outcome of a mental sickness, but it often is.

National Institute for Health Development (TAI) data on suicides in 2009–2014 reveal that these were actually most widespread in summer i.e. June – totalling 148 occasions – followed by January, April and August. During the six years, Suicides were lowest in February, at 91.

Estonian-Swedish Mental Health and Suicidology Institute (ERSI) head Airi Värnik said suicides are also frequent on special occasions like Christmas, Midsummer Day, own birthday, or anniversary of the death of a loved one. That’s because it is then that these people feel especially lonesome and forsaken.

«June may also be linked with the start of the holiday season – now, the people will need to decide for themselves what to do next,» said Ms Värnik. She said the pre-suicide condition still cannot necessarily be labelled a mental disorder, though depression is often the case. «Rather, suicide is an adaptation disorder.»

-The spring of birth, the fall of death

The early spring suicide has been linked with the surrounding environment coming alive which pains people. «They say a depressive person should not be taken to a too merry company,» explained Ms Värnik. «The contrast is too much. The fall, again, is the time that everything dies which may sync with the mood.»

Meanwhile, the amount of suicides in Estonia has gradually fallen. True: last year Statistical Office counted 236 suicides which are still 27 more than the year before that. Among them, women amounted to a fifth. At the same time, 2012 has almost the same number of suicides than 2014.

In 2005 there were 273 suicides after which the figure went down till 2008 (242) and in 2009 it may have been the economic crisis that boosted it to 269, after which the welcome decline set in again. Even so, the worst of times belong to the 1990ies – in the gloomy record year of 1994, Estonia suffered 614 suicides.

«When treating suicide as adaptation disorder, we may say that the society has stabilised,» said Ms Värnik. Some suicides also remain unidentified. «This, for instance, goes for the bodies found where the autopsy fails to show for sure what was the cause of death.»

Last year, the suicides included two youths aged 10–14, and nine aged 15–19. The numbers highest among men and women aged 45–54.

North Estonian Regional Hospital mental clinic head Kaire Aadamsoo said they have never had lots of empty beds. «Always, the beds occupancy is over 90 percent. True, in August and September the load eases a bit,» she said. «Perhaps, over the millennia, natural selection has sifted out those who were sick during potato-picking and harvest? Well this surely is an altogether unscientific answer.» Anyway, this autumn is nothing out of the ordinary for their clinic, she noted.

When it comes to the seasonality of mental disorders, the summers also have fewer patients because then part of the personnel is on vacation and less of the beds in use. «Meanwhile, if there were just as great a rush in summer as in winter, we couldn’t cope,» added Ms Aadamsoo. She said they are toiling the hardest from January to April.

But still even the scientific world features the term seasonal affective disorder i.e. the winter depression.

«This is being linked to the bipolar mood disorder,» said Ms Aadamsoo. «However, it has not been specified in international classification of sicknesses. I have never hear that it would be a topic in Estonia – With clinical treatment studies, we must for instance assess if a patient’s mood disorders were repeated seasonally; but I have participated in lots and lots of depression studies and I do not remember patients with such a problem.»

-The light therapy

An alleged help against the autumn mood disorder is light therapy, but concerning its effectiveness the specialists disagree. Ms Aadamsoo says light therapy isn’t yet science-based enough to be compensated by health insurance fund. «I think the light therapy rather works when one is in California or Mexico.»

Tartu University Hospital mental clinic head Sven Janno, however, said they typically have more asking for help in autumns and springs. «Mental sicknesses tend to strike more often in October-November, and we also have more work in springtime, in March-April,» he said.

When it comes to the September and October of this present year, Mr Janno said adults have had fewer bed days than in 2014, 2013 or 2012. Year-on-year, the drop is a whopping third.

«As to the reason why, neither do I have the right answers at the moment,» said Mr Janno, refusing to speculate about it perhaps being the extraordinarily dry and sunny October.  

Psychotic disorders (like schizophrenia – N. N.), said Mr Janno, tend to rather manifest in spring and fall. Even those with non-psychotic disorders like depression or anxiety are more frequent guest at the hospital in the autumn. «In the winter there truly is some quieting down, perhaps this is something to do with the weather,» he added. But Mr Janno would still underline there is nothing scientific about what he just said.

Mr Janno treads just as carefully about the effect of light. «They do talk about depression related to light, which would be seasonality,» he added. «Meanwhile, they are trying to gain further understanding about the effect of the rapid increase of daylight in spring – for those with bipolar disorder, it then tends to intensify.»