For those of us who suffer from seasonal depression—also known as Seasonal Affective Disorder or SAD—November through March can seem like an eternity. It is estimated that up to 20% of Americans suffer from SAD to some degree, and women make up the vast majority of this group!
Typical symptoms of SAD include increased carbohydrate cravings, weight gain, feeling irritable and tired with the need to sleep more, disrupted sleep cycles and a disinterest in social activities.
It is most likely a combination of factors that causes SAD, including genetic predisposition, some combination of nutritional/hormonal/neurotransmitter imbalances, and lack of natural sunlight. The good news is there are a number of strategies that SAD sufferers can take to lift their moods during the winter months. As a matter of fact, everyone can benefit from many of these steps, even if one’s symptoms aren’t severe enough to be given a label.
Get your Vitamin D levels tested: If you suffer from seasonal depression and are not sure of your vitamin D level, please ask us or one of your other doctors to run the simple vitamin D test called “25 (OH) D.” Our bodies can readily manufacture Vitamin D when our skin is exposed to the ultraviolet rays from natural sunlight. But living in the northern hemisphere during the winter months, we don’t receive enough sunlight to make adequate vitamin D. Many of us are probably not storing up enough D from summer sun exposure due to either direct avoidance of the sun or heavy use of sun block. Let me be clear that I am not advising not using sun block! But getting about 15 minutes of morning or late afternoon sun without sun block will certainly help to increase your levels. (And for those with a personal or family history of skin cancer, year-round vitamin D supplementation is a safe option.)
Use a lightbox: Many people respond beautifully—and quickly—to light therapy. Light therapy boxes cost around $200 (up to $500 for additional features) and should emit approximately 10,000 lux (units of light intensity). Many people suffering from SAD will see improvement within about a week, using this type of box for about 30 continuous minutes daily. Note: tanning beds are not a form of light therapy, and they emit high concentrations of damaging UV rays, as well. In contrast, light boxes provide safe, full spectrum light with very little, if any, radiation.
Keep a regular sleep schedule: Our natural circadian rhythms are directly influenced by light. Less exposure to natural light during winter months can lead to sleep cycle disruption, which can contribute to SAD. Normally, the approach of evening darkness stimulates the production of melatonin, a hormone that causes us to feel drowsy in preparation for sleep. As morning light increases, melatonin levels drop, preparing us to awaken and feel ready to go. There is some evidence that people with SAD have a delayed melatonin response, which pushes their sleep cycle back and can result in feeling more lethargic throughout the day. I, therefore, recommend that SAD sufferers stay on a very consistent sleep/wake schedule and that they try to go to bed earlier rather than later. Our bodies’ inner clocks respond very well to regular routine. I will test melatonin levels for those patients with significant sleep disruption and, if warranted, will give very low doses of melatonin to help their bodies get back into a natural rhythm.
Get some exercise: Some of my patients tell me they would rather do anything outdoors than be cooped up in the gym. But for those of us who won’t spend time outside during winter months, the gym or yoga studio is a great option. Most gyms offer a wide variety of fun classes, as well as childcare for moms with young children. I will readily admit that my dance classes are both my medicine and therapy! Research has shown a relationship between regular physical exercise and increased levels of both serotonin (the neurotransmitter that helps us feel calm, happy and relaxed) and endorphins (opiate-like neurochemicals that have a pain-relieving and mood-enhancing effect).
Leave the sweets at the market: When our serotonin and other brain chemicals are low, our physiological response is to try to raise them quickly by eating those refined-carb and sugar-laden foods, and the temptation is hard to resist. But the benefits are short-lived eating in this manner; while we may feel better temporarily, our energy and mood are soon crashing and we are once again craving the sugar. Obviously, it is easy to put weight on when caught up in this cycle. I recommend leaving the “goodies” in the store and preparing whole foods that can also be comforting: warm, creamy oatmeal, baked yams, a nice pot of vegetable or lentil soup (and for those times when you need a little sweetness, a couple of squares of dark chocolate).
Make some plans! Don’t wait for the winter to be over to plan some outings, whether it is a weekend away, a movie with a friend, or a girls’ night out, make sure you schedule things into your calendar that you can look forward to.
Consider Neurotransmitter testing: I recommend testing neurotransmitter levels for my patients who suffer from SAD, as well as anxiety and depressed mood, in general. This is done through a simple saliva and urine test, which can identify neurotransmitter imbalances. The test results will direct my treatment strategies which include using targeted natural support formulas to aid in the balancing of brain chemicals.
Take high-quality supplements: I always recommend a high-quality multi to provide a sound nutritional foundation. Beyond that, my recommendations for patients with SAD depend greatly upon each individual’s unique situation, including their current diet and lifestyle, what medications they are already taking, and other health conditions they may have. Various supplements that have been useful for SAD and that I may recommend include the following: (Please note that some of the supplements below can be dangerous if taken in conjunction with other medications or health conditions. It is important to work with a qualified healthcare provider when embarking on a supplement regime.)
Fish Oil: Omega-3-fatty acids used at therapeutic doses can help significantly with mood stabilization.
St. John’s Wort extract: This herbal medicine has a very good track record of easing mild to moderate (but not severe) depression.
5-HTP: 5-hydroxytryptophan, a naturally-occuring amino acid, is the direct precursor to the neurotransmitter, serotonin.
Sam-e: S-adenosylmethione is a compound found naturally in the body from the essential amino acid, methionine, and the energy producing compound, ATP. When used for depression, Sam-e is thought to increase the availability of both serotonin and dopamine.