Seasonal Affective Disorder, or SAD, affects roughly 6% of adults in the US. Defined as annual depression occuring the winter months and lifting with seasonal change, SAD is a more severe form of the “winter blues.” Over 25% of Americans report some sensitivity to the decrease in light during the fall and winter.
The specific cause of SAD is not fully understood, but it is believed to be caused by a confluence of factors including: age, gender, genetics and individual brain chemistry. SAD is more common in women, and in young adults to mid-life. It is also more common in those living in northern states with reduced sunlight exposure in the fall and winter months.
The symptoms of SAD are due to a chemical imbalance marked by a decline in serotonin, a neurotransmitter that governs mood, and melatonin, the hormone responsible for sleep/wake cycles. Production of both melatonin and serotonin depends on exposure to UV light, and the absense of light exposure is a key factor in the decline of levels.
The symptoms of SAD may include:
- Mild to moderate depression in the fall and winter
- Fear, worry, anxiety
- Loss of energy
- Social withdrawl
- Oversleeping
- Aggravation in the afternoon
- Pain – fibromyalgia, TMJ, migraines
- Difficulty concentrating
- Appetite changes, cravings for sweets and carbs, especially in the afternoon and evening
- Weight gain
- Sleep problems, insomnia
- If untreated can lead to serious problems including suicidal thoughts and behavior, school or work problems, social withdrawal and substance abuse
The most common treatment for SAD is light therapy with full-spectrum light bulbs or lightboxes. Full-spectrum lightboxes come in a variety of designs, the Ott light and the Verilux products are two quality brands with affordable lamp options. Medical research typically cites results from light therapy with 30 minutes of exposure to 10,000 lux daily. Lux is a standard measurement of luminescence; on a typical overcast day one would be exposed to 10,000 -25,000 lux.
Because Vitamin D is produced in the skin cells upon contact with sunlight, many people in northern climates can be deficient or insufficient in Vitamin D and require supplementation. This important nutrient helps maintain mood, immune function, and hormone balance. Because Vitamin D is a fat-soluble nutrient that can accumulate in the body, it is recommended that one test blood levels of Vitamin D (a test known as 25-hydroxy-vitamin D) prior to supplementation. This can help determine what dosage of supplementation would be ideal; in some cases of extreme deficiency, your doctor may recommend weekly megadoses to help bring the level up to the optimal range, then switch to a lower maintenance dose.
Other natural treatments for SAD are aimed at increasing serotonin and melatonin levels. One option is the herb St. Johnswort, which has been extensively studied for the treatment of mild to moderate depression, and is useful for SAD. St. Johnswort should not be used by patients who are already taking anti-depressants, as it works similarly to the medications and can potentiate their effects. Another option might be 5HTP, a natural substance which is a precursor to both serotonin and melatonin. This can help naturally increase serotonin levels and boost mood.
Lifestyle modification is also an important part of coping with SAD or other forms of depression. Counseling or psychotherapy, stress management and mind-body techniques may all be helpful. Additionally, a balanced whole-food diet high in vegetables, fruit, whole grains, beans, nuts, seeds and fish is optimal for maintaining overall health. Avoiding sugar, alcohol and caffeine is key as these substances can aggravate a depressed mood.
Finally, exercise and time spent in nature are important ways to elevate mood and promote health. Exercise naturally raises serotonin levels, helps improve sleep and maintains physical health. Many studies demonstrate that time in nature also brings a sense of well-being, in addition to some sunlight exposure even during the winter months. Dressing warmly and taking a brisk walk every day can help beat the winter blues.
For more information please see the following resources:
WebMD – Seasonal Affective Disorder
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