As the weather shifts and the days feel shorter and darker your mood might also change. For some people the darker days of fall and winter cause a type of depression known as Seasonal Affective Disorder (SAD). I want to share some naturopathic therapies you can try if you're feeling the winter blues.
What is Seasonal Affective Disorder (SAD)?
This type of depression typically occurs only during the fall and winter months and gets better in the brighter spring and summer. Women and those of us who live far from the equator are more likely to experience it as well as those with a history or family history of depression or bipolar disorder.
Our mood is regulated by a number of mechanisms including the neurotransmitters, serotonin, norepinephrine and dopamine, and melatonin, a hormone involved in regulating our circadian rhythm. Those who experience SAD may have trouble regulating serotonin. There is a space between neurons called the synapse where neurotransmitters hang out and affect the nearby neuronal activity. In SAD, serotonin doesn't stay around in that synapse very long so its effects are decreased. This mechanism is the basis for commonly prescribed anti-depressants called serotonin reuptake inhibitors (SSRIs) that help keep serotonin in the synapse longer. Those who experience SAD may also produce more melatonin, which is involved in regulating our day to day circadian rhythms and makes us feel sleepy at night. As the days become darker more melatonin is produced, making you feel sleepy and tired all the time. Vitamin D is also involved in serotonin and hormone regulation and those who experience SAD may be low in this vitamin.
Symptoms of SAD include:
Low energy
Sleeping more than usual
Eating more than you usually do
Gaining weight
Craving carbohydrates
Decreased socializing or feeling the desire to "hibernate"
Naturopathic Therapies for SAD
Naturopathic therapies aim to address the production and regulation of the neurotransmitters involved in SAD. Lifestyle changes you can make include light therapy, moderating alcohol use and getting more physical activity into your day. Supplementation with vitamin D, 5-HTP, tryptophan, and St. John's Wort may also help in addition to these lifestyle suggestions.
Light therapy - Darker days mean less light so this therapy aims to replace that light exposure either through a light box or by getting outside when the sun is coming up in the morning. I'd recommend a light box that provides 10,000 lux of cool-white light for 20-30 minutes in the morning. Sit about 12 inches away from the light box and keep your eyes open. You can read or eat while you do this, but you don't have to look at the light. Choose a light box that doesn't provide ultraviolet light. If you don't tolerate light boxes well or don't want to buy one try getting outside in the morning light to get natural sunlight. It usually takes about 1-2 weeks to feel improvement and works best if you continue this therapy throughout the winter months until you begin to naturally feel better in the spring. Use caution if you have a retinal disease, history of bipolar disorder or are taking medication that increases your sensitivity to light.
Vitamin D - There are vitamin D receptors in a part of our brain called the hypothalamus that controls our hormones and is involved in depression. It's a good idea to check vitamin D levels with a blood test before supplementing with high doses because vitamin D is stored in the body and toxicity can occur if you use it long term. If you don't know your vitamin D levels you can try a daily dose around 2000-4000 IU, which is usually safe for most people.
Tryptophan and 5-HTP - These amino acids are building blocks for serotonin and melatonin, however, there are a couple different pathways the body can use for tryptophan. Because there are a few pathways for tryptophan, it can be beneficial to pair it with vitamin B6 and B3 (niacinamide) to increase the likelihood that it produces melatonin and serotonin. 5-HTP may work even better because it can be directly converted to serotonin and then melatonin and can cross the blood brain barrier allowing more to get directly to the brain.
St. John's Wort (Hypericum perforatum) - This herb has many properties including being an antiviral, anti-inflammatory and a wound healing plant, but one of its most well known uses is as an anti-depressant in mild to moderate depression and SAD. It works similarly to a drug class of anti-depressants called selective serotonin reuptake inhibitors (SSRIs), which keeps serotonin around in the neuronal synapses longer so it continues to have positive effects on mood. St. John's Wort also has the same effect on another feel good neurotransmitter called dopamine. St. John's Wort works well along with light therapy. This herb can increase your sensitivity to UV light especially in fair skinned individuals. It also affects the liver's ability to metabolize other drugs so check with your doctor if you're on other medications. Notable drug interactions include coumadin (Warfarin), omeprazole (Prilosec), simvastatin and pravastatin, and oral birth control pills. It also should not be used with other anti-depressants or MAOIs.
Limit or abstain from alcohol use - This time of year with lots of holiday celebrations you may be more likely to drink or you may have increased your use to feel better, which is common for those with depression to do. Although alcohol may initially make you feel good, it ultimately acts as a depressant, increases adrenal stress hormones and disrupts your ability to get restful, deep sleep. It decreases blood sugar, limiting the energy that's available to your brain and making you crave carbohydrates to get your blood sugar up. All these effects can make feelings of depression worse so it may be best to keep it in moderation, decrease your use or not drink at all during the fall and winter.
Exercise - Getting daily physical activity can be a powerful way to improve mood due to the effects of exercise on neurotransmitters such as dopamine, serotonin and norepinephrine. Exercise can change the structure and function of your brain resulting in better mood, memory and focus that can last for hours after you're done working out. Check out this amazing TED Talk The Brain Changing Benefits of Exercise to learn more. You don't need a gym membership to workout. You can go for a walk, run or bike ride or try searching for videos on YouTube, which is one of my favorite sites for free workouts. Try out Yoga With Adriene or PopSugar Fitness, which are two of my favorite channels.
A Note About Depression
SAD is considered one type of depression, but if you continue to feel depressed during other times of the year you may be experiencing major depression. If you have these symptoms nearly every day or daily please seek help from your doctor because there are treatment options that can help you feel better.
Symptoms of major depression include:
Feeling hopeless, guilty, worthless
Losing interest in things that you used to enjoy
Having low energy
Trouble sleeping
Experiencing a change in your appetite or weight
Feeling sluggish or agitated
Difficulty concentrating
Having frequent thoughts about harming yourself, death or suicide
The colder, darker months of fall and winter can decrease mood in many people. If you're noticing your mood slipping into the "winter blues" there are many naturopathic therapies you can do including light therapy, exercise, and supplementation with vitamin D, 5-HTP, tryptophan or St. John's Wort. I hope you got some good tips from this post and would love to hear how you keep your spirits up this season!
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In Health,
Dr. Jamie
Resources
“Hypericum Perforatum.” The Naturopathic Herbalist, 25 Sept. 2015, thenaturopathicherbalist.com/2015/09/14/hypericum-perforatum/.
Kurlansik, Stuart L., and Annamarie D. Ibay. “Seasonal Affective Disorder.” AAFP Home, 1 Dec. 2012, www.aafp.org/afp/2012/1201/p1037.html.
“Seasonal Affective Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml.
This website is not intended for the purpose of providing medical advice. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.
