By Natasha Turner, ND

Every fall I am consumed with the sad realization that I will soon face yet another long winter. Unlike many of my friends who are avid snowboaders or skiers, I have most of my fun in the summer sunshine. How do I cope? Every November I begin to plan my escape and then count the days until my vacation in the sun. I have found the key is to have something to look forward to.

Many people, not unlike me, suffer from seasonal affective disorder (SAD), the seasonal depression we feel as the days grow shorter and we experience a shortage of sunlight. SAD was officially named in the 1980s, but it has been recognized for over a hundred years. Even animals react to the changing seasons with changes in mood and behavior. Many of us dread the dark mornings and short days, finding that we may eat or sleep more to compensate. But how do you know if the changes in your appetite, level of motivation or sleep patterns are normal, or if they are more concerning, like those associated with SAD?

How Do You Know if You Have SAD?
SAD symptoms include:

Sleep problems: Your sleep habits may change. You may be oversleeping but not feeling refreshed, have an inability to get out of bed or require a nap in the afternoon. We should sleep between 6 and 9 hours per night; children and teens require slightly more sleep, about 9.5 hours.

Overeating: Individuals with SAD may have increased carbohydrate cravings (a craving for sugary and/or starchy foods), leading to weight gain which further contributes to depression.

Depression: You may experience feelings of despair, misery, guilt, hopelessness or anxiety. You may find normal tasks become frustratingly difficult, you may cry for no apparent reason or be unable to concentrate.

Family problems: You may avoid company, preferring isolation. Irritability and impatience are common, as are loss of libido or loss of feeling.

Lethargy: SAD may create feelings of overwhelming fatigue, or of feeling too tired to cope. Everything becomes an effort and you may have no motivation.

Physical symptoms: Sometimes joint pain or stomach problems may manifest and you may experience lowered resistance to infection.

Behavioral problems: This tends to be more common in children and teens.

A diagnosis of SAD is fitting if your symptoms have occurred for two years or more, with no non-seasonal depression episodes. Symptoms may begin around September each year and last until April, but tend to be worst in the darkest months—January and February. People who work in windowless environments, however, can be at risk any time of the year. Typically, full remission from seasonal depression occurs in the spring and summer months.

What Causes SAD?
Winter’s short, dull days and long, dark nights cause a change in the brain's chemistry, specifically in the pineal gland. The pineal gland secretes the hormone serotonin, made from the essential (meaning we must get it from our diet) amino acid tryptophan. Some of the serotonin is then converted into melatonin. Melatonin induces sleep, but is only created when we are in complete darkness; even an area of skin on the back of the leg exposed to light will decrease production. In the long, dark days of winter, melatonin levels increase and researchers believe this increase causes the symptoms of SAD.

Treatment Options
Light therapy: Since SAD is related to a lack of light, it only makes sense that using light as a form of treatment would help reduce symptoms. Phototherapy or bright light therapy has been shown to suppress the brain’s secretion of melatonin. Light devices (light visors) can be worn around the head or banks of white fluorescent lights (light boxes) on metal reflectors can be placed in the home or office. Look for full-spectrum lighting. Exposure for 30 minutes to 2 hours per day in the morning has been found to be very effective.

For mild symptoms, spending time outdoors during the day or arranging homes and workplaces to receive more sunlight may be helpful. One study found that an hour-long walk in winter sunlight was as effective as two and a half hours under bright artificial light. Vacationing in the sun will also help.

Vitamin D: Vitamin D is produced when the sun’s rays hit our skin, making deficiencies common in winter. It has also been found that SAD tends to be prevalent when vitamin D stores are low. One may wonder if the light therapy discussed above works for SAD because the broad-spectrum light allows the skin to produce vitamin D. Many studies have tested the hypothesis that vitamin D deficiency might play a role in SAD.

One such study was conducted on a group of 15 subjects with SAD. Eight subjects received 100,000 IU of vitamin D and seven subjects received phototherapy. At the onset of treatment and after one month of therapy subjects were administered the Hamilton Depression Scale questionnaire as a means of analysis. All subjects receiving vitamin D improved in all outcome measures. Surprisingly, the phototherapy group showed no significant change in depression scale measures. Improvement in vitamin D levels was associated with significant improvement in depression scale scores. This allows the conclusion that Vitamin D may be an important treatment for SAD.
Note: The dosage of vitamin D listed here should not be taken unless under the direction of a licensed health care provider. Many individuals report an improvement in symptoms with only vitamin D 1,000 IU per day.

Exercise: It is proven as an effective means to decrease depression and anxiety.

Eat a balanced diet: Follow a diet that is balanced with protein, carbohydrate and healthy fats, like the Truestar Nutrition Plan. Avoiding sweets and starchy foods will help break the cycle of overeating and assist with weight loss. Eating more protein often helps decrease sugar cravings.

St. John’s wort: Taking 900 mg of standardized St. John’s wort daily throughout the winter can help with the symptoms of mild to moderate depression. Ideally, it is best to begin taking this one month prior to the onset of your symptoms. It can take up to a month for St. John’s wort to reach full effectiveness. If you already have the symptoms, however, it is not too late to take this herb.

References