Feeling a little SAD lately?

Most of us are feeling at least a little tired of all the snow, and are thinking more and more often about spring and sunshine. However, for some of us the change of season is much more noticeable because of the huge difference it makes in our mood. It’s normal to have a few days of low mood, but if it persists for most of the winter months and you aren’t motivated to do anything you enjoy then it may be something a little bit more.


Seasonal affective disorder (also called SAD) is a type of depression that occurs at the same time every year. If you're like most people with seasonal affective disorder, your symptoms start in the fall and may continue into the winter months, sapping your energy and making you feel moody. Less often, seasonal affective disorder causes depression in the spring or early summer.

What are the signs of SAD?

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Winter-onset seasonal affective disorder symptoms include:

• Depression
• Hopelessness
• Anxiety
• Loss of energy
• Heavy, "leaden" feeling in the arms or legs
• Social withdrawal
• Oversleeping
• Loss of interest in activities you once enjoyed
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain
• Difficulty concentrating

SAD can occur during other times of the year as well, but more people tend to be more affected by the winter. The specific cause of SAD is still unknown, but several suspected contributing factors include:

·      Your biological clock (circadian rhythm). The reduced sunlight in fall and winter may disrupt your body's internal clock, which lets you know when you should sleep or be awake. This disruption of your circadian rhythm may lead to feelings of depression.

·      Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in seasonal affective disorder. Reduced sunlight can cause a drop in serotonin that may trigger depression.

·      Melatonin levels. The change in season can disrupt the balance of the natural hormone melatonin, which plays a role in sleep patterns and mood.

Other possible risk factors include:

• Being female. SAD is diagnosed more often in women than in men, but men may have symptoms that are more severe.
• Living far from the equator. Seasonal affective disorder appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter, and longer days during the summer months.
• Family history. As with other types of depression, those with seasonal affective disorder may be more likely to have relatives with the condition.
• Having clinical depression or bipolar disorder. Symptoms of depression may worsen seasonally if you have one of these conditions.

If you think you may have SAD it is important that you discuss how you are feeling with your health care provider. SAD is considered a type of depression, which can worsen and potentially lead to thoughts of suicide. If you are having thoughts of harming yourself or others it is of the utmost importance to seek medical help immediately!

What Can We Do About SAD?

Light Therapy (phototherapy) has been shown to be a very effective treatment for reducing feelings of SAD. The specialized light box mimics natural light, which seems to have an effect on brain chemistry related to mood. Most people start to respond after 2 to 4 days and causes few side effects.

Conventional Treatment: If symptoms are more severe then a combination of psychotherapy and medication (eg. Zoloft or Paxil), may be employed by your doctor. Generally a medication with the fewest side effects will be chosen, and your doctor may suggest beginning the antidepressant prior to the start of your symptoms each year.


Naturopathic Treatment

St. John’s Wort: has been used to treat mild to moderate depression. Some studies have found St. John’s Wort to be comparable to tricyclic and SSRI (fluxotine) with fewer side effects.

SAMe: synthetic form of the same substance that is made naturally in the body from a reaction between methionine (an essential amino acid) and ATP, has been shown to alleviate depression as well as the pain of osteoarthritis.

Melatonin. This natural hormone helps regulate mood. A change in the season may change the level of melatonin in your body.

Omega-3 fatty acids. Omega-3 fatty acid supplements may help relieve depression symptoms and have other health benefits. Sources of omega-3s include fish such as salmon, mackerel and herring. Omega-3s are also found in certain nuts and grains and in other vegetarian sources, but it isn't clear whether they have the same effect as fish oil.

Lifestyle

Let the sun shine in: Open the blinds, trim a few branches, add a skylight if need be. Do whatever you can to allow more natural light into the home and office.

Go outside: Try and get outside during the day when the sun is shining. Take a nice walk, sit on a bench, just try and get into the natural light more often.

Exercise: Regular exercise has been shown through many studies to improve mood and relieve stress and anxiety.

Mind-Body Therapy

All of the following have been linked to decreased feelings of depression to varying degrees:

- Acupuncture
- Yoga
- Meditation
- Guided Imagery
- Massage



There is no one set formula for preventing SAD, but through proper treatment and working with your health care provider you can learn to manage this condition well. Talk to your Naturopathic Doctor today about getting assessed and treated if needed, and as always talk to your health care provider before beginning any new medication or supplement.









References:

Godfrey A. & Saunders P.R. (2010) Principles & Practices of Naturopathic Botanical Medicine: Volume I: Botanical Monographs. Central Nervous System, pg. 161-163. CCNM Press.
Mayo Clinic. Diseases and Conditions: Seasonal Affective Disorder (SAD). http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/definition/con-20021047
Murray M. & Pizzorno, J.. (1998) Encyclopedia of Natural Medicine (2nd Ed.). Depression, pg 377-400. Three Rivers Press.