Coping with Winter Blues
Seasonal Affective Disorder (SAD) is a type of depression that is seasonally dependent and most often experienced in the fall and winter months. As the amount of daylight significantly decreases during these seasons, it affects the production of our serotonin, melatonin, and vitamin D levels, all of which can lead to feelings of depression and fatigue.
Our sleep-wake cycle in every 24-hour day - our circadian rhythm - is an internal clock that’s governed by the amount of light and dark we’re exposed to. When daylight hours decrease, melatonin levels increase, making us feel drowsy and ready for bed. However, serotonin levels decrease with reduced light exposure, further impacting energy levels and mood.
These changes can cause us to experience the following symptoms of SAD:
· Fatigue / low energy levels
· Cravings for carbohydrates and sugar
· Sleeping more or less than usual
· Feelings of sadness, irritability and/or anxiety
· Withdrawing from people and/or activities you normally enjoy
· Difficulty concentrating
Ways to cope with Seasonal Affective Disorder
Sync your circadian rhythm with nature
Go to bed a little earlier and sleep longer.
Start each day with exposure to light, especially if your day starts while it’s still dark outside. Walking outside in the morning light is the easiest and least expensive way to achieve this.
Try using a phototherapy box or “happy light” that mimics sunshine. Research shows it typically takes one week of consistent morning light exposure, for 30 min at 10,000 lux or 1-2 hours at 2500-7500 lux to begin to perceive a difference.
Switch to a dawn-simulating alarm clock. Rather than the annoying buzz of an alarm clock, a dawn-simulating alarm wakes users more gently with a soothing sunrise simulation.
Avoid (or decrease) caffeine / stimulants
While this may seem counter-intuitive, chronic use of stimulants leads to adrenal fatigue. Patients are often surprised when stopping chronic caffeine intake actually increases their energy!
Regular exercise
Exercise supports serotonin levels, improves circulation (including to the brain where it improves cognition), and energy production in the mitochondria of the cells. It’s also a self-esteem booster!
Even though it’s cold out, it’s imperative to get outside in nature, even if only for a brisk 5-10 minute walk. Forest bathing (immersing yourself in nature) has been shown to lower blood pressure and cortisol levels.
Be proactive with diet
Eating balanced meals at regular intervals can help dampen glucose swings that lead to cravings.
The order food is eaten has a huge impact on glucose levels. Eating vegetables and/or protein before carbohydrates/sugar helps smooth out glucose swings that can trigger insulin production and cravings that lead to weight gain and increased depression.
For more information on balancing blood sugar through dietary choices, see our previous blog article here.
Don’t isolate yourself
Initiating fun activities leading up to fall may be easier than trying to start from scratch once SAD sets in.
Commit to doing something you look forward to with friends at least once weekly. Bonus benefits if it’s physically active!
Optimize your vitamin D levels with supplementation
Ask your doctor to test for 25-OH vitamin D levels. Share the symptoms you’re experiencing to help establish medical necessity so insurance is more likely to cover the cost.
Aim for 60-80 ng/ML on labwork.
If your levels are under 60, begin supplementation, going as high as 10,000 IU per day for the first few weeks for a quicker correction. Most Ohio residents need 2000-5000 IU per day to maintain ideal levels.
Consider supplemental support
St. John’s Wort (SJW) is a natural serotonin re-uptake inhibitor (SSRI) that works similarly to Prozac, Paxil, Zoloft, Celexa and Lexapro. There are drug-herb interactions with SJW, so check with your healthcare provider before beginning if you take prescription medications. Here at LOL, we most often use one tablet of a time-released SJW twice daily, with breakfast and dinner. If serotonin levels are extremely low, a precursor may make more sense since SSRIs don’t promote any additional serotonin production. They merely keep what you having circulating longer.
5HTP and tryptophan are amino acid precursors to serotonin that may improve depressive symptoms with the first dose. Consult your doctor before use if you have high blood pressure, diabetes, liver disease or are pregnant or nursing. We typically recommend one or two 50 mg capsules taken 1-3 times daily, with or without food. (While it’s commonly advised to avoid 5HTP and tryptophan use alongside SSRI medications, we often combine these therapies since SSRIs don’t help your body produce more serotonin, they only keep what you have circulating longer. We recommend working with a seasoned functional medicine provider if combining these treatments.)
Sam-e, derived from the amino acid methionine, is prescribed for depression and anxiety by doctors in several European countries. Aside from mood elevation, Sam-e has also been shown to have anti-inflammatory and pain-relieving properties. Use under the supervision of a physician is recommended in cases of bipolar disorder, HIV or similar immuno-compromised conditions or alongside other supplements or medications that affect serotonin, dopamine and norepinephrine. Dr. Axe weighs in here on Sam-e.
Omega3 oils are commonly deficient in the standard American diet (ironically, also termed “SAD”!), and the high prevalence of omega-6 oils actually further exacerbates this. About 60% of the human brain is fat, and approximately half of the fat is omega-3. Lower levels of omega-3 are associated with smaller brain size in older adults, a sign of accelerated brain aging. In the developing brain of a fetus, several studies correlate pregnant women’s fish oil intake with higher scores for their children on tests for intelligence and brain function. Omega-3 fatty acids are abundant in all cell membranes, facilitating communication between brain cells and helping maintain normal brain function throughout life.
If you’ve tried all the above and are still struggling, nutrient and neurotransmitter levels can be assessed to determine what additional support may be needed.
See the link here to learn more about what laboratory tests we offer.
Schedule with Francie or Caitlin to begin your journey past SAD!
Watch our YouTube videos from Caitlin to learn more about SAD (part 1 & part 2).
The good news is, we’re past winter solstice, so we’re gaining 2-3 minutes of sunlight each day!