Winter Depression Seasonal Affective Disorder. Shorter length, gloomy days are here. Navigating the dark winding path of Seasonal Affective Disorder (S.A.D.) can be much more tolerable with a few simple insights and relevant clinical tools. Like anything else challenging in life, you have a choice to shift your energy into positivity and overcome. S.A.D. is just another one of those challenges. So, let’s dive in together and discuss ways of climbing out of it.
Symptoms of S.A.D. may consist of any combination of the following:
- difficulty waking up in the morning
- nausea
- tendency to oversleep and over eat
- craving for carbohydrates
- weight gain
- lack of energy
- difficulty concentrating on or completing tasks
- withdrawal from friends, family, and social activities
- decreased sex drive
- lack of motivation
What is Seasonal Affective Disorder?
S.A.D. is considered a recurrent major depressive disorder that occurs at a specific time of the year and fully remits otherwise. SAD is recognized as a common disorder, with its prevalence in the U.S. estimated to affect 10 Million Americans and an additional 10-20% suffering from mild versions of the diagnosis. It is reported that women are 4X as likely to suffer from S.A.D. as men. It is my opinion that S.A.D. is part of a combination of factors that, when put together, yield a symptom of imbalanced chemistry. I do not believe there is a mysterious winter time disorder looming in the dark shadows. I say this as a few simple modifications and clinical supports have had a powerful impact in the severity of many of my patients Winter Blues.
Modifyable Lifestyle Factors to support Mood:
Understanding the role of modifiable lifestyle factors can be very helpful in managing Seasonal Affective Disorder. These are well accepted factors for the modification of mood:
• Exercise has been proven many times to be more effective for mood enhancement than prescription medications for depression. Maintenance of a steady exercise regimen can be very beneficial to your mood. Exercise is understandably harder to do with a lack of motivation but technology has made it easier than ever. YouTube has a fantastic selection of in-home cardio, Pilates, yoga, spinning bike, cross training, thera-band workouts. Pick your favorite personality, style and vibe and dive in. No need to leave home, just add it to your schedule and execute. If you can commit to a routine of every other day that would be a great start. Daily is preferable but any movement in the beginning is great for you. There is an aspect of social interaction that decreases depressive tendencies so if you have a gym membership or group class that you can attend it would be double benefit to get out, work out and interact socially.
• Balanced Sleep and a Circadian Rhythm is very important to optimizing mood. Maintaining a regular sleep wake cycle during the winter months has been shown to decrease the severity of S.A.D. Melatonin is a beneficial tool for this. I use a sustained release Melatonin to afford patients the best opportunity to fall asleep, stay asleep, achieve restorative quality sleep and wake rested. 3 or 6mg at bed will usually do the trick.
• Hydration is so very important on all levels. In opposition, drinking large amounts (4 cups) of caffeine has a diuretic effect and can cause some electrolyte imbalances that affect the neurotransmitters in your brain. Drink water, add lemon, ginger and cucumber for a twist. If you can drink 50% of your body weight in ounces of water a day you should be well hydrated unless you have specific mineral imbalances. Warm lemon water is wonderful in the winter months. I consider herbal tea as water consumption.
• Positive Mental Attitude. I get it, we are talking about winter blues and I am suggesting that you stay positive. As referenced above, you can to choose to feel better. It is not the cure, but it can help when combined with the other interventions. This might mean having a written message of positivity for yourself when you wake in the morning. Download an app with positive daily messages. Buy some fresh flowers and put them where you spend time in the morning. Allow yourself “you” time to read positive or humorous materials, watch your favorite comedian on YouTube. Give yourself the grace of a few boundaries from toxic individuals and known stressors. Being positive takes some work like any other task. You can survey the week ahead and prepare yourself for the challenges of the week by observing that they are there and reminding yourself that you will over-come. Counseling is an incredible asset if you have the time. Many counselors offer on-line sessions now so it can make it easier to work with someone within your tight schedule.
• Diet. In over 20 years of practice I have observed diet modification to be the most powerful modifiable, non-clinical tool to impact S.A.D. Primarily, avoiding sugar and alcohol that are both known to be depressants. Secondarily, avoiding any foods that are sensitivities or cause you to feel tired or bloated after consumption. Let’s mind the microbiome here. 95% of your serotonin (happiness hormone) is made in the gut then transmitted to the brain. If you are eating foods that cause inflammation in the gut, white refined processed foods, GMO, high starch and sugary substances, you can impact the hormones that support balanced mood. Don’t forget all of the colors of veggies in the Phyto-nutrient spectrum. All of those colors have different healing properties that are directly linked to mood. One trick with overcoming poor dietary habits is to honor the comfort of eating refined foods. When you feel down and out, certain sugary foods can release endorphins in the brain affording temporary satisfaction but are followed with an increase in depression. We have spent the majority of our lives reaching for sugar to feel better or celebrate. So you are working against a deeply ingrained pattern here. It is helpful to take a moment and think about the effect of the food on your body and mood later. Ask yourself if the 10-15 minutes of satisfaction from eating a hand full of sugar is worth a few days of feeling tired or more depressed after the fact. Often, in a moment of feeling like reaching for sugar, a large glass of water and waiting 5 minutes will get you past the stress eating urge.
There are many Clinical Tools and supportive therapies to help modify S.A.D.
Along with making some modifications to the lifestyle factors listed above there are a number of powerful clinical tools that are very supportive of modifying S.A.D.
• Vitamin D3. A deficiency in vitamin D3 has been linked to low mood. The difference between 1.4% in Florida prevalence of S.A.D. to to 9.7% in New Hampshire speaks volumes. You can take the number 35 and multiply by your body weight to determine a baseline daily dose in I/U requirement for D3 supplementation. For example if you weigh 150 lbs X 35 =4725 I/U of D. So you would be OK to take 5,000 I/u 1x day through the winter months. In the office I use blood work to confirm levels of vitamin D because you can become toxic with high levels of Vitamin D so it is worth having your doctor evaluate levels. The formula above is safe for prevention.
• Light Therapy. Full spectrum lights placed in the area where you will spend time in the morning have shown positive results in decreasing winter mood shifting. Studies have shown 30-60 minutes in bright light in the morning to help. You can search for full spectrum lighting on Amazon.com to get a light box and plug it in where you have your morning rituals.
• Essential fats are very supportive of optimal mood. The ratio of EPA/DHA is very important. I use 900 Epa/660 Dha 2x day for patients over 150 lbs. Half of that if lower weight or on blood thinners. This is my Omega-Mend supplement (2 capsules 2x day).
• 5-HTP. I am a huge fan of the supplement 5-HTP. Tryptophan is a precursor to serotonin. 50 or 100mg of 5-HTP before bed is great for improving quality of sleep and building up levels of serotonin that improves mood. I do not use this with children and certain prescription drugs for depression. 5HTP (2 capsules at bed).
• For women who have a history of lower mood or any PMS with their menstrual cycle modifying the progesterone/estrogen ratio has a wonderful impact on S.A.D. tendencies. Menses 1 (1 capsule 2x day).
• Active B-vitamins support neurotransmitter function and can optimize mood. Super B (1 capsule 2x day)
• SAMe plays a role in the immune system, maintains cell membranes, and helps produce and break down brain chemicals, such as serotonin, melatonin, and dopamine. By improving metabolism of brain chemicals SAMe has been demonstrated to decrease depressive mood shifts. SAMe (1 capsule 2x day).
• Mega Sporebiotic. As the only probiotic currently published to repair leaky gut syndrome in 45 days, adding a powerful probiotic to support the health of your gut and serotonin can have positive outcomes on mood. Taken (1 capsule 2x day for 2 months then 1x day for maintenance).
My clinical suggestions to be coupled with the modifiable lifestyle factors to support S.A.D.: (150 lb individuals – ½ dose for lower body weight, not outlined for pregnant women or children).
➢ Vitamin D3 to (1 capsule 5000mg/day) breakfast (or dosed to body weight formula listed above).
➢ Omega-Mend (2 capsules 2x day) breakfast and lunch
➢ 5HTP (2 capsules at bed) + Melatonin (3 or 6mg at bed)
➢ Super B (1 capsule 2x day) breakfast and lunch
➢ Menses-1 (1 capsule 2x day) breakfast and lunch (for women)
➢ SAMe (1 capsule 2x day) breakfast and lunch
➢ Mega Sporebiotic (1 capsule 2x day) breakfast and lunch.
➢ Full Spectrum Light Therapy in the mornings
In Summary:
There are many tools to help feel better during the winter. Start by Integrating or modifying a few of the listed lifestyle factors that may be out of balance for you. Shift over to eating a diet low in refined carbohydrates and high in a broad color spectrum of veggies coupled with healthy fats and proteins. Consider adding some of the listed clinical tools/vitamins into your daily/weekly routine. Observe how you improve over a few weeks and decide if you need more support. Some patients have the need for clinical supervision due to the level of their Affective Disorder. If you find that more help is required to get you feeling better: go to www.IFM.org and find a Functional Medicine Certified Practitioner to help you navigate the waters for your individual needs. Severe clinical depression should always be supported by a trained physician.
Like choosing health, tackling S.A.D. naturally is achievable with some time, structure, clinical support and planning. Choose to enjoy your Winter Season. Don’t forget to check the website for my “Staying Well Through Winter” article to avoid getting sick this Winter.
None of the information in this article is intended to diagnose or treat you, the reader, with a mood disorder.
In Health,
Dr. Conan Shaw DC, CCN, IFMCP
Board Certified Clinical Nutritionist
Certified Functional Medicine Practitioner
