Seasonal Affective Disorder (SAD)
Seasonal affective disorder (SAD) is characterized by symptoms of depression that develop in the dark winter months and that lift with the onset of spring and summer. Although many of us feel a little less energetic in the winter, people with SAD suf- fer from more than just a prolonged bad mood. They have a medical condition typi- ﬁed by fatigue, poor concentration, and an intense craving for carbohydrates. They may also feel an overwhelming need for sleep, although the sleep itself is rarely refreshing. This general slowdown of the body, combined with an excessive intake of carbohydrates, may lead to weight gain and a suppressed immune system. Seasonal affective disorder should not be confused with the depression that afﬂicts some people during the holidays, when unresolved conﬂicts or problems tend to rise to the surface.
The most compelling theory regarding the cause of SAD has to do with the decreased amount of light that is available in the winter. A U.S. winter’s day can have fewer than eight hours of sunlight, compared to sixteen hours of sun in the summer. In the last few years, we’ve learned that there’s a reason that people feel more exu- berant in the summer: Natural sunlight affects a substance in our bodies called melatonin, by acting as a control mechanism for it. As the sun sets, our pineal glands (located in our brains) sense the decrease in light and begin to secrete the sleep- inducing hormone melatonin. Melatonin secretion can be magniﬁed by increasing our exposure to sunlight during the day. But when we’re deprived of sunlight, there’s noth- ing to keep melatonin levels in check, and it takes all our effort just to get out of our warm beds in the morning. Also, our stress hormone cortisol may rise, which con- tributes to fatigue, insomnia, depression, and decreased immunity. In addition, low levels of the neurotransmitter serotonin may occur, which contributes to depression. Researchers have found that serotonin production is directly affected by the duration of bright sunlight.
It is unclear why some people are affected by a lack of sunlight more than others. What has been demonstrated time and time again, however, is that light therapy is the most effective way to alleviate the symptoms of SAD. If you suffer from winter depression, there’s a very good chance that you’ll beneﬁt greatly from just a few sim- ple changes: utilizing speciﬁc light therapy, installing full-spectrum lights that imi- tate the effects of the sun, spending time outdoors every day, and arranging your life so that you’re near a window as often as possible. Other natural treatments, includ- ing dietary changes and some herbal supplements, will round out an effective course of action for lifting the “winter blues.”
• Fatigue and lethargy
• Increased desire to sleep
• Fitful, unrestful sleep
• Inability to concentrate
• Cravings for sweets and other car- bohydrates
• Weight gain
• Reduced sex drive
• Lack of natural sunlight
The following tests help assess possible causes of SAD:
Hormone testing (thyroid, DHEA, cortisol, testosterone, IGF-1, estrogen, progesterone)—saliva, blood, or urine
Vitamin and mineral analysis (especially magnesium, B12, folic acid, B1)—blood
Digestive function and microbe/parasite/candida testing—stool analysis Food and environmental allergies/sensitivities—blood, electrodermal Blood-sugar balance—blood
Toxic metals—hair or urine analysis
Amino acid analysis—blood or urine
One way to maintain a good mood is to keep your blood-sugar levels steady. Vegeta- bles and lean protein will stabilize blood sugar. Make a small meal or a snack of them every few hours to ward off the urge for bread or sweets. When you do eat carbohy- drates, make sure they’re complex carbohydrates, like oats, brown rice, or whole wheat. These foods are high in ﬁber, which slows the release of sugars into your bloodstream.
Put turkey, chicken, tuna, or salmon on your daily menu. These foods are high in protein, which you need for energy, and tryptophan, which stimulates the “feel-good” hormone in your brain.
B vitamins act as a tonic on the nervous system. Include brewer’s yeast, green leafy vegetables, and live unsweetened yogurt in your meals or snacks.
Brussels sprouts are a perfect food for SAD sufferers. Brussels sprouts are a con- centrated source of vitamin C, which ﬁghts fatigue and has a stimulating effect on your mood. Unlike citrus fruits, brussels sprouts are also low in sugar. Cooking destroys vitamin C, so eat brussels sprouts raw, perhaps in a salad or served with a dip.
Food to Avoid
Try to resist your cravings for sugar, bread, and other simple carbohydrates. Although these foods may temporarily lift your mood, your blood sugar will soon crash, leav- ing you feeling even worse than before. And the weight gain that often results from overindulging in carbohydrates will aggravate your fatigue and leave you suscepti- ble to colds, the ﬂu, and other winter ailments. If you must treat yourself to simple carbohydrates, make sure to have them as part of a complete meal—have an occasional sweet dessert, say, after eating a meal that consists of protein, vegetables, and some whole grains. That way, the sugar won’t deliver as potent a punch to your bloodstream.
People with SAD also tend to rely on caffeine to rouse them in the morning and keep them alert during the day. But caffeine works much like sugar does, in that once
the rush peaks and declines, you’re left feeling exhausted and crabby. Caffeine also depletes your body of several nutrients that are essential for a healthy nervous sys- tem. Limit yourself to one cup of coffee or tea a day.
Junk food probably isn’t a direct cause of SAD, but it can certainly exacerbate the symptoms: Weight gain, a suppressed immune system, and fatigue have all been linked to the consumption of additives and artiﬁcial ingredients. Avoid food that’s had all the life processed out of it.
Alcohol is a depressant, so avoid wine, beer, and liquor. If you are so unhappy that you feel as if you need alcohol, talk to a doctor or a therapist. You may have a drink- ing problem—or you might be headed for one.
If you’ve been turning to carbohydrates and junk food for comfort, you could beneﬁt from a detoxiﬁcation plan. To remove excess sugar and toxic build-up from your system, go on a three-day juice fast. Green drinks will be especially stabilizing to your body at this time. At the end of your fast, you’ll feel much lighter and more energetic.
Super Seven Prescriptions—Seasonal Affective Disorder
Super Prescription #1 Saint-John’s-wort (Hypericum perforatum)
Take 300 mg of a product standardized to 0.3 percent hypericin three times daily (a total of 900 mg). Saint-John’s-wort (Hypericum perforatum) has been shown to be helpful for SAD, when combined with light therapy.
Super Prescription #2 S-Adenosylmethionine (SAMe)
For two weeks, take 200 mg twice daily of an enteric-coated form on an empty stomach. If you notice improvement, stay on this dosage. If there is little improve- ment, increase to 400 mg two to three times daily. SAMe increases the concentra- tion of brain neurotransmitters that are responsible for your mood. Take a 50 mg B-complex, because B6, folic acid, and B12 are involved with proper SAMe metab- olism. Note: People with bipolar disorder should use this supplement only with medical supervision.
Super Prescription #3 5-hydroxytryptophan (5-HTP)
Start with 50 mg taken three times daily on an empty stomach. The dosage can be increased to 100 mg three times daily, if necessary. The supplement 5-HTP is a pre- cursor to the neurotransmitter serotonin. Take a 50 mg B-complex, as B6 is required for the proper metabolism of 5-HTP. Note: Do not take in conjunction with pharmaceutical antidepressants or antianxiety medications.
Super Prescription #4 B-complex vitamins
Take a 50 mg B-complex one to two times daily. B vitamins such as B12, folic acid, and B6 are intricately involved with neurotransmitter metabolism. Sublingual B12 and folic acid supplements are useful for seniors or people with absorption difﬁculties.
Super Prescription #5 Fish oil
Take a product containing a daily dosage of 500 to 1,000 mg of EPA/DHA. Essential fatty acids such as DHA improve neurotransmitter function.
Super Prescription #6 Ginkgo biloba
Take 60 to 120 mg twice daily of a standardized product containing 24 percent ﬂavone glycosides and 6 percent terpene lactones. Ginkgo improves blood ﬂow to the brain and enhances neurotransmitter activity.
Super Prescription #7 High-potency multivitamin
This provides a base of nutrients that are involved with brain function.
DL-phenylalanine (DLPA) is an amino acid used by the brain to manufacture neuro- transmitters. Take 500 to 1,000 mg on an empty stomach each morning. It should be avoided by people with anxiety, high blood pressure, or insomnia. Do not take it in combination with pharmaceutical antidepressants or antianxiety medications.
L-tyrosine is an amino acid that also helps depression. Take 100 to 500 twice daily on an empty stomach. Do not take it in combination with pharmaceutical antidepres- sants or antianxiety medications.
L-tryptophan has been a historic favorite of nutrition-oriented doctors for the treat- ment of depression. It acts as a precursor for the neurotransmitter serotonin. Take 500 to 1,000 mg three times daily on an empty stomach. This amino acid requires a pre- scription from your doctor and is available from compounding pharmacies.
Ashwagandha (Withania somniferum) improves stress hormone balance and relaxes the nervous system. Take 1,000 mg two to three times daily.
If you are low in the hormone DHEA, work with a doctor to normalize your lev- els. A good starting dosage is 5 to 15 mg.
Phosphatidylserine improves memory, and studies show that it’s helpful for depres- sion. Take up to 300 mg daily.
Vitamin D has been found in studies to help improve mood. It is particularly impor- tant for people who do not get regular sunlight, especially seniors. Take up to 1,000 IU daily.
Acetyl-L-carnitine has been shown to be helpful for seniors with depression. Take 500 mg three times daily.
If you feel tense and on edge, several herbal teas can help you calm down. Pep- permint and chamomile have mild relaxing properties, but if you need something a little stronger, try hops (Humulus lupulus) or passionﬂower (Passiﬂora incarnata).
Oatstraw (Avena sativa) tea is a good tonic for the nerves. Drink a cup as needed. For insomnia that accompanies or causes depression, valerian or kava kava tea,
taken before bedtime, can be quite helpful.
Pick the remedy that best matches your symptoms in this section. Take a 6x, 12x, 6C, or 30C potency twice daily for two weeks to see if there are any positive results. After you notice improvement, stop taking the remedy, unless symptoms return. Consul- tation with a homeopathic practitioner is advised.
Arsenicum Album is for people who are susceptible to depression and who also suffer from anxiety and insecurity. They are often perfectionists who may have severe phobias. Restlessness and insomnia between 12 and 2 A.M. are common.
Aurum Metallicum is for deep depression, in which there are thoughts of suicide. The person feels no joy and is in despair. There is relief from being in the sun.
Note: Suicidal tendencies should always be discussed with a doctor.
Ignatia (Ignatia amara) eases depression that is brought on by grief or emotional trauma and that is characterized by rapid mood swings. Frequent sighing and a sensa- tion of a lump in the throat are characteristics of people who beneﬁt from this remedy.
Kali Phosphoricum is for depression as a result of overwork. Mental fatigue is a common symptom that this remedy will help.
Natrum Muriaticum is for depressed people who do not reveal their emotions and who hold their feelings inside. They feel emotionally reserved and withdrawn. They feel a deep need for the company of others but are then aggravated when people con- sole them. They often have a strong craving for salt and an aversion to sunlight.
Pulsatilla (Pulsatilla pratensis) is for people who burst into tears at little or no provocation. They may also be driven to seek constant comfort and reassurance. They are very sensitive and feel better from crying, attention, sweets, and being in the open air. Their symptoms are worse in a warm environment. In women depression is often worse around the menstrual cycle or with menopause.
Sepia is for women who feel indifferent to their families. They have feelings of depression, fatigue, and irritability, as well as a low sex drive. They feel worse when others console them and better when they exercise. They are usually chilly. They have a strong craving for sweets (chocolate) and salty or sour foods. Depression that is asso- ciated with a hormone imbalance, as seen with PMS and menopause, is a strong indi- cation for this remedy.
Staphysagria is for people who have suppressed emotions (such as anger) that con- tribute to depression. They usually are quiet and do not stand up for themselves, which results in their shame and resentment. Headaches and insomnia are also common.
• Lung 1 relieves fatigue and depression. It also improves concentration.
• Other points that stimulate energy are Bladder 23, Gallbladder 20, and
A circulatory massage will get your blood ﬂowing and will increase your energy levels.
If you don’t have the time or the money for a professional massage, ask a loved one to give you a head massage. This therapy stimulates blood ﬂow to the brain.
To improve brain function, work the big toe, which controls the head. Work the solar plexus and the diaphragm to balance the nervous system.
Hot and cold hydrotherapy is an invigorating way to increase circulation and energy.
Lemon balm, melissa, and geranium will each rouse your spirits. Use them in any preparation you like.
If you have trouble sleeping, place a lavender-scented sachet under your pillow. This relaxing oil encourages a satisfying rest.
General Stress-Reduction Therapies
If you’re depressed, you’re experiencing powerful and probably continuous levels of stress. It is vital for your emotional and physical health that you ﬁnd at least one way to control anxiety, fear, or tension. Prayer, counseling, and positive mental imagery are all helpful.
If you sense that your depression is more than you can handle, don’t hesitate to seek help from a psychotherapist, a religious adviser, or a support group. It helps a great deal to talk to people who work with others’ emotional pain.
Make an effort to stay in contact with beauty. If you have a garden or live near a nice park, spend as much time there as possible. And try to bring some of that beauty indoors: Buy yourself a bouquet of ﬂowers, listen to a favorite CD, or hang a water- color of a nature scene on the wall in your ofﬁce.
Regular exercise has been shown to be effective in improving depression. Try to get some physical activity every day for thirty minutes.
It may sound simplistic, but one quick way to feel better, at least temporarily, is to go dancing. Dancing releases endorphins, powerful hormones that will raise your spir- its, and you’ll beneﬁt from the touch of other people, not to mention from the pleas- ure of losing yourself in the music.
Helping others with their problems is a great way to relieve depression.
Bach Flower Remedies
Consult the chart on pages 648–650 to determine the best remedy for your particu- lar needs. Once you’ve chosen a remedy, place 10 drops of the liquid under your tongue. Hold the drops in place for thirty seconds and swallow. Use as often as needed.
Olive is the remedy for people who feel completely drained of energy and who have lost any interest in social or other activities.
If you have a strong sense of duty that forces you to carry on, despite severe exhaus- tion, and if you tend to neglect your personal needs and desires, take Oak.
If you have trouble making decisions and suffer from frequent mood swings, take Scleranthus.
The very best way to reduce the effects of SAD is to work with a doctor who can help with the proper use of light therapy. This can be done by getting outdoors between 5 and
7 A.M. and being exposed to light or using a bright light box (especially in northern cli- mates, where the sun doesn’t rise until later in the morning during short winter days, and frequent overcast skies dim the sunlight). Several different companies make bright light boxes. The most important thing to look for is a brightness rating of at least 10,000 lux. (In comparison, at a distance of two feet a standard 60-watt light bulb gives off only 300 lux.) Make sure the light box is equipped with a UV ﬁlter to protect the skin and the eyes. Also, use full-spectrum ﬂuorescent lights in your home and workplace.
• Exercise is a proven mood-booster, and exercise in the sunlight does double duty for SAD sufferers. Take frequent walks outside, or participate in outdoor winter sports like ice-skating or cross-country skiing.
• Human beings weren’t meant to spend their days in windowless ofﬁces. If changing jobs is not an option—and for most of us, it isn’t—take your breaks outdoors. When the weather is good, pack a salad or another healthful lunch and dine al fresco. If it’s too cold where you live to eat outdoors, then at least use your breaks to bundle up and take a quick stroll around the block. Even on cloudy, snowy, or rainy days, enough sunlight comes through to make a differ- ence in your melatonin production.