The weather has taken a decided turn here in Portland this weekend. It is hard to believe a week ago I was sweating on the side of a baseball field and today I am hunting around for my fleece before I head out to yoga. As we move into this period of cold, wet, grey days, many people find themselves experiencing feelings of lethargy, sadness and insomnia. Fortunately, there are steps you can take to improve these feelings.
What is Seasonal Affective Disorder?
Seasonal Affective Disorder (SAD) or the “Winter Blues” is thought to be a subset of Major Depressive Disorder in which a person experiences a decreased mood related to the change in seasons. SAD begins and ends at about the same time every year. Most people with SAD begin experiencing symptoms in the fall which continue into the winter months. People who suffer from SAD often report a decrease in energy and increased feelings of moodiness. Less often, SAD causes depression in the spring or early summer, often leading to different symptoms than those of winter SAD. In both types, SAD depressions are usually mild to moderate, but can occasionally be more severe. Treatment needs to be appropriate to the severity of the condition for each individual. Personal safety should be the first consideration in the assessment of all depression, as suicide or self harm can be a risk for people experiencing more severe depressive symptoms.
Symptoms of Seasonal Affective Disorder.
In both summer and winter SAD, symptoms may start out mild and become more severe as the season progresses. Because SAD is thought to be a possible type of major depression, people experiencing SAD will often exhibit symptoms of major depression such as:
- Feeling depressed most of the day, nearly every day
- Feeling hopeless or worthless
- Having low energy
- Losing interest in activities you once enjoyed
- Having problems with sleeping
- Experiencing changes in your appetite or weight
- Feeling sluggish or agitated
- Having difficulty concentrating
- Having frequent thoughts of death or suicide
People experiencing SAD in the winter usually report some of the symptoms below:
- Tiredness or low energy
- Problems getting along with other people
- Hypersensitivity to rejection
- Heavy, “leaden” feeling in the arms or legs
- Appetite changes, especially a craving for foods high in carbohydrates
- Weight gain
People with summer SAD often exhibit a different set of symptoms:
- Trouble sleeping (insomnia)
- Weight loss
- Poor appetite
- Agitation or anxiety
Causes of Seasonal Affective Disorder:
Currently, the exact cause of Seasonal Affective Disorder is unknown. However, scientists believe it could be related to the decrease in sunlight we experience in the winter months. In fact, people who live in the Northern climates which experience shorter days in the winter are more likely to suffer from SAD. The decrease in sunlight leads to a disruption in melatonin and serotonin, two brain chemicals which affect mood. Other theories hold the decreased sunlight is responsible for a Vitamin D deficiency. Currently, more research is needs. Fortunately, effective treatments do exist for SAD.
- Light Therapy: Light therapy seems to be the most effective treatment for the Winter Blues. Light therapy is obtained by sitting in front of a light box on a daily basis. Light boxes or “happy lights” can be purchased for between $100-$200 and work by mimicking the patterns of summer light. People experiencing SAD generally spend between 20-90 minutes a day sitting about 1-3 feet in front of the box with their eyes open. Light therapy seems to be most effective if done in the morning hours.
- Try to get outside every day. Even if it is just for a few minutes, exposure to natural sunlight does seem to help alleviate SAD. Morning sun seems to be best.
- Exercise: Exercise and other types of physical activity help relieve stress and anxiety, both of which can increase SAD symptoms. Not only does being fit make you feel better about yourself, it can also lead to a release of endorphins which will lift your mood. Exercise outside is best but just moving your body in any way that is comfortable for you is important.
- Fill Your Living Spaces with Natural Light: Open your curtains and shutters. Cut branches away from your windows. Allow as much natural sunlight as possible into your home and workplace.
- Vitamin D: Vitamin D is often called the “sunshine vitamin” because our body needs exposure to sunlight for its production. These days, people are spending more time inside and even when they do go outside, are slathering themselves with sunscreen. Both of these factors contribute to what many are calling a Vitamin D deficiency epidemic. Supplementing with Vitamin D does seem to provide some relief for people experiencing SAD. See your doctor to obtain a simple blood test to determine your Vitamin D level. If your blood level is less than 50 ng/ml, consider talking to your doctor about Vitamin D supplementation. Supplementing with Vitamin D can take months to reach normal levels. Vitamin D3 is the most bioavailable form of Vitamin D. It is difficult to reach adequate levels of Vitamin D through diet alone but some foods high in Vitamin D include cod liver oil, salmon, sardines, milk, tuna and eggs.
- Eat foods containing tryptophan. Many who suffer from SAD experience decreased levels of serotonin, the brain’s “feel good” neurotransmitter. Tryptophan is an amino acid known to be a precursor of serotonin. Theory holds that eating tryptophan rich foods may help increase your body’s production of serotonin, leading to improved mood. Turkey is the richest food source of tryptophan but spinach, bananas, shrimp, crab, sesame seeds and egg whites are also other good sources.
- Eat your Omega-3 fatty acids: Some studies have shown that essential omega-3 fatty acids appear to help maintain healthy levels of the brain chemicals dopamine and serotonin. Cell membranes are partly made up of omega-3 fats. Higher omega-3 levels in the body may make it easier for serotonin—a chemical that aids brain cells in communication—to pass through cell membranes. Serotonin is known as “the feel good hormone” because it influences brain cells related to sexual function and desire, mood, appetite, sleep, memory and learning and some social behavior. Dopamine is a neurotransmitter that helps control the brain’s reward and pleasure centers. The brain releases dopamine in response to pleasurable experiences, such as eating or having sex. The “more potent” forms of omega-3s, eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) are best obtained through cold water fish such as salmon, tuna, sardines, anchovies and mackerel. Vegan sources of omega-3 fatty acids include algae. Flax, hemp seeds, pumpkin seeds, chia seeds and walnuts are all rich sources of ALA, the precursor to DHA and EPA. Unfortunately, most people are very poor convertors of ALA to DHA and EPA so relying on seeds and nuts to meet your omega-3 needs may not be enough.
- Mindful carb snacking: Many people who experience the winter form of SAD report intense carb cravings. Since eating carbs actually promotes the production of serotonin, scientists speculate these cravings might be the body’s attempt to make more serotonin. However, eating the right kind of carbs is important. Focus on eating complex carbohydrates such as whole grains, beans, peas, lentils and brown rice to avoid the sugar roller coaster ride that can come from eating simple carbs. For most people, as few as 30 grams of carbs a day is enough to produce adequate serotonin.
- Focus on gut health: Having a healthy gut is necessary to overall health. With over 80% of our serotonin being produced in the gut, ensuring your digestion is working at an optimal level is important. A healthy gut also allows your body to make use of as many of the healthy nutrients you are providing it as possible. Adding probiotics, fermented foods and chewing your food thoroughly are all important steps to a healthy digestive system.
If you are experiencing symptoms of Seasonal Affective Disorder and are having difficulty completing the necessary tasks of daily life or are experiencing feelings of self-harm, contact your health care provider to establish a plan to help alleviate your symptoms.
Resources: Winter Blues by Norman Rosenthal