BY Dr. Arianna Staruch, ACHS Academic Dean

Wintertime blues are common for those of us living in the northern latitudes of the U.S., and they usually begin when the days get shorter, darker, and greyer. The clinical name is Seasonal Affective Disorder or SAD. It seems to be more common in women but more severe when it occurs in men. There may also be a genetic component, as with other forms of depression, that runs in families. Generally speaking, with SAD the changing levels of light impact the pineal gland and the production of both serotonin and melatonin, which may be connected to the development of depression in some people[1].

Symptoms of SAD may include any or all of the following[2,3]:

    * Carbohydrate cravings, appetite changes, weight gain
    * Loss of energy, fatigue
    * Depression, hopelessness, anxiety
    * Increased sleepiness and sleeping
    * Loss of interest in activities and social withdrawal
    * Difficulty concentrating

SAD may increase the risk for a major depressive episode, which can lead to social withdrawal, work problems, substance abuse, and suicidal thoughts.

Since the cause of SAD seems to be a lack of light, it makes sense that adding light may address the underlying cause and provide support. A number of clinical studies have now shown the effectiveness of light therapy in the treatment of SAD. A light box delivering 2,000-10,000 lux for 30-120 minutes daily during the winter is typical[4].

In addition, different color temperatures of “full spectrum” light have been studied and the use of the light box both morning and evening seems to work best[5].  Bright light seems to increase serotonin levels, so it is no surprise that light therapy has been shown to be as effective as Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant medications, which raise serotonin levels, in a number of studies[6,7].

Natural support for serotonin may include L-tryptophan and St. John’s wort Hypericum perforatum; however, there have not been any controlled trials with these supplements and SAD. There may be a disturbance of circadian rhythm in SAD, and so there is some thought that melatonin taken at night might help re-establish a proper rhythm. The only studies with melatonin, however, have been with jet lag and shift work and not SAD.

Natural support options for other forms of depression include omega-3 fatty acids and S-adenosylmethionine (SAMe), a synthetic form of a compound naturally formed in the body from the essential amino acid methionine and adenosine triphosphate (ATP), which is the energy-producing compound found in all cells of the body[8]. Remember that these herbs and supplements may interact with medications, such as antidepressants and blood thinning medications. Always check with your primary care provider and your pharmacist before starting any natural support supplement[9].

Lifestyle support includes making interiors lighter with bright colors, opening blinds, and using more full spectrum lighting.  You may also be able to help balance your brain chemistry by getting outside for a walk within two hours of waking up and by reducing stress with regular exercise[10].

So, as the days get shorter, think about supporting balanced moods with a healthy diet, regular exercise, and increased exposure to light in the mornings and evenings.

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1. http://www.webmd.com/depression/tc/seasonal-affective-disorder-sad-topic-overview

2. http://www.nlm.nih.gov/medlineplus/ency/article/001532.htm

3. http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195/DSECTION=symptoms

4. Chronobiol Int. 2003 Mar;20(2):189-207.

5. Altern Med Rev. 2005 Mar;10(1):5-13.

6. Ann Clin Psychiatry. 2007 Oct-Dec;19(4):239-46.

7. Psychol Med. 2007 May;37(5):727-36.

8. http://altmedicine.about.com/od/treatmentsfromatod/a/SAMe.htm

9. http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195/DSECTION=symptoms

10. http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195/DSECTION=symptoms