Beating the Winter Blues: Understanding Seasonal Affective Disorder

Seasonal
affective disorder (SAD) affects approximately half a million people
each year. It is caused by a biochemical imbalance in the brain as a
result of decreased hours of sunlight during the winter months. Some
people are affected only mildly resulting in fatigue, lack of
motivation and moodiness; but for others it is an incredibly
debilitating condition causing severe depression, recurring
infections and chronic fatigue.

Causes
of SAD:

• Doctors
  don't know the causes of seasonal affective disorder, but heredity,
  age and your body's chemical makeup all seem to play a role. This
  is the genetic predisposition; however, there must also be an
  environmental trigger. The reduced availability of sunlight during
  winter months in what is implicated in triggering SAD.

• Reduced
  sunlight may disrupt circadian rhythms that regulate your body's
  internal clock, which lets you know when it's time to sleep and when
  it's time to wake up

• The
  disruption in circadian rhythm can cause mild to severe depression,
  fatigue and malaise

• Melatonin,
  a sleep related hormone, has increased production during winter
  months. While its release is important during sleep, if melatonin
  is released during the day it can contribute to depression and
  fatigue.

• Neurotransmitter
  serotonin (brain chemical) release is stimulated by sunlight. Low
  levels of serotonin are often found in people suffering from
  depression¹.

Signs and symptoms:
Seasonal affective disorder is a cyclic, seasonal condition, which
means signs and symptoms are present only during a particular season
and then go away. Most of the time, the signs and symptoms of SAD
appear during the winter and recede during the spring and summer.
There are some exceptions to the rule, however. Some people have
worsened signs and symptoms of depression in the spring. Other people
— less than one in 10 — experience periods of mania or hypomania,
a less intense form of mania, during the summer. This is sometimes
referred to as reverse SAD. Characteristics of mania may include
persistently elevated mood, increased social activity, hyperactivity
and unbridled enthusiasm out of proportion to the situation².

Signs and symptoms of SAD:

Prevention:

• Establishing
  proper circadian rhythm:

  • Regular
    sleep/wake patterns

  • Sleeping
    in complete darkness

  • Stress
    reduction and management

• Eating
  a well balanced diet high in nutritional value, avoiding refined
  sugar, trans and saturated fat, and processed food

  • Plenty
    of green leaky vegetables will provide important vitamins and
    minerals necessary to support neurotransmitter production resulting
    in improved sense of wellbeing

  • Omega
    3 fatty acids (DHA, EPA), are essential in preventing depression.
    Foods rich in omega 3s include fish (salmon, sardines, and
    mackerel), walnuts and flax seeds.

• Regular
  exercise releases endorphins which improve mood and establish a
  sense of wellbeing.

• Avoid
  depressants such as alcohol and drugs

• Minimize
  and manage stress. There is an intimate relationship between
  chronic stress and the onset of depression. Chronic stress
  stimulates chronic release of hormones (cortisol and epinephrine)
  that in turn affect the release of serotonin and other
  neurotransmitters important in maintaining a positive sense of well
  being.

Treatment:
although treatment can be very effective in reducing the symptoms of
SAD, prevention is always the best defense.

• Light
  therapy has been shown to
  help SAD in up to 85% of people. Regular strength light bulbs are
  not sufficient to stimulate the pineal gland in the brain
  responsible for releasing the hormones deficient in SAD. Light
  intensity on a bright summer day reaches up to 100 000 lux while
  ordinary light bulbs have an intensity of only 200 - 500 lux. Light
  treatment at a minimum dose of 2500 lux daily starting in early
  autumn throughout the winter is very effective in treating SAD. The
  light must be allowed to shine directly through the eyes(rather than
  through a window or glasses) from a light box two to three feet away
  for a minimum of one hour (up to four hours) a day. Activities such
  as reading, working and eating while in front of the light box are
  encouraged. Effects can be noticed within two or three days.

• Serotonin
  inducers/enhancers (5 HTP,
  Griffonia, SSRIs): substances that promote serotonin production are
  often effective in increasing mood and combating depression. There
  are effective alternatives to anti depressants which block the
  clearance of serotonin from the nervous system but often have
  adverse side effects, such as dry mouth, weight gain, insomnia,
  migraines, and decreased libido. Supplementing with 5-HTP will
  directly increase the amount of circulating serotonin. Botanical
  medicines such as Griffonia will also enhance the production of
  serotonin without the adverse effects of anti depressants.

• Psychotherapy:
  identifying and addressing depression is often helpful in the
  restoration of balance. Counseling and psychotherapy can often help
  identify and give advice as to how to manage depression associated
  with SAD.

Dr.
Heidi Rootes in a Naturopathic physician trained in diagnosing and
treating a variety of acute and chronic conditions including SAD.
Her clinic is at the Vitality Clinic in Vancouver. For more
information about Dr. Rootes and her practice please visit her
website at www.vitalityclinic.ca