Lift Yourself Out of Winter Depression

The days are short.

The air is cool.

And, it might have you feeling a little blue.

If you associate Old Man Winter with a little depression, you may be one of as many as 10% of Americans who experience Seasonal Affective Disorder (SAD).

Melatonin, vitamin D, serotonin, and catecholamines (norepinephrine/“adrenaline”) may all be linked to seasonal affective disorder, but no single cause has been identified (1).

Light exposure upon waking is thought to protect against feelings of depression, while exposure to light during the night may also disrupt melatonin production and affect sleep-wake cycles.

The frequencies of light in the early morning until ~10am help promote the production of serotonin which helps our mood, this serotonin then breaks down into metabolites that are the building blocks to melatonin which will rise at night to help you sleep.

If you miss this morning exposure, you can disrupt the normal rhythm of hormones in the body related to wakefulness, mood, and sleep.

Disturbances in sleep are closely associated with lowered mood and changes in melatonin release (2).

One theory is that because the days are shorter in the winter with later sunrises and earlier sunsets, but other factors such as vitamin D status, and serotonin regulation may also play important roles.

You’ll find that many of the natural strategies are about reducing stress, supplying the raw materials to serotonin and melatonin production, as well as related stress and blood sugar cycles that can strain the same systems.

Signs and Symptoms of SAD:

Changes in sleep and circadian rhythm are the most prevalent signs of depression. Someone with SAD symptoms may recognize:

• Difficulty falling asleep
• Decrease in total sleep time and efficiency
• Early Morning waking
• Rapid Eye Movement Sleep Alterations (“dream” sleep).
• Changes in Temperature regulation
• Altered timing of peak cortisol (stress hormone) release
• Daily changes in mood (3; 4)

According to the U.S. National Library of Medicine, SAD is also characterized by:

• Increased appetite and weight gain
• Increased sleepiness and daytime sleepiness
• Less energy and ability to concentrate in the afternoon
• Loss of interest in work or other activities
• Slow, sluggish, lethargic movement
• Social withdrawal
• Unhappiness and irritability

Medical Treatment of SAD:

Medical Treatment of SAD may incorporate certain prescription drugs (9; 10).

Taking Melatonin:

Melatonin is produced in the pineal gland and release is partly controlled by light-sensitive pigments in the retina known as Melanopsin.

The body synthesizes melatonin from tryptophan and serotonin with help from B-vitamin cofactors. This is a recipe for supporting melatonin without taking it directly, yet too much of a good thing may make someone feel anxious or irritable – back down if this is the case or check with your natural health professional.

Food sources of tryptophan include fleshy meats such as turkey, beef, liver, salmon, lamb, scallops, snapper, halibut,  and chicken breast, and other non-meat sources such as mushroom, and spinach.

Supplements that may promote serotonin levels include St. John’s Wort, SAMe, and 5-HTP. *It is important to be mindful of nutrient-drug interactions such as with anti-depressants as you do not want to combine these therapies.

Melatonin not only promotes sleep but is also a potent antioxidant that may offer cancer-protective benefits (11).

Other studies report sedative, antianxiety, antidepressant, anticonvulsant, and analgesic (pain/inflammation-supportive) properties (12).

There is a close association between disruptions in melatonin production and the occurrence of depressed mood (13).

Melatonin Doses:

Dosages of melatonin vary depending on the resource you read. Melatonin should not be used if you are taking benzodiazepines (ex/ Xanax, Valium, etc), alcohol, or other nervous system depressants (muscle relaxers, nerve-slowing drugs).

• A low dose of 0.3mg may be safe over long periods of time, while “clinical” doses of 3-5mg or higher may be safe over the course of a few months to a year and have utility for inflammation support.
• Some studies suggest safety at higher doses at 10-40mg when used only for a few weeks, and 100mg when used for only 1-2 days.
• One should be cautious for use with those prone to seizures, especially children, and for those concerned about potential reproductive side effects from chronic melatonin use. This may be related to serotonin-like activity can be excitatory when in excess, or that those with seizure disorders may be on medications that are contraindicated with melatonin.

Short-term side effects may include “heavy-headedness”, vivid dreaming, or increased drowsiness upon waking.

High doses and/or chronic usage of melatonin can alter pituitary feedback loops of other hormones. The reproductive system is known to be affected and melatonin may decrease fertility in both men and women!

As melatonin is a hormone and may interact with existing medications, it is generally recommended to seek advice on usage and dosage from a qualified health professional.

Vitamin D and Seasonal Affective Disorder:

Vitamin D is a bit of a misnomer as it is actually a hormone, not a vitamin.

Vitamin D is produced in the skin from exposure to sunlight, sent to the liver to be converted to a pro-hormone, and finally activated by the kidney or immune system for activity in the body.

The Institute of Medicine recently recommended an increase of Vitamin D intake from 400IU/day to 600-800IU, and many health professionals now recommend that serum 25-OH Vitamin D levels be between 40-80nmol/L, with 50-70nmol/L being “optimum”.

Vitamin D may help improve mild depressive symtpoms, but researchers posit that it is too early to conclude a strong relation to depression (14) .

Low Vitamin D3 levels may increase risk of SAD, as well as other neurological disorders such as multiple sclerosis, Alzheimer’s, Parkinson’s disease and schizophrenia (15) .

It is thought that low Vitamin D status as an infant and child may actually predispose you to an altered psychiatric state in adulthood (16).

For more information regarding Vitamin D:

• Why is Vitamin D Important
• The Importance of Vitamin D During Pregnancy and Beyond (Part 1)
• The Importance of vitamin D During Pregnancy and Beyond (Part 2)

Light Deprivation and Bright Light Therapy for SAD:

Beyond stimulating vitamin D production, bright light can also stimulate healthy melatonin production.

Light therapy is known as an effective “treatment of choice” for seasonal affective disorders (9; 17; 18).

Light boxes vary in style and intensity, but a 10,000lux light box (affiliate, non-affiliate) seems to work well at 30 min/day exposure upon waking. Lower intensities such as a 2,500 lux light box may require two hours to see effectiveness.

Some individuals report improvements with as little as 15 minutes a day using higher lux models.

Light therapy seems to work best directly upon waking as exposure to light during the evening may disrupt melatonin production.

Alternative Herbs and Supplements for SAD:

According to an article published in the Journal of Affective Disorders: Rhodiola rosea, chromium, 5-HTP, and inositol supplementation may act as natural anti-depressants.

Chromium has specifically been suggested to support seasonal affective disorder (19).

As mentioned earlier, St. John’s Wort may be helpful for depression as it is thought to support serotonin production. Kava is a lesser known and controversial root that may help with generalized anxiety (20).

Social Factors and Winter Depression:

Mixed opinions suggest that certain careers may pose increased risk for SAD, particularly night-shift workers. Those working in an office environment with little exposure to sunlight may also be at risk.

Lifestyle Recommendation Summary for Seasonal Affective Disorder-Winter Depression:

• Eat a low-glycemic, blood-sugar-friendly diet
• Reduce caffeine intake
• Seek stress-reducing activities such as meditation, yoga, deep breathing, and exercise.
• Ensure adequate vitamin D status within the recommended “healthy range” of 40-80nmol/L.
• Sleep in a dark room and consider purchasing “blackout blinds”. Blue lighting may improve sleep.
• Seek out early morning exposure to bright light, or purchase a 10,000 lux lightbox.
• Consume foods high in tryptophan such as turkey and chicken.
• Consider medical treatment when warranted.
• Consult a natural health professional on personal use of one or more of the following herbs and supplements: Vitamin D,  Melatonin, St. John’s Wort, SAMe, 5-HTP, stress-supportive like Everyday Stress Support, and blood-sugar supportive herbs & supplements such as taking Berberine Reset before meals.