If you’re feeling lethargic, craving carbohydrates and have an overwhelming urge to hibernate, you might be experiencing seasonal affective disorder (also known as SAD), a type of depression that strikes during the fall and winter months. More than 10 million Americans suffer from SAD each year, accounting for about one out of every three cases of depression in the United States. SAD is more common in northern latitudes, and women are four times more likely to develop SAD than men.
SAD is distinguished from other types of depression in that it has a distinct physiological basis. People who suffer from SAD are espec-ially sensitive to the reduced amount of sunlight that occurs during the shorter days of fall and winter. Because the disorder is often misdiagnosed or not diagnosed at all, many people don’t realize they are suffering from SAD. The effects of the disorder, however, can severely disrupt careers, education, relationships, home life and activities.
Do You Have SAD?
The key characteristic of SAD is that the symptoms occur seasonally, generally appearing in the fall and continuing until spring. A clinical diagnosis of SAD requires that the symptoms be experienced for at least two consecutive winters, followed by periods of normal moods in the spring and summer. There also must be no other explanation for the mood changes.
A range of symptoms make up SAD, including depression, anxiety, loss of energy, irrita- bility, changes in sleep patterns (especially sleeping more), changes in appetite (generally a desire for foods high in carbohydrates), weight gain, loss of sexual desire, decreased concentration and creativity, inability to complete tasks and social isolation.
Researchers believe that SAD is a natural physiological response to seasonal light changes and that some people are more negatively affected by these changes than others. The apparent reason for SAD is that when sunlight decreases, the body’s master biological clock has to adjust. The hormone melatonin (produced by the pineal gland), which regulates the sleep/wake cycle (circadian rhythm), increases with darkness and triggers the desire to sleep. Many animals slow down their activities or go into hibernation during the winter months, but obviously, hibernation isn’t an option for humans.
Research also shows that without sunlight, the brain doesn’t produce enough serotonin, which results in symptoms of depression.
Short of moving to a sunnier climate, there are a variety of things you can do to alleviate SAD. For the most part, the following suggestions will help anyone weather the cold and gray of winter with a brighter mood and more energy.
Brighten Your Mood with Light
To counteract the desire to hibernate, one of the most effective treatments for SAD is phytotherapy, or bright light therapy. Bright light suppresses the secretion of melatonin, which decreases the desire for excessive sleep and helps alleviate depression. If you suffer from minor symptoms of SAD, simply making the effort to spend at least 30 minutes outdoors in the sunlight every day can relieve symptoms. For more severe cases of SAD (or if you live in a particularly dreary climate), you’ll probably need to use a light box that produces an intensity of 2,500 to 10,000 lux (the measurement of light level). A light box employs lights that are up to 20 times brighter than normal indoor lighting. Bright light therapy requires sitting one to two feet from the light box for 15 minutes to several hours, depending on the severity of symptoms. Light box therapy is generally safe but can occasionally cause headaches, irritability or eyestrain.
Get Moving: Overcome SAD with Exercise
Exercise is one of the most powerful and simple ways of overcoming depression and keeping it at bay. In fact, regular daily exercise has been proven to be as effective as antidepressant drugs for relieving mild to moderate depression.
Although all forms of exercise are helpful, aerobic exercise — such as brisk walking, dancing or cross-country skiing — appears to be the most beneficial for alleviating depression. Vigorous exercise stimulates the release of endorphins, the body’s natural mood-elevating compounds. Studies show that people who exercise regularly not only have decreased symptoms of fatigue, anxiety and depression, but they also have higher self-esteem.
The minimum amount of exercise that appears to be effective for preventing and relieving depression is approximately 30 minutes of activity five days a week. Exercising in the morning seems to be most helpful for establishing a balanced and positive mood for the day, but exercise is beneficial at any time.
Regulate Your Mood with Food
Keeping blood sugar levels balanced is essential for those who are prone to depression because the brain and nervous system are highly sensitive to blood sugar fluctuations. In addition, keeping blood sugar stable ensures a constant supply of energy and helps to prevent fatigue. To keep blood sugar levels on an even keel, avoid sugar, refined carbohydrates and excessive amounts of caffeine.
For optimal blood-sugar control, eat three moderate meals daily plus a midmorning, midafternoon and before-bed snack. Avoid skipping meals or going for more than three hours without eating. Although eating too many carbohydrates (especially “simple” carbohydrates, such as white bread, pasta and rice) contributes to sluggishness and weight gain, complex carbohydrates, such as legumes, whole grains, nuts, seeds, vegetables and fruits, provide a steady source of energy for the body and brain. Including moderate amounts of these foods helps to stabilize blood sugar.
Nerve cells in the brain communicate through chemicals called neurotransmitters, which are dependent upon specific nutrients in the blood. Protein-rich foods, such as chicken, turkey, fish, eggs, lentils, almonds and yogurt, are made up of amino acids, the building blocks for neurotransmitters. To ensure an adequate supply of protein in your diet, eat a small serving of protein at each meal and include protein (such as a few nuts or a small piece of lowfat cheese) with each snack for a total of eight to 10 ounces (around 70 grams) of protein daily.
Essential fatty acids (EFAs) are another important factor for alleviating depression. Depression is associated with low levels of EFAs, particularly omega-3 fatty acids. Omega-3 fatty acids are thought to enhance nerve cells’ responsiveness to serotonin, the brain’s natural mood-uplifting chemical. Omega-3 fatty acids are found in salmon and other cold-water fish, walnuts and flaxseeds. To obtain sufficient amounts of omega-3 fatty acids, eat cold-water fish at least twice a week and a small handful of raw walnuts or one tablespoon of ground flaxseeds daily.
Overcoming Depression the Natural Way
Because low levels of many nutrients are associated with depression, it’s helpful to take a high-potency vitamin and mineral supplement daily. The B-complex vitamins are particularly important in the treatment of mood disorders as they are critical for the production of neurotransmitters and a healthy nervous system.
Vitamin B6 helps regulate mood and is involved in the production of serotonin. Foods rich in B6 include whole grains, dark leafy greens, bananas, chicken and avocados.
Vitamin B12 also is essential in the prevention and treatment of depression. This vitamin is found in animal proteins. Many people have deficiencies of vitamin B12 because it is not easily absorbed during digestion. If you suffer from depression, you might want to consider taking sublingual tablets of B12 in addition to a B-complex supplement. Sublingual tablets are dissolved under the tongue and absorbed directly into the bloodstream. Take 1 mg of vitamin B12 every other day.
A lack of folic acid, another B vitamin, also causes depression and changes in personality. Folic acid occurs abundantly in leafy green vegetables, but not many people eat sufficient amounts of leafy greens and the vitamin is destroyed during cooking. To ensure that you are getting adequate amounts these essential nutrients, buy a B-complex supplement that supplies 50 to 100 mg per day of B1, B2, B3, B5 and B6, plus 400 micrograms of folic acid.
Specific minerals also play an important role in alleviating depression. Calcium and magnesium are two of the most important, and both help to calm the nervous system. Foods rich in calcium include dairy products, broccoli, kale, oranges, sesame seeds, sardines and almonds. To ensure sufficient amounts of calcium, take 800 to 1,200 mg of supplemental calcium daily in the form of calcium citrate, which is the most easily absorbed form. For best assimilation, divide into two or three doses and take with meals.
Good dietary sources of magnesium include legumes, nuts, seeds and whole grains. Again, to ensure sufficient levels of this important mineral, take 400 to 600 mg of supplemental magnesium daily in the form of citrate, malate, aspartate, gluconate or lactate.
Herbs to Keep You Happy
Doctors often prescribe antidepressants for people suffering from SAD. Although these drugs can effectively relieve depression, they are not benign substances. For one thing, the drugs don’t alleviate depression for everyone. It’s also not unusual for antidepressants to cause side effects, including headache, nausea, agitation, insomnia and sexual difficulties.
Herbs provide a welcome alternative to pharmaceutical antidepressants. However, if you are currently taking antidepressant drugs, check with your doctor before using herbal antidepressants. Antidepressant drugs should never be discontinued abruptly; to do so can cause unpleasant withdrawal symptoms.
• St. John’s wort (Hypericum perforatum). The popularity of St. John’s wort for treating mild to moderate depression is well deserved. In dozens of studies, the herb has been proven to relieve mild to moderate depression as effectively as prescription antidepressants.
Some research indicates that St. John’s wort also might be helpful for severe depression. In a study of 251 people diagnosed with moderate to severe depression, half were symptom-free after six weeks of taking St. John’s wort, compared with 35 percent of the group taking the antidepressant drug Paxil over the same period.
A typical dosage of St. John’s wort is 300 mg of a standardized extract taken three times daily. Because St. John’s wort has a cumulative effect on mood, it can take one to two months to notice a significant difference. The herb can interact with numerous medications, so consult your doctor if you’re taking prescription drugs.
You might have heard cautions concerning the combination of St. John’s wort and sunlight. Although it’s true that the herb can cause photosensitivity (an allergic reaction that occurs with exposure to the ultraviolet rays of sunlight), this reaction is unlikely in humans. However, you can safely use light box therapy along with St. John’s wort — light boxes do not produce ultraviolet light.
• Kava (Piper methysticum). Pacific Islanders have used kava for centuries as a ceremonial herb to enhance feelings of relaxation and sociability. Kava has a mild tranquilizing effect, and in normal doses it elicits feelings of general well-being. Researchers have identified compounds in kava called kavalactones, which are responsible for the herb’s relaxing and mood-elevating properties.
A typical dosage of a standardized extract of kava is 40 to 70 mg of kavalactones three times daily. If you are using nonstandardized kava products, a typical dosage is one 500-mg capsule or 15 to 30 drops of liquid extract up to three times a day. Do not exceed recommended doses of kava and do not take the herb for more than four weeks without consulting a qualified health practitioner. Do not use kava if you suffer from liver problems (see “Is Kava Safe?” on Page 26).
• Lavender (Lavandula angustifolia). Herbalists often recommend lavender to improve mood. In a small but interesting study, researchers found that an alcohol extract of lavender enhanced the effectiveness of imipramine, a prescription antidepressant.
In the four-week trial, 45 patients diagnosed with clinical depression were given one of three treatments: 60 drops of lavender tincture and a placebo; imipramine and a placebo; or imipramine with 60 drops of lavender tincture. Although the lavender tincture alone was less effective than imipramine, the combination of the two was more effective than imipramine alone. The researchers noted that combining the two alleviates depression symptoms more quickly and effectively. 8
Laurel Vukovic writes and teaches about herbs from her home in southern Oregon. She is the author of 1001 Natural Remedies (DK, 2003) and Herbal Healing Secrets for Women (Prentice Hall, 2000).