Are you feeling SAD this winter? Discover how you can change that

Are you Sad in winter?                            
During wet rainy days, grey skies and winter months, some people suffer from symptoms of depression that can appear gradually or come on suddenly.  These symptoms often dissipate as spring arrives and stay in remission through the summer months unless heavy rains and grey skies are present.  For some people, this is a sign that they suffer from Seasonal Affective Disorder (SAD).

Symptoms:
Symptoms usually appear during the colder months of autumn and winter, when there is less exposure to sunlight during the day.  Depression symptoms can be mild to moderate, but can be severe.  Those who work long hours inside office buildings/factories with few windows may experience symptoms all year, and some individuals may note changes in mood during long stretches of cloudy weather irrespective of season.  Symptoms and feelings can include, but are not limited to:

Ø  fatigue

Ø  lack of interest in normal activities

Ø  social withdrawal

Ø  craving foods high in carbohydrates

Ø  weight gain

Ø  not wanting to get out of bed or wake up

Ø  depression with sometimes – suicidal feelings

Those with SAD may not experience every symptom.  For example, energy level may be normal while carbohydrate craving may be extreme.  Sometimes a symptom is opposite the norm, such as weight loss as opposed to weight gain.  In a small number of cases, annual relapse occurs in the summer instead of the autumn and winter, possibly in response to high heat and humidity.  During this period, the depression is more likely to be characterized by insomnia, decreased appetite, weight loss, and agitation or anxiety.

How Does SAD Develop?

SAD has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and lack of sunlight.  Just as sunlight affects the seasonal activities of animals, SAD may be an effect of this seasonal light variation in humans.  As seasons change, people experience a shift in their biological internal clock or circadian rhythm that can cause them to be out of step with their daily schedule.  SAD sufferers may be producing hormones (such as cortisol) and neurotransmitters that promote wakefulness into the early hours of the morning and still produce sleep inducing chemicals such as melatonin until midday.  Hence you are not able to sleep until past midnight and struggle to drag yourself out of bed until late morning.

Melatonin is a hormone whose main function is to induce sleep by travelling through the bloodstream and transmitting the sleep message to other body systems.  In healthy individuals the secretion of melatonin peaks in the middle of the night during your deepest sleep.  At dawn, sunlight shining into the eye triggers the pineal gland to switch off the production of melatonin, thus removing the desire to sleep.  Since melatonin travels to all parts of the body in the blood, it has far-reaching effects, as all hormones do.  During the hours of darkness and sleep, melatonin influences the secretion of hormones from the pituitary gland, often referred to as the "master gland" of the endocrine system.  The pituitary then reduces hormone production from other endocrine glands such as the thyroid and adrenals.  These glands produce vital hormones such as thyroid hormone, cortisol, and adrenaline, which control metabolism and motivate us to action during our waking hours.

Researchers have proved that bright light makes a difference to the brain chemistry.  Evidence suggests that the farther someone lives from the equator, the more likely they are to develop SAD.  The most difficult months for SAD sufferers seem to be June to August, or in northern hemisphere December to February.  SAD may begin at any age, but usually between 18 and 30 years.  Women are eight times more likely to suffer from SAD than men.  The prevalence of SAD increases until the mid 50’s then declines, often considerably lower at age 65 and over. 

Another major theory explaining SAD involves disruption to the way the neurotransmitter serotonin works.  Serotonin is an extremely important chemical messenger in the brain and its function has a major impact on mood.  Low serotonin function can result in a type of depression characterized by symptoms such as feelings of sadness, worthlessness, guilt, and suicidal thoughts.  Serotonin levels vary significantly in normal humans across seasons with lowest levels in winter months.  Research indicated high daytime levels of melatonin in SAD patients, and found that serotonin levels of everybody tested, even healthy volunteers, were lower in winter than in summer.  Receptors on brain cells that are stimulated by serotonin are not functioning correctly, resulting in abnormal neuroendocrine responses and the symptoms experienced in SAD.

Serotonin is actually converted into melatonin.  This happens as light levels fall in the evening and the pineal gland signals for melatonin production to increase.  Serotonin and melatonin are opposing, with serotonin stimulating us during the daytime and melatonin inducing sleep at night.  In SAD, melatonin levels are higher than normal during the day, so sufferers experience sleepiness and other melatonin induced effects, and are prone to serotonin deficiency symptoms such as negative emotional states.

It is important for your doctor to rule out a diagnosis of clinical depression or manic-depression, which can also have predictable cycles throughout the year.  Most people with SAD have unipolar depression, but as many as 20% may have or go on to develop a bipolar or manic-depressive disorder.  Manic or hypo manic episodes can also occur in the spring and summer.  It is important to discriminate the improved mood associated with recovery from the winter depression and a manic episode because there are important treatment differences.

Conventional treatments:

Increased exposure to sunlight can improve symptoms of SAD.  Such as a long walk outside or arranging your home or office close to a window during the day.  If depressive symptoms are severe enough to significantly affect your daily living, light therapy (phototherapy) has proven an effective treatment option.  Bright light makes a difference to the brain chemistry ideally exposure of 30 to 90 minutes a day during winter/overcast days.

SAD can be misdiagnosed as hypothyroidism, hypoglycaemia, infectious mononucleosis, and other viral infections, so correct evaluation is necessary.  SAD may be confused with more serious conditions such as severe depression/bipolar disorder.

If you feel the depression is severe or if you are experiencing suicidal thoughts, consult a doctor immediately regarding treatment options or seek help at the closest emergency room.  A mental health professional can diagnose the symptoms and suggest therapy options.  With the right course of treatment, SAD can be a manageable condition.

How natural therapies can help:

I recommend seeing a qualified naturopath and obtaining a full blood test of minerals, hormones and most importantly melatonin, tryptophan and serotonin. 

Recently 3 doctors advised me that the latter 2 tests are rarely if ever requested.  When I queried why they said they could not see a valid reason for such a test and that anti depressants were usually prescribed. 

Absorption of B6 & B3 is important.  So it is probably best not to self prescribe but to see a practitioner who can help you.

Serotonin is produced from the amino acid tryptophan.  Unfortunately, if a gut dysbiosis is present, the unfriendly microorganisms such as bacteria and yeast can get hold of the tryptophan before we have time to absorb it through our intestines.  Without sufficient supply of tryptophan, susceptible individuals are likely to become deficient in serotonin, with the result being various forms of depression, including SAD. 

A few factors contributing to cause are:

Ø  Dietary

Ø  Malabsorption of specific amino acids and nutrients

Ø  Stress and lifestyle factors

Ø  Genetic potential

Lyn Craven is a Practitioner of Naturopathy, Bowen Therapy, Energy/Reiki Therapist, Meditation Teacher, and a Corporate Health Presenter/Consultant.  Lyn is a health researcher/writer of various topics for Health magazines and has produced a meditation CD assisting people manage stress. This CD is available on line – 2 minute sound sample is on the website. She runs a private practice in Sydney and conducts workshops in Sydney & Sunshine Coast.  She can be contacted on 0403 231 804 lyncraven@bigpond.com  Website:  www.lyncravencorporatehealth-naturopath.com