Feeling SAD? – Dr. Sarah Kent |ND
Fall is here and winter is beckoning. The change of light that signals fall and causes the change of colours also warns of shorter days and less daylight. Our climate grants us extended evenings in daylight during the summer for shorter days in the winter. I hope you’ve enjoyed your summer evenings and soaked up enough sun to boost vitamin D stores well into 2014 (yet protected yourself well against extended sun exposure).
For some people, transitioning into winter is seamless, for other it presents a struggle, fighting lethargy and decreased affect. If you are in this latter group you may suffer from seasonal affective disorder. I’ll explain what this is along with ways to cope and ways to prevent .
What is Season Affective disorder (SAD)
SAD stands for seasonal affective disorder, essentially a form of depression that cycles with the seasons, typically fall & winter (1). People who suffer from SAD experience clinical depression usually starting in fall, lasting throughout the winter into the spring. This is different from just feeling gloomy from weather and temperature changes, its a more intense depressive reaction that impairs quality of life in the following ways:
- feeling depressed most of the day especially in the morning for at least 2 weeks
- loosing interest in normal activities and relationships for at least 2 weeks.
- it can also include other related symptoms such as:
- Daily Fatigue
- Feelings of worthlessness & or guilt almost daily
- Impaired concentration & indecisiveness
- too much or too little sleep
- recurring thoughts of death or suicide
- significant weight loss or gain (5% of body weight) in one month
If you think you might be suffering form SAD or major depressive disorder please get in touch with your health care provider.
The following are some non invasive tools and tricks that may help people who either suffer from SAD or who feel more down in the winter time
1) Vitamin D – vitamin D is typically low in people who live in northern latitudes where there is significant reduction in sun exposure during winter (i.e. Canada). Why is this important? Because your body makes Vitamin D through several steps that dependent firstly on exposure to UVB radiation on the skin (or through ingestion of certain foods like liver). In the winter there is less of this. Low Vitamin D in people has been linked to increase in many diseases and disorders, that include SAD (natur). One study among many has found that increasing vitamin D stores from baseline in people with SAD, has significant benefit in mood (4). Increasing vitamin D stores while experiencng mood disorders has shown benefit (4) however ensuring they are optimal prior to the change of seasons may have a profound implication on prevention. Its best to get your levels tested first in order to inform therapy / dose. Make sure to have this discussion with your health care provider.
2) Light therapy – exposing oneself to a light that emits similar frequencies as daylight can result in modest increases of vitamin D and may even offer other benefits to mood and hormones. Its routinely suggested as a therapy for many condition, including ‘winter blues’ and SAD. Typical therapy includes using a ‘light box’ for 15min to 3 hours, once to several times a day. The optimal time is suggested to be at 6:30 am and any activity that is permissible while facing the light box is allowed; directly staring into the device is contra indicated. (5)
3) Exercise – the benefits of exercise especially as they relate to mood disorders is in my opinion, almost irrefutable. Motivation is often lacking in dark winter nights to engage in exercised especially those that occur outside. So my suggestion is to ensure that you are getting outside and moving your body, at least 3 times per week. Winter time outdoor activities such as skiing / snowboarding etc are great however they are usually done on the weekends and can be quite pricey. What I’m suggesting is weekday outside activity. The equipment you’ll need for this is:
- A warm jacket
- A head lamp
Keeping warm and knowing where you are going (via the headlight) is an amazing way to access the great outdoors or your suburban neighbourhood stroll. Its refreshing and reinvigorates. If you don’t currently own a headlight check out Mountain Equipment Coop (http://www.mec.ca/shop/camping-headlamps/50130+50522/?h=10+50130+50037&gclid=CO6smcCpiroCFQkSMwoddQYA4Q).
People often find it difficult to get out there after a long day at work, in the darkness. Here are some tips to ensure you do.
Start making this a routine now, while the weather is nice, the leaves are beautiful and the daylight reaches in to early evening.
Make an agreement with a friend, that you will meet 2-3 times a week at a certain time.
Go directly from work. Have children / spouse? Alternate with them so 1 or 2 times per week you will do your activity and the other time you will let them do an activity straight from work. Have a dog? Needs to be let out? Take the dog with you or hire a dog walker for those few times a week (http://www.dogwalkingcalgary.com/)
4) Consult your Naturopath. Often those who are susceptible to mood disorders including SAD have a disturbed serotonin brain function (6) something your ND can help you with. Also working with ND, you can identify any other reason for which you may be experiencing less then stellar health / mood that include genetic influence, dietary & gastro intestinal function and overall nutrient deficiencies.
Any questions / comments? I would love to hear them. Enjoy the rest of the fall and the winter!
1) Mayo clinic: https://www.google.ca/search?q=light+therapy+the+mayo+clinic&ie=UTF-8&oe=UTF-8&hl=en&client=safari
2) CMHA: http://www.cmha.ca/mental-health/understanding-mental-illness/mood-disorders/seasonal-affective-disorder/ copyright 2013
3) Merck manual: http://www.merckmanuals.com/professional/psychiatric_disorders/mood_disorders/depressive_disorders.html?qt=seasonal%20affective%20disorder&alt=sh#v1028030. 2010-2013
4) Gloth FM 3rs, Alan W, Hollis B. Vitamin D vs broad spectrum phototherapy in the treatment of season affective disorder. J Nutr Health Aging. 1993;3(1) 5-7
5) www.columbia.edu Q & A on bright light therapy.
6) Timo Partonen, Jouko Lönnqvist.Seasonal affective disorder. The Lancet, Volume 352, Issue 9137, Pages 1369-1374