Seasonal Affective Disorder (SAD)
Feeling the winter blues?
Although SAD is often referred to as winter depression or the winter blues, for me it definitely kicks in during the autumn months. From around the second week of October, I just want to hibernate under a cosy blanket with an unlimited supply of chocolate hobnobs and cups of tea. Socialising doesn’t appeal, especially at night. I’m no longer interested in eating fruit or salad or anything cold and fresh. I crave carbohydrates and overeat for comfort. Drinking water feels like a chore, so I end up surviving on coffee and tea. I have zero energy, am often tearful and feel incredibly low and can’t understand why. I experience weight gain, bloating, constipation and feel lower than ever.
Does this sound familiar to you?
Seasonal affective disorder is extremely common in the northern hemisphere, where there is a significant reduction in daylight hours during the autumn and winter months. It can affect anyone, but research suggests it is more common in women. In fact, when first identified by Dr Norman E. Rosenthal back in the early 1980s, the typical patient with SAD was described as a premenopausal woman experiencing carbohydrate craving, hypersomnia, weight gain, and fatigue during bouts of winter depression. Dr Rosenthal pioneered the use of light therapy to treat SAD.
What are the symptoms of SAD?
Interestingly, symptoms of SAD have been described as energy-conserving, leading to various theories linked to the behaviours of our ancient ancestors in anticipation of food shortage in the winter. The high prevalence of SAD in premenopausal women has also been suggested as a link to preserving fertility in those times.
Commonly recorded symptoms of SAD include:
Overeating
Carbohydrate cravings
Weight gain
Hypersomnia (prolonged nighttime sleep & excessive daytime sleepiness)
Struggling to get out of bed in the morning
Feelings of guilt and/or anxiety
Tearfulness
Fatigue/lethargy
A desire to “hibernate”
Feeling low/depressed
Reduced libido
Irritability
Lost interest in usual activities
Lost interest in socialising
Preferring to spend time alone
What causes SAD?
SAD has been linked to the shorter days we experience during autumn and winter. Our circadian rhythm relies on daylight to time important bodily functions. Increased darkness and reduced sunlight disrupts this by altering the neurotransmitter levels in the brain which impact our mood, energy and sleep. Reduced sunlight can also negatively affect our vitamin D levels.
SEROTONIN - This neurotransmitter is known as the happy hormone. It helps with our sleep and wakefulness, regulates anxiety and happiness, helps control bowel function, and much more. Exposure to sunlight triggers our brain to stimulate serotonin release. When we experience a lack of sunlight, it is thought that serotonin levels drop. Low levels of serotonin are linked with depression. Serotonin is synthesised in response to carbohydrate-rich, protein-poor foods, which is why SAD sufferers often experience carb cravings.
MELATONIN - This neurotransmitter is known as the sleep hormone. It provides signals to tell your body when it’s time to sleep and when it’s time to wake. Our melatonin levels start to rise when it’s dark outside, making us sleepy. Daylight will reduce melatonin levels, promoting wakefulness. It is thought that people with SAD are producing higher levels of melatonin due to increased periods of darkness, resulting in prolonged sleep and daytime tiredness.
VITAMIN D - Since we need sunlight to make vitamin D, many of us in the UK become deficient during autumn and winter months. As well as keeping our bones, teeth and muscles healthy, vitamin D plays an important role in serotonin activation. Symptoms of deficiency include fatigue and depressive mood.
How can I improve my SAD symptoms?
You should seek advice from your GP if you are suffering from depressive symptoms, especially if these are not of a short-term, seasonal nature. They will discuss all of the options available to you.
There are some simple naturopathic and lifestyle steps you can take which may improve your symptoms. Ideally you should work with a nutritional therapist to guide you through these. They will ensure you are taking the correct dosages of any relevant supplements and will ensure no interactions exist with any medications you are taking. A nutritional therapist will also be able to arrange for testing to look at any nutritional deficiencies you may be experiencing
SUPPLEMENTS
Ideally you should be increasing your intake of the below nutrients through a diverse, whole food diet containing plenty of fruit & veg, wholegrains, nuts & seeds, beans & pulses, fish, eggs and a small amount of meat and dairy. In cases of insufficiency, supplements can be a great way to boost your nutrient levels, but make sure you are taking an appropriate dosage and follow the guidelines of your health practitioner.
Vitamin D - The NHS advises everyone in the UK to take a vitamin D supplement during autumn and winter when sunlight is lacking. Adults are recommended to take 400IU (10mcg) per day, up to a maximum of 4000IU (100mcg). Seek advice from a nutritional therapist to determine your optimum dose. Good food sources of vitamin D include oily fish, egg yolks and red meat.
5-HTP - 5-HTP is made naturally in the body from the amino acid tryptophan (found in foods such as chicken, tofu, milk, eggs, cheese, fish, peanuts and sesame & pumpkin seeds). It is then converted in the brain to serotonin. Taking a 5-HTP supplement may help increase your serotonin levels.
Omega 3 Fish oil - Omega 3 plays an important role in serotonin regulation. If you are not getting enough oily fish in your diet (2-3 portions of salmon, mackerel, anchovies, sardines or herring) then you should probably be taking a supplement. There are plenty of good vegan options available as well.
Iron - It may be worth having your iron levels checked either with your GP or with your nutritional therapist. Symptoms of low iron include fatigue and weakness. Low iron can have a detrimental effect on your immunity, which is very important in the colder months. It isn't recommended to take high doses of iron supplements without professional advice, as there can be a risk of toxic overload, especially if you are not menstruating.
Probiotics - Research suggests there may be a direct link between gut health and mental health. More than 90% of serotonin and 50% of dopamine is made in the gut and some of your dopamine is directly produced by your gut bugs. Research shows that a healthier and more diverse gut microbiome is linked to better overall health. Your nutritional therapist would advise which strain of probiotic would be best for you, should you choose to supplement. You can also look at introducing probiotic foods into your diet a few times a week, such as miso, kimchi, kefir, sauerkraut and kombucha.
LIFESTYLE MEASURES
Get outside in daylight as much as possible to increase your sunlight exposure and natural production of vitamin D and serotonin.
Try light therapy using a light box to simulate sunlight exposure. Usually 15-30 minutes per day is recommended, however you should discuss with your GP first if you are taking medications, suffer from light sensitivity or an eye condition, sensitive skin or a history of skin cancer.
Exercise regularly to boost chemicals in the brain which promote energy, alertness and pleasure such as endorphins, serotonin and dopamine.
Talk about your feelings with a professional therapist or with family and friends. Being open about how you feel can help to reduce the associated feelings of guilt. You may also find that others have been experiencing similar symptoms to you.
Hydration is beneficial to our physical health, but research also shows a benefit to our mental health. Studies have found a link between dehydration and increased risk of anxiety and depression. Try sipping warming herbal teas throughout the day if cold water doesn’t appeal to you. Aim for 1.5-2 litres of water per day and limit coffee and tea to 2-3 cups per day.
