Are you a bit of a SAD case?
Nutritional Focus

When the dark days of autumn and winter hit, do you find it hard to get up in the morning, feel sleepy during the day and crave carbohydrates? If so, you may be a bit of a SAD case. Read more about Seasonal Affective Disorder and what you can do about it here…
Are you a bit of a SAD case

When the dark days of autumn and winter hit, do you find it hard to get up in the morning, only to find you then feel sleepy, lethargic and irritated all day? Do you crave carbohydrates and struggle to find pleasure in simple daily life? Seasonal Affective Disorder, or SAD is normally characterised by depression during the winter months. So if you are a bit of a SAD case, what can you do about it?

Many of us get a bit fed up during the winter months. Rainy days and short days are no fun for anyone, but for some people the change of seasons guarantees a much more serious struggle with depression. Seasonal Affective Disorder, or SAD, is caused by extreme changes in seasonal mood cycles. It is normally characterised by depression during the winter months, which is why it is sometimes known as ‘winter depression.’ Experts estimate that between 1% and 3% of all people in northern climates experience Seasonal Affective Disorder, with women being particularly at risk, but the figure may be higher, as it may often go undiagnosed. It is thought to be related to changes in levels of the brain chemicals melatonin and serotonin in response to changing exposure to light and darkness, and while the exact cause of SAD is not fully understood, it’s often linked to reduced exposure to sunlight during the shorter autumn and winter days. It’s also possible that some people are more vulnerable to SAD as a result of their genes, as some cases appear to run in families. Seasonal affective disorder or SAD is characterised by typical symptoms of depression such as sadness, despair, hopelessness, guilt, irritability and the loss of pleasure in normal everyday activities. Like other forms of depression, SAD can result in the desire for excessive periods or frequency of sleep, lethargy, carbohydrate cravings, overeating and weight gain, which can in turn result in more depression. These symptoms usually occur in the autumn and winter and disappear with the onset of spring and summer. SAD can be difficult to diagnose because there are many other types of depression that have similar symptoms, but a doctor will normally confirm a diagnosis of SAD if your depression occurs at a similar time each year and the periods of depression are followed by periods without depression.

Why so SAD?

The predominant theory is that a lack of sunlight might stop a part of the brain called the hypothalamus working properly, which may affect the production of melatonin. Melatonin is the hormone that makes you feel sleepy, and it’s important to the deep sleep stage of your sleep cycle, but in people with SAD, the body may produce higher than normal levels, leading to continual drowsiness during the day. Lack of sunlight may also lead to lower levels of another hormone called serotonin. This is linked to feelings of depression because serotonin is one of the hormones that affects your mood. Serotonin also impacts on appetite and also on sleep – mainly because it is used in your body to produce melatonin. There are also theories that your body’s internal clock (circadian rhythm) may be affected by changing exposure to light. This is because your body uses sunlight to time various important functions, such as when you wake up, so lower light levels during the winter may disrupt your body clock.

Lifestyle changes

If your SAD symptoms are severe then you may need to see your doctor about possible treatment options, but for many people, use of herbal and nutritional supplements and the adoption of a few lifestyle changes can make a huge difference, and may be enough to help them to manage without need for further interventions. Firstly, replacing simple carbohydrates, such as sweets and processed foods made with white flour with unrefined, whole grain options may help achieve long-term control over negative mood. Spending as much time as you can outdoors to help improve the regulation of important brain chemicals that affect mood is essential. Make sure you take advantage of every sunny day we get by getting outside! Regular aerobic or anaerobic exercise is crucial too, so try to find time to do an hour at least three times a week. If this alone doesn’t work, then try light therapy to reduce symptoms by using a full-spectrum fluorescent light during dark mornings or evenings. Lamps are easy to buy and are well worth the investment if you suffer badly every year. You may be low in vitamin D, so take supplements and eat vitamin D rich foods such as fish, eggs, butter, cheese, leafy green vegetables and mushrooms regularly. If you suffer badly see a qualified health practitioner to find out if you should take large amounts of vitamin D under medical supervision to help improve mood and well-being.

St John’s Wort

Many pharmaceutical anti-depressants act by inhibiting the reuptake of the hormone serotonin, which is involved in regulating mood. Preliminary studies have shown that the herb St. John’s Wort, which is popularly used in the treatment of mild to moderate depression, also inhibits the reuptake of serotonin, along with the other neurotransmitters norepinephrine and dopamine. Put simply it makes more of these neurotransmitters available to the brain enabling it to act as an anti-depressant (1). Try Nature’s Aid Ucalm St John’s Wort tablets, take 2 tablets per day. A good alternative to tablets is A. Vogel Hypericum St John’s Wort Drops. St John’s Wort must not be taken alongside pharmaceutical antidepressants and also causes sensitivity to sunlight so don’t sunbathe or use sun beds while taking it.

Hypericum

Tulsi

Tulsi, or Holy Basil, is a prominent herb in the Ayurvedic tradition in India, where it is frequently planted in courtyards to bring awareness of the divine. It is regarded as a protector and giver of mental clarity, and for this reason beads made from Tulsi stems are often worn during meditation. It is the volatile aromatic oils that are regarded as a remedy for depression and are thought to aid the spirit. However, modern research into this sacred Indian plant has revealed that it contains rosmarinic acid which contributes to its ability to rebalance the body and act as an adaptogen. Tulsi also contains ursolic acid which aids correct cellular function and helps to reduce inflammation and moderate part of the body’s immune response. It also has potent antioxidant effects and prevents increases in corticosterone levels which can become elevated in times of stress (2,3). Try Tulsi Organic Basil capsules. Take 2 per day with food.

5-HTP

5-hydroxytryptophan (5-HTP) is normally sourced from the seeds of Griffonia simplicifolia, a woody shrub from North Africa. It is a building block for the hormone serotonin, an important hormone that is involved in the regulation of mood and sleep. Disruptions in emotional well-being, including depression, have been linked to serotonin imbalances in the brain (4). Supplementing with 5-HTP (5-hydroxytryptophan) may increase serotonin synthesis. Some trials using 5-HTP with people suffering from depression have shown signs of efficacy (5,6). One double-blind trial found that 5-HTP was as effective as, or nearly as effective as, an antidepressant drug (fluoxetine) (7). 5-HTP is often recommended as a treatment for insomnia, and studies have shown that it may increase rapid-eye-movement (REM) sleep, which is a stage of deep sleep which we need to feel fully rested and to maintain good brain function. If we are deprived of REM sleep it can impact on our mood, so improved sleep is one way in which 5HTP acts to improve mood. Higher Nature Serotone 5-HTP contains various co-factors that help you to utilise the 5-HTP, these include various B vitamins and zinc. Do not take it if you are pregnant or taking fenfluramine. 5-HTP should not be used if you are taking prescribed anti-depressant medication.

Vitamin D

Vitamin D has many important roles in the body, and is important for brain function and the immune system. It is obtained from the diet and is also manufactured from sunlight in the spring and summer months. SAD is common when vitamin D stores are low, particularly in the winter months, and research has revealed that blood levels of vitamin D are significantly lower in people with depression than in healthy people (8,9). In one double-blind trial, healthy people were given 400–800i.u. per day of vitamin D3 (the most popular form of vitamin D), or no vitamin D3, for five days during late winter. Results showed that vitamin D3 significantly enhanced positive mood and reduced negative mood compared to a placebo (10). Other studies have also confirmed the benefit of supplements in the treatment of mild depression (11). There are many good Vitamin D supplements available. As it is also important for the immune system, 2 – 3,000i.u. per day is a sensible dose to take during the winter months. Better You D3000 Vitamin D Daily Oral Spray provides 3000i.u. (75 micrograms) of vitamin D3 per measured spray and is easy to use. A good alternative if you are vegan or prefer taking capsules is Viridian VitaminD3 2,000i.u.

 

REFERENCES:
1. Müller WE, Rolli M, Schäfer C, Hafner U. Effects of hypericum extract (LI 160) in biochemical models of antidepressant activity. Pharmacopsychiatry 1997;30(suppl):102-7.
2. Bhargava KP, Singh N. Anti-stress activity of Ocimum sanctum Linn. Indian J Med Res 1981;73:443-51.
3. Sembulingam K, Sembulingam P, Namasivayam A. Effect of Ocimum sanctum Linn on noise induced changes in plasma corticosterone level. Indian J Physiol Pharmacol 1997;41:139-43.
4. Van Praag HM, Lemus C. Monoamine precursors in the treatment of psychiatric disorders. Nutrition and the Brain, vol. 7, RJ Wurtman, JJ Wurtman, eds. New York: Raven Press, 1986 [review].
5. Van Praag H, de Hann S. Depression vulnerability and 5-hydroxytryptophan prophylaxis. Psychiatry Res 1980;3:75-83.
6. Nolen WA, van de Putte JJ, Dijken WA, et al. Treatment strategy in depression. II. MAO inhibitors in depression resistant to cyclic antidepressants: two controlled crossover studies with tranylcypromine versus L-5-hydroxytryptophan and nimifensine. Acta Psychiatr Scand 1988;78:676-83.
7. Jangid P, Malik P, Singh P, et al. Comparative study of efficacy of L-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode. Asian J Psychiatr 2013;6:29–34.)
8. Penckofer S, Kouba J et al. Vitamin D and Depression: Where is all the Sunshine? Issues Ment Health Nurs. 2010 Jun; 31(6): 385–393.
9. Hoogendijk WJ, Lips P, Dik MG, et al. Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch Gen Psychiatry 2008;65:508-12.
10. Lansdowne ATG, Provost SC. Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology 1998;135:319-23.
11. Khoraminya N, Tehrani-Doost M, Jazayeri S, et al. Therapeutic effects of vitamin D as adjunctive therapy to fluoxetine in patients with major depressive disorder. Aust N Z J Psychiatry 2012;Oct 23:[Epub ahead of print].

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