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S.A.D. Support - By Dr. Henry Malus, ND

November 07, 2022

S.A.D. Support - By Dr. Henry Malus, ND

The fall has finally arrived, bringing rain (hallelujah!), cooler temperatures, changing leaves, and of course pumpkin spice everything. Some people may experience big changes in their mood, motivation, sleep cycles, and food cravings during these months. Some changes are natural, expected, and manageable. A somewhat mild form of the ‘winter blues’ may affect up to 20% of people. However, for approximately 5% of Americans, these changes are disruptive and require extra care and attention.

Symptoms of Seasonal Affective Disorder (S.A.D.) include: increased sleep hours and yet daytime drowsiness, feelings of depression, fatigue causing the inability to carry out normal routine, loss of interest in life activities, feelings of worthlessness, weight changes, the inability to concentrate, increased carbohydrate cravings  specifically sweets. If you or a loved one experiences these symptoms in the same season for two or more consecutive years, you should talk to your doctor about a diagnosis of S.A.D.

Our minds and bodies naturally respond to change in the hours and the angle of the sunlight. For a variety of reasons, we all adapt to those changes differently. Symptoms of S.A.D. usually occur in October-April -though they will sometimes last longer, and sometimes occur in the spring or summer. 50-70% of people diagnosed with S.A.D. will experience the symptoms again.

Theories about the causes of this disorder include:
• Circadian rhythm -lack of bright white or blue light entering the retina affects the circadian rhythms.
• Serotonin dysregulation -Serotonin receptors and its precursor, tryptophan vary with the seasons and within different parts of the brain.
• Seasonal immune system challenges, inflammation.
• Genetics -those with a family history of depressive disorders are at increased risk.

S.A.D. occurs more often in temperate climates. Immigration to cloudier climates increases the risk of S.A.D. compared to native populations. A cold and dark winter can trigger depression. Women are twice as likely as men to get S.A.D. Night shift workers are more likely to experience S.A.D.


There are effective treatments for S.A.D., including:
Therapy:
• Workbooks/Journaling
• Group therapy
• Cognitive Behavioral Therapy


Planning -get things started before symptom onset.
• Holiday plan, vacation planning -imagining future plans
• Meal prep -making soups (split pea, turkey chili, kitchari)
• Plan vacations during winter to sunny locations.
• Adapt -plan activities to match the rhythm of what your body needs. Start with self assessment.

Track your sleep cycle and complete https://carleton.ca/healthy-
workplace/wp-content/uploads/SAD_questionnaire.pdf

Light Therapy - Dawn simulation -increasing the intensity of light with waking. Limit exposure to blue light/electronic screens after 6pm. Monitor the impact with questionnaires or journal entries to strategically use light therapy with melatonin surges.

Exercise: outdoors/noontime when possible to maximize sun exposure. Yoga or other core strength and balancing exercises.


Relationships -spend more time actively building up your healthy support systems. Find new group activities or renew commitments to ones previously enjoyed.


Supplements:
• Vitamin D -in foods -egg yolks, butter
• L-tryptophan
• Herbs: Tea/Tinctures/Capsules -Ginseng, Lion’s mane, Chaga, Licorice, Gotu Kola, St. Johns wort. Consulting with an herbalist or integrative physician will help tailor any herbal remedies to your specific symptoms and physiology.


Aromatherapy -essential oils for use in a diffuser.
• Bergamot
• Citrus -neroli
• Basil
• Rose


Skin Care -stay hydrated and keep skin healthy with use of oils such as shea butter, jojoba, coconut, sesame oil.


Medication may be necessary for some people. If your symptoms do not improve with light therapy, counseling, diet, and lifestyle changes, consider talking to your doctor about medications. It may be appropriate to use these medications seasonally.


Functional medicine testing can help find and treat some of the sources of seasonal depression. Contact your integrative mental health professional to request testing.


• Metabolic profile
• Thyroid hormone
• Melatonin
• Adrenal function
• Vitamin D level
• B-vitamin levels
• Neurotransmitter assessment


Regardless of the timing or persistence of depression symptoms, if you feel overwhelmed or it is adversely affecting your life, it’s time to seek help.


Anyone feeling severe symptoms of depression or suicidal thoughts should seek help at the closest emergency room. The National Suicide Prevention Lifeline can be reached by calling 988 or online at suicide.org


Disclaimer: Information in this article is not meant to be medical advice, but a review of symptoms to be aware of and remedies to consider in consultation with a licensed medical provider.


For references and links to other resources visit malushealth.org/resources

Thompson, C., Thompson, S., Smith, R. (2004).
Prevalence of seasonal affective disorder in primary care; a comparison of the
seasonal health questionnaire and the seasonal pattern assessment
questionnaire. Journal of Affective Disorders, 78(3), 219-226.


Wetzler, K. E. (2002). The Pineal Gland and Seasonal Affective Disorder, Senior
Thesis. Portland, OR: NCNM.


Self-help interventions for depressive disorders and depressive symptoms: a
systematic review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2542367/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673349/

https://www.helpguide.org/articles/depression/seasonal-affective-disorder-
sad.htm

SAD Questionnaire -https://carleton.ca/healthy-workplace/wp-content/
uploads/SAD_questionnaire.pdf


Therapy light. https://brainmd.com/bright-minds-therapy-lamp


Sleep tracking app https://www.sleepcycle.com/






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