Tuesday, January 22, 2013

Is it time to be SAD?

By: Dusten Nelson

I recently had a request to put out some information on Seasonal Affective Disorder or SAD – The clinical term for “winter blues”. SAD (which can happen in any season, but is more commonly diagnosed as  “Depression” when it occurs during spring and summer) was first validated by the medical community in 1984 by Norman Rosenthal at the National Institute of Mental health. Seasonal Affective Disorder was determined to be a form of depression that occurs at the same time every year (fall or winter) and is more likely to occur in women than in men. – Lending more clinical credibility to my wife’s claim that it is in fact more difficult to be a woman.

What does SAD look like?
How do you test for it? Here’s the problem…there are no definitive tests for SAD thus it becomes a diagnosis of exclusion, meaning it’s a diagnosis reached by a health care provider if after performing an evaluation or testing they cannot determine a differential diagnosis.

How can you treat it? Since we don’t know exactly what causes SAD, we cannot definitively determine a successful treatment strategy. Despite not knowing the exact cause of SAD, several treatment strategies have proven successful in the past 25 years.
Possible Causes and Treatments: 
Sunlight – Though SAD can be diagnosed in any season, more cases seem to be reported in winter months in cold weather climates. As the days get shorter, the amount of sunlight we receive decreases. This not only has an affect on our “tan”, it also has a significant effect on our hormones. Melatonin (which plays a major role in our sleep/wake cycles) increases as exposure to sunlight decreases. Elevated levels of melatonin can improve sleep quality but when melatonin levels increase too much it in can also result in feelings of lethargy and excessive affinity for beanbag chairs, lava lamps and Pink Floyd music – you know what I mean? – “I’d be a lot cooler if you did” – Dazed and Confused reference for you Matthew McConaughey movie buffs.

Back to the point- in the same way Melatonin INCREASES with decreased exposure to sunlight, Serotonin levels DECREASE with decreased exposure to sunlight. This is a big problem since Serotonin levels are directly related to your “mood”. Adequate levels of Serotonin are crucial to elevating mood and can play a big part in alleviating the depressive symptoms associated with SAD. It may sound crazy but sunlight directly affects our serotonin levels and thus, our mood. So what do you do when you live in an area with long, cold, dark winters? Move.  But if that’s not an option – try installing full spectrum lighting in your house.

Full spectrum light contains infrared (IR) and ultraviolet (UV) wavelengths, which despite popular belief are necessary for optimal health. Problems begin when people get too much UV exposure - which is probably not the case if you are living in a northern climate and suffering from SAD. Full spectrum bulbs range widely in quality and can be expensive to purchase (I have seen high quality full spectrum bulbs sell for $30-$40 each).  Though they are typically more energy efficient, which will reduce your energy costs, full spectrum bulbs can have significant effect on the winter blues.

If changing light bulbs doesn’t seem like your cup of tea, try changing your diet.

Proper nutrition plays a crucial role in the production of neurotransmitters and hormones – which in turn directly affect the symptoms of SAD.

Vitamin D  Sunlight plays a key role in our ability to maintain adequate serum levels of vitamin D. Direct sunlight facilitates Vitamin D production in the skin. Research suggests that if you live north of 40 degrees of latitude (or south of 40 degrees in the southern hemisphere) it is difficult to maintain adequate Vitamin D levels year round, creating a window for a drop in Vitamin D levels and an increase in the occurrence of SAD symptoms. Supplementation of Vitamin D can be effective in raising serum levels quickly and thus is should be monitored closely by a qualified health care practitioner.

Carbohydrate Cravings  - Decreased levels of serotonin can also result in the carbohydrate cravings commonly described in the list of SAD symptoms.

Nutritional interventions can be successful at alleviating these symptoms. Since Tryptophan (an amino acid) is a precursor of Serotonin, consuming Tryptophan rich foods can increase Serotonin production and help alleviate symptoms.  To this point I have not been able to find significant research to support the Tryptophan-SAD link though empirically I have found that increasing Tryptophan in the diet (in food and supplement form) can help alleviate symptoms associated with SAD.  

Where can you find Tryptophan?  The first food everyone mentions is Turkey, and yes, Turkey does contain Tryptophan, but really all meat and seafood caries significant levels of Tryptophan – thus eating meat is important.

I also like a Magnesium and Tryptophan supplement that includes Magnesium Taurate, Glycinate, Fumarate, Orotate and 300 mg of Tryptophan to supplement the diet in some situations.

Beyond Tryptophan, steps can also be taken to increase the consumption of foods to boost Serotonin. Basmati rice (more so than other varieties of rice do to its less damaging effects on blood sugar levels), apricots, apples, pears, grapes, plums, grapefruits and oranges, when combined with adequate levels of omega-3 fatty acids, can improve Serotonin levels. If that doesn’t work, you could try a Using a 5-HTP supplement which have been shown to increase Serotonin levels quickly, though it is best to have this monitored by a qualified health care professional.

Weight Training:  Research has long suggested the correlations between weight training and resolution of depression symptoms. I am not aware of any research to support direct link between SAD and weight training, however, there is research to support a negative relationship between cardio training (especially late in the day) and an increased occurrence of SAD symptoms. This is not said to discourage people from running but rather recommending the inclusion of significant weight training to reduce symptoms of SAD.  And no, “band training” doesn’t count.

Here is what you should take away from this discussion: 

  • Seasonal Affective Disorder or SAD is a classification for depression occurring the same time every year.
  • It is more common in women than men.
  • It is more common in northern climates (north of 40 degree latitude) in the fall and winter.
  • There is no definitive cause or test for SAD.
  •  SAD may be linked to low sunlight exposure, low levels of Vitamin D, low serotonin levels and elevated levels of Melatonin

This is a list of steps you could take at home to improve SAD symptoms.

  • Install full spectrum lights in your home (and office if you can)
  • Consume 3g of pure epa/dha omega-3 fatty acids per day.
  • Take a Vitamin D3 supplement (consult with a qualified health care practitioner for an appropriate dosage)
  • Take Magnesium with Tryptophan supplement.
  • Eat meat with every meal (Doesn’t have to be turkey to work)
  • Consume certain foods to raise Serotonin levels.
  • Take a 5-HTP supplement to increase Serotonin levels.
  • Weight training for one-hour at least 3 times per week.
  • Hydrate – every process in the body is improved with hydration.

In addition to adding full spectrum bulbs, eating meat with each meal and weight training at least 3-hours per week, if you are interested in trying a supplement program, one recommendation might look something like this:
Vitamin D3- 2,000- 10,000 IU per day (again dosages range greatly and should be adjusted for you by a qualified health care professional)
Omega-3 – 1-2g of pure EPA/DHA oil per meal.
Magnesium with Tryptophan – 250 mg – 1,000mg in the evening
5-HTP – 50mg -600 mg per day can have an effect though it may be best to take 100-200 mg three times per day.

As always, Statements on this blog are intended for educational awareness and do not replace the recommendation of your personal medical professional. Before beginning any exercise, nutrition or supplementation programs always speak with a qualified medical professional and decide which programs are right for you.

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