Right about this time of year, there tends to be a shift in the mood of some individuals. For Susan, it started the first week of December. Susan noted changes in her well-being. She was feeling down, highly irritable, excessively fatigued, dealing with a frustrating 10 lb weight gain and a desire for extra sleep. Upon a visit to her primary care physician, she was informed that she was suffering from SAD (Seasonal Affective Disorder), a prevalent mental health issue.

What Susan is experiencing is not unique; Seasonal Affective Disorder (SAD) is a form of depression that comes and goes in a seasonal pattern. Some refer to it as a severe form of the winter blues as it often begins/occurs during the fall or winter seasons every year with spring/summer remission. In North America, the prevalence of SAD increases with latitude.  

For many years researchers for The National Institute of Health (NIH) have been studying the “winter blues” and Seasonal Affective Disorder (SAD). They have learned about possible causes and found treatments that seem to help most people. Still, much remains unknown about these winter-related shifts in mood.

What Causes SAD

SAD tends to be triggered by circadian rhythm dysregulation (shorter days and lack of daylight). Reduced sunlight exposure can trigger a chemical imbalance in the brain that affects your sleep-wake patterns (circadian rhythms). Some individuals with SAD produce excess melatonin (the sleep hormone), which can leave you feeling drowsy, disoriented and sleepy throughout the day

Reduced activity of the feel-good neurotransmitter serotonin is lowest in the winter season) which some researchers equate to the lack of adequate amounts of sunlight. Low serotonin levels could lead to depression and adversely affect sleep, appetite, memory and mood.

Signs and Symptoms

• Watch for your blue mood to last all day and for more than two weeks.
• Do the feelings of sadness affect your performance and relationships at home, work, or school?
• Pay attention to changes in appetite and weight, sleep problems, withdrawal from family, friends, hobbies, etc.
• Do you have periods of agitation, irritability, fatigue, anger, crying and loss of concentration?

You may experience some aspects of SAD during the winter but do not meet the diagnostic criteria for this mental disorder. Periodic episodes of sadness during winter are more recognized as the “winter blues,” and a few good days of sunshine are enough to re-establish your well being

Other symptoms of depression include:

• changes in appetite and weight
• sleep problems
• loss of interest in work, hobbies, people or sex
• withdrawal from family members and friends
• feeling useless, hopeless, excessively guilty, pessimistic or having low self-esteem
• agitation or feeling slowed down
• irritability
• fatigue
• trouble concentrating, remembering and making decisions
• crying easily or feeling like crying but not being able to
• thoughts of suicide (which should always be taken seriously)
• a loss of touch with reality, hearing voices (hallucinations) or having strange ideas (delusions).

Solutions for SAD

The severity of your symptoms should dictate what wellness path you choose. Each person’s experience with SAD is different, and more severe symptoms should be addressed with your health care professional. They may suggest daily light therapy (exposure to fluorescent lights), often the primary treatment for SAD. Daily light therapy exposes an individual to a bright lightbox (10,000 lux) that stimulates sunlight.   Other therapies may include cognitive behavioural therapy (CBT), which develops skills to improve coping through the SAD season, and if required, anti-depressants

Exercise generally aids in the natural production of endorphins (the feel-good hormones).   But morning exercise, especially outdoors or under light, is even more important for individuals suffering from SAD. Note that exercise late at night may not be ideal for SAD as it can disrupt the onset of melatonin release, impacting sleep.

Researchers have linked a Vitamin D deficiency with SAD, winter blues and other forms of mild depression. Vitamin D may play a role in the production of serotonin and dopamine, the “happy chemicals that tend to be low when a person suffers from SAD. Vitamin D also helps to regulate hormones to ensure they are active in producing energy and vitality.

Consider increasing your B vitamins which help to stabilize the central nervous system and the chemical-sending messengers that control mood within your nervous system. A deficiency in B Vitamins can cause tiredness, nervousness, irritability, depression and insomnia.

5-HTP (5-hydroxytryptophan) is a precursor to serotonin, which we know to be the happy hormone that transmits a feeling of happiness and joy. Serotonin also helps regulate melatonin production and stabilize the body’s sleep-wake cycles. 

St John’s Wort is an herbal supplement still used in Europe today as a natural alternative to anti-depressants, following the same pathways of healing the brain (serotonin) that prescribed medications for depression do. St. Johns Wort helps relieve restlessness and nervousness, helps to promote healthy mood balance and reduces sleep disturbances associated with mood imbalance. Due to the metabolic action of St John Wort, it cannot be taken if you are already using prescribed medications for depression. It can take up to 4 weeks of regular St John’s Wort use before you see results.

Alternatively, you can try SAMe (S-adenosyl-L-methionine). This supplement tends to work more quickly than St John’s wort but maintains the same benefits. The difference is that there are fewer long terms studies for SAMe. SAMe will have similar side effects to St John’s Wort and cannot be used with any prescribed meds for mood disorder or depression. In some cases, the SAMe may cause insomnia, dry mouth and dizziness. Both supplements may also interfere with blood thinners and other prescribed medications.

Consume fatty fish rich in omega-3 EPA/DHA (salmon, herring, sardine, mackerel) or supplement with high-potency fish. A medical review on fish oil indicated a beneficial effect of EPA plus DHA supplementation on depressed moods.

Modifications in diet and lifestyle (don’t forget the exercise!) can benefit the winter blues and SAD. Find out what works for you, and even on those dull gray days, try to look on the bright side and find the best things that winter can offer.

Depression, no matter the type, can feel incredibly isolating. Reaching out to friends and family and establishing a support network is imperative to care for your mental health.