Diagnosing illness is a tricky business. Most doctors do their best to help patients, but certain conditions are very similar to others, and teasing them apart can be difficult. For many physicians, seasonal affective disorder (SAD) is an ailment that flies under the radar, and it’s easy to see how it can be overlooked or mistaken for something else. The symptoms, which occur in women (like my patient, Elinor) far more often than men, include:
- Low energy or fatigue
- Increased appetite
- Weight gain
- Brain fog
- Carbohydrate cravings
- Lack of interest in favorite activities
- Excessive sleep without feeling rested
- Outbursts of anger or irritation not typical of the individual
All these symptoms can be mistaken for ordinary depression. But antidepressants, the usual remedy for that condition, seldom work on SAD because it’s really a different beast altogether. SAD symptoms appear to be triggered by seasonal events — fewer daylight hours and overcast skies — that interfere with the body’s circadian rhythms and neurotransmitter production.
When there’s less daylight and fewer opportunities for sun exposure, levels of serotonin, the body’s own “feel good” chemical, plummet. Our bodies attempt to increase serotonin by triggering a craving for carbohydrates. As I wrote recently, carbohydrates are important ingredients in serotonin production. But in cases of SAD, eating more carbs does not fix the problem. Instead, it leads to weight gain, sleepiness or fatigue, and even more carb cravings. Fortunately, there are ways to turn SAD around and enjoy the winter season.
How to Stop Being SAD
If you recognize SAD symptoms as something occurring in your own life, please read on. Many doctors write antidepressant prescriptions for SAD patients without considering other treatment options. And that’s really a shame because antidepressants fail to help a significant number of SAD sufferers, and the side effects of the drugs themselves can be very serious.
Instead of symptom-masking drugs, I recommend the following three steps:
- Eat an anti-SAD diet. Proper balance of key nutrients is important for everyone, but that’s especially true for SAD sufferers. Balancing carb intake with the right proportions of protein and fats is a must if you really want to free yourself from this condition. I also suggest avoiding sugar. Sweets seem to make the condition worse for most of my patients.
- Exercise regularly. Exercise is one of the most effective remedies for ordinary depression, and it works well for SAD, too. As I’ve said many times, you don’t need to become a professional athlete to reap the rewards of exercise. Simply set aside 20 to 30 minutes each day to walk, dance, or engage in some other activity you enjoy. If the weather’s bad, you can always walk in place indoors. In fact, you can combine your daily workout with a bright-light box (see below for details) for even bigger improvements.
- Use natural remedies. Based on results among my own patients, a handful of nutrients exist that can help turn SAD around. They include vitamin D, essential fatty acids (EFAs) rich in omega-3s, melatonin, 5-HTP, and/or GABA.
- Vitamin D: Low levels of vitamin D are very common among older patients. Our bodies need direct sunlight to make vitamin D, which means exposing bare skin without sunblock. Unfortunately, even if you live in a climate where this is possible during winter, many older people choose to avoid sun exposure; and even those who do spend time in the sun may not be able to produce vitamin D, since that ability decreases with age. As a result, many seniors suffer from a vitamin D deficiency. The remedy here is simple: Take vitamin D supplements. One recent study found that individuals diagnosed with SAD who took vitamin D improved during the one-month trial, while those who did not take vitamin D did not feel better at the end of the study. Start with 1,000 IU daily. You can also have a simple blood test to determine the appropriate dosage.
- Essential fatty acids (EFAs): Also known as good fats, EFAs are one supplement I recommend to just about everyone, but particularly patients with emotional difficulties, including SAD. Fish is a good source of EFAs, but since heavy metals and other toxins pollute most fish, I recommend Calamarine, a toxin-free supplement rich in omega-3s. And because vitamin D and essential fatty acids are so important to heart and brain health, I’ve combined them in my Omega D3 formula to maximize their benefits.
- Melatonin: A naturally occurring hormone, melatonin is another supplement I recommend to SAD sufferers. Normally, melatonin is released in response to the daily cycle of light and dark, with production peaking between 10 p.m. and 2 a.m. Unfortunately, as we age, melatonin production decreases. If you’re tossing, turning, and doing just about everything except sleeping in the wee hours of the night, a melatonin deficiency could be the problem. Since a melatonin shortage also plays a role in SAD, supplements can solve both problems. I encourage male patients to take 3 mg about 30 minutes before bedtime, while females should take 2 mg. Melatonin has few, if any, side effects. In addition, low levels of melatonin are linked to Alzheimer’s, heart disease, various types of cancer, type 2 diabetes, and a long list of other disorders, so this is one nutrient you don’t want to ignore.
- 5-HTP (5-hydroxytryptophan): SAD sufferers may want to consider adding the supplement 5-HTP to their daily regimen. This amino acid helps increase levels of serotonin, the brain neurotransmitter linked to feelings of well being. I suggest taking 100 to 400 mg daily.
- GABA (gamma-aminobutyric acid): Similarly, the neurotransmitter GABA helps us relax, focus, and deal with stress. I recommend a dose of 200 to 750 mg daily.
Finally, check out bright-light boxes and broad-spectrum light bulbs. Studies show that some individuals with SAD respond well to the light boxes, which mimic the sunlight we would obtain outdoors, without risking exposure to harmful UV rays. Instructions with most of these units recommend 30 or so minutes of use each day, so you can combine your light-box time with exercise and take care of two birds with one stone! Another option is to use a lamp with broad-spectrum light bulbs. Some of my patients use them at their desks or while reading to get an extra boost of light during winter.
As you can see, there are plenty of options for treating seasonal blues, so please don’t suffer through another winter. With a few well-chosen supplements, a little exercise, and a well-balanced diet, you should be back to normal in just a few weeks — with plenty of time left to enjoy the holiday season!