Seasonal Affective Disorder
Updated: Mar 31, 2020
Seasonal changes can change more than just the weather...
Seasonal Affective Disorder (SAD) is a combination of biochemical imbalances and mood disturbances that occur with a seasonal pattern; typically occurring in the autumn and winter, with remission in the spring or summer. Although the condition is seasonally limited, people effected by SAD experience significant impairment from these seasonal changes. SAD primarily presents as a type of depressed mood with symptoms like having low energy, difficulty sleeping/hypersomnia, losing interest in activities and socialization, difficulty with concentration and changes in appetite. It can also show up differently in people with other mental health concerns - like hypomania in the spring/summer in people with bipolar tendencies, or summer depression with winter hypomania.
SAD has a prevalence of 1.5-20%, depending on your latitude from the equator, and may be associated with low vitamin D levels. Studies have also examined the relationship with suppressed cortisol excretion, disrupted cortisol awakening response (CAR), imbalance of neurotransmitters (like serotonin and melatonin), and have noted that it is more common in those who experience mood variability throughout the year. In Canada, youth and teens (12-24) typically display symptoms of low mood and low energy, while adults tend to display symptoms related to sleep and appetite disturbance. Summer SAD may be associated with high airborne pollen days, as some studies have made this connection with an exacerbation of depression and seasonal variability.
With so many factors at play, it is important to figure out how the seasons are effecting you so we can properly address and treat your concerns. As a Naturopathic Doctor, to me this means treating the underlying root cause and supporting the body as it needs to be supported. While this looks different for everyone, things we would be considering include
digestive function, immune function, and the make up of your microbiome
nutrient deficiencies like B vitamins, vitamin D, Omega 3 Fatty Acids and dietary patterns that support appropriate neurotransmitter and catecholamine production
treating any underlying mental health concerns with things like natural health products, botanical medicine, acupuncture, and therapy
address any underlying conditions that may be contributing to the problem (eg. hypothyroidism, hormone imbalances, chronic pain, chronic fatigue syndrome, adrenal insufficiency, chronic viral infections etc)
Things you can do at home to help improve the outcomes of your Seasonal Affective Disorder are effective, fairly simple to maintain, and can be used as prophylaxis before the subsequent autumn/winter seasons.
1) Review Your Whole Health: Review your foundations and make note of where you may be able to make adjustments in your everyday choices - Are you eating well? Sleeping well? Managing your stress? Are you moving enough? Are your thought patterns more positive or negative? What are you doing for self-care? Are you taking time to acknowledge and meet your foundational and emotional needs?
2) Journalling: If you’re experiencing seasonal affect, try writing out how you feel and brainstorming what could be contributing. Journalling can provide insight into the minute daily problems that we tend to accept; by laying everything out on a piece of paper, you may be able to understand and critically assess the issue(s) with better perspective. Try completing a Wellness Wheel Evaluation as a simple assessment tool to get you started. It’s important to figure out if how you feel is thought based, repetitive ongoing stress, or if theres something else going on that can be treated.
3) SAD Lamps: For 30 years, light therapy has been a first-line treatment for SAD. Studies have shown that using a lamp with 2,500lux (2 hours in the morning) - 10,000lux (30 minutes in the morning) shows clinical improvement in depressive symptoms within 1-2 weeks of use, and improves vitamin D levels after 1 month. To avoid relapse, light therapy should be continued daily, beginning in the fall through the end of the winter season until the remission of symptoms in the spring. People who experience SAD typically have a good understanding of when their mood improves; if you're unsure, track your mood to better understand yourself.
Get Inspired to Implement Change!
If you’ve been struggling with seasonal mood changes, it may be time to try something new. If you’re still feeling stuck or wanting more support and direction - its always okay to ask for help. Reach out to your naturopathic doctor, therapist, family and friends for support. If you're wanting to dig a little deeper into your mental health, I'd love to help.