Wednesday, January 26, 2011

SEASONAL AFFECTIVE DISORDER (SAD)


by Denise Ann Rodrigues, R.N.C.P, R.O.H.P
Moving in to the winter months, longer nights and shorter days in winter arrives while longer days and shorter nights in the summer approaches which means less sunlight throughout the winter months and varying changes in the amount of sunlight we receive throughout different seasons.  This will of course affect our natural circadian rhythm (sleep and wake cycles) and the feel good hormone “serotonin” responsible for mood regulation.  The sleep hormone “melatonin” released by the pineal gland is decreased and stress hormone “cortisol” released by the adrenal glands is increased. Hmm, no wonder why we appear to be more stressed in the winter months and our adrenals are out to toast.
SAD is just another form of “seasonal depression” for which the causes are unknown by scientists but it has been acknowledged that sunlight reduction is a major contributor.  It can be very challenging to determine the difference between seasonal depression and other depression related conditions.  Serious cases involve substance abuse, school and work problems, suicidal thoughts.
Symptoms:
·        Depression
·        Hopelessness
·        Anxiety
·        Loss of energy
·        Social withdrawal
·        Oversleeping
·        Loss of interest in activities you once enjoyed
·        Weight gain
·        Difficulty concentrating and processing information
·        Appetite changes, especially a craving for food high in carbohydrates
Reverse seasonal affective disorder (hypomania) can occur in the spring and summer months as well.  These symptoms can result in bipolar disorder and includes:
·        Persistently elevated mood
·        Increased social activity
·        Hyperactivity
·        Unbridled enthusiasm out of proportion 
Get tested to see if there is a possible diagnosis if you believe you have SAD.  Clinically, antidepressants are used for seasonal depression, be open to other “natural alternatives” as well.
Counseling
Cognitive behavioral-therapy has shown to provide emotional support to patients suffering from this condition.  Psychotherapy is another option to treat this imbalance as moods can also affect how a person reacts and psychotherapy can teach someone how to let go of negative thoughts and manage stress.
Lifestyle Changes
Spending more time with loved ones and making your living and working environment brighter and sunny is beneficial. Positive thoughts and things, taking long walks and being in nature and sitting under a tree helps, regular exercise such as walking and biking has therapeutic benefits.  Acupuncture, yoga, meditation, massage therapy and guided imagery can be very helpful in managing SAD.
Melatonin
Melatonin supplementation helps regulate mood, seasonal changes affects melatonin level in the body as we talked about earlier.  Please consult a health care specialist before doing so.   
Light Therapy
Full spectrum light therapy is designed to replicate natural sunlight and known to be effective since controlled studies concluded that it works by restoring proper melatonin synthesis and secretion, stimulating normal circadian rhythms (natural 24 hour release of the body’s hormones) One can also try replacing standard light bulbs at home with full-spectrum light bulbs.  And don’t forget your Vitamin D, at the least 2000 IU’s per day.  You can double the dose in winter months by supplementing and maximize on food therapy.  Yes, fresh fruits and vegetables, at least 2 – 3 liters of water per day, 25-40g of fiber, optimal protein and carbohydrate intake.
St John’s Wort ( Hypericum perfoliatum )
St. John’s Wort extract given at a dosage of 300 mg three times per day has had positive effects at relieving SAD on its own.  Studies show a higher potency when used with the combination of light therapy.
Stick to the plan, no more winter blues!
·        Nurture yourself
·        Practice stress management
·        Always socialize and share feelings with loved ones
·        Take regular vacations to warm sunny areas and countries if you can
References
*Murray, Michael, N.D and Pizzorno,Joseph, N.D-Enclopedia of Natural Medicine, revised 2nd Edition: Three Rivers Press1997. pgs 792-793
*N. Rosenthal et al, Antidepressant Effects of Light in Seasonal Affective Disorders, Am J Psychiatry 142 (1985): 163-170
http://www.webmd.com/depression/tc/seasonal-affective-disorder-sad-topic-overview

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