A multifaceted approach to treating seasonal depression

Photo Cred: Oleg Magni/Pexels

By Matthew Jachman

People experiencing an emotional “damp, drizzly November”—to quote the melancholy opening paragraph of Herman Melville’s “Moby Dick”—may be suffering from seasonal affective disorder (SAD), a form of depression triggered by the reduced daylight hours in the northern hemisphere.

Winter-pattern SAD is characterized by symptoms such as a consistent depressed mood, sluggishness, feelings of guilt or worthlessness, and a loss of interest in once-enjoyable activities, according to the National Institute of Mental Health (NIMH). The disorder has a recurring seasonal pattern, with symptoms typically appearing in the fall as the amount of daily sunlight diminishes and tapering off in the spring as daylight hours increase, the NIMH says.

Summertime SAD is recognized, but less common, the NIMH says. Its symptoms include insomnia, agitation, poor appetite, and incidents of violent behavior.

Millions of adults in the U.S. may suffer from SAD, women are more susceptible to it than men, and it is more often found in people with major depressive disorder or bipolar disorder than in the general population, according to the NIMH.

Wintertime SAD is linked to biochemical changes caused by reduced exposure to sunlight, changes that can throw off the body’s circadian rhythm, or biological clock, according to the American Psychiatric Association (APA).

The farther one lives from the equator, the APA says, the more likely it is that one will have SAD. Complicating the picture is that colder weather keeps more people indoors, further limiting their exposure to the sun.

“It’s not the cold, it’s not the winter per se, it’s the reduction of the amount of daylight,” said Mark Frye, MD, a psychiatrist at the Mayo Clinic in Rochester, Minnesota.

Professionals in whole-body health advocate a multi-pronged approach to combating SAD, the idea being that multiple remedies can work better in concert.

“We’re complex beings. There’s no one thing that’s going to fix everything, right?” said Michelle Simon, ND, PhD, the president and chief executive officer at the Institute for Natural Medicine (INM) in Seattle, Washington. “And everything is interrelated, so you have to assess the whole person to effect a cure.”

Here’s a look at some of the remedies for wintertime SAD prescribed by Simon and others who work in integrative medicine:

Supplementation 

Because vitamin D, which is closely linked to mood, is produced by exposure to sunlight, its levels tend to drop during the winter months among people in North America, said Dennis Godby, ND, a naturopathic physician in Sacramento, California.

Godby often prescribes a vitamin D supplement for those experiencing wintertime SAD. “The winter season, I call the vitamin D deficiency season,” Godby said.

The Mayo Clinic recommends 600 international units (IU) of vitamin D daily for adults up to 70 years of age, and 800 IU daily for those over age 70.

However, according to the National Center for Integrative and Complimentary Health, studies on the effectiveness of vitamin D supplements in treating SAD show mixed results.

Healthful eating

SAD sufferers should also make sure they’re getting enough vitamin B-12, maintain a healthy blood-sugar balance and eat a diet rich in omega-3 fatty acids, found in fish, nuts like walnuts, and seeds. Limits on caffeine and alcohol consumption are also important, Godby said.

A diet of whole foods, and restrictions on processed foods and sugars, can combat SAD and depression in general, said Simon.

“There is research to show that people who eat a lot of processed food and sweetened things are more likely to be diagnosed with depression,” she said.

Get moving

Exercise is also helpful in relieving depression, and especially important in fighting SAD, Godby said. Even on overcast days with limited sunlight, it’s better to exercise outdoors, he said.

“I’d rather people get outdoors, but even walking indoors … would be preferable to no exercise at all,” Godby said.

Let there be light

Frye recommends light therapy for many of his patients with wintertime SAD. Patients typically need a lightbox that produces 10,000 lux of light. Those with certain eye diseases, or who have a light sensitivity or are taking certain medications, may have to avoid lightboxes, the NIMH said.

Godby said getting outdoors, even if sunlight is diminished, is preferable to using lightboxes. Being active and outside is not only effective in treating SAD, he said, but good for health in general.

Traditional therapies

More traditional methods of countering depression, such as talk therapy and antidepressant medications, can also relieve SAD symptoms, Frye said.

“The thing that I would also always encourage is a full assessment of that person, and not relying on any one therapy,” said Simon, adding that untreated depression can have serious consequences. “It’s not to be taken lightly.”

About the Author

Matthew Jachman

Matt Jachman is a Detroit-area freelance journalist. A vegetarian for more than 40 years—and now an almost-vegan—he enjoys working out, music, theater, and film. He has an English degree from Wayne State University and is an early retiree from newspaper giant Gannett Co. Inc.