By: Lisa Murray-Doran N.D.
Natural Treatments: Light Therapy
Other Easy and Practical
Suggestions
Contact and Consultation Information
Mammals
naturally want to hibernate in the winter, and many humans feel as if they
would like to just curl up and sleep for the entire winter as well. Seasonal Affective Disorder (SAD) is an atypical form of depression
related to changes in seasons. SAD is
cyclic and seasonal with symptoms coming back year after year, tending to
come and go at about the same time every year. The changes in mood are not
necessarily related to obvious things that would make a certain season
stressful (like regularly being unemployed during the winter). Signs and symptoms usually occur only in the
darkest of winter months — when days are very short and nights are very long –
however some people who suffer from SAD report that their symptoms can begin as
early as mid September and last until March in Canada. Some researchers believe that a lack of
sunlight disrupts the body's daily (circadian) rhythms, which regulate your
internal clock.
Over 75% of sufferers are women & the Great Lakes
region is one of the most affected areas in North America.
SAD is likely due to an imbalance of the two
neurotransmitters – Serotonin &
Melatonin. The production of these neurotransmitters is controlled by the
pineal gland which is located at the centre of your brain and is sensitive to
natural light.
Melatonin is produced in darkness; with high levels of
this hormone you have symptoms of depression, fatigue, anxiety & require
more sleep. The decreased hours of daylight allow for an increase in melatonin
in winter.
Serotonin production is also lower in the winter, which is unfortunate as it accounts for calmness, feeling of well being & decreased stress and anxiety. One of the chief symptoms of SAD is a marked increase in appetite – especially a craving for carbohydrates, which often explains the resulting weight gain SAD sufferers remark on. As we increase the consumption of carbohydrates, our serotonin levels increase and so do positive feelings. So it is important to learn about other ways to assist in increasing our bodies serotonin levels.
SAD is characterized by the following symptoms:
·
A
change in sleeping patterns (don't feel refreshed after oversleeping, can't get
out of bed, you need to take a nap during the day)
·
Extreme fatigue
·
increased appetite
·
increased craving for carbohydrates (especially in
evening)
·
weight gain
·
decreased concentration
·
decreased libido
·
withdrawal from family & friends
·
feelings of depression, anxiety & irritability - you experience feelings of
despair, guilt, anxiety and hopelessness
·
Everyday
chores become very hard
·
Lack
of feeling/emotion
·
Joint
pain
·
Stomach
problems
·
Lowered
resistance to infection
·
Behavioural
problems (usually in young people)
·
P.M.S.
that gets worse or only happens during the winter
·
A
decrease in productivity
·
Feeling
sad all the time
Traditional
antidepressant drugs such as tricyclics are not
usually helpful for SAD as they exacerbate the sleepiness and lethargy that are
symptoms of the illness.
The
non-sedative SSRI drugs such as sertraline (Lustral), paroxetine (Seroxat) and
fluoxetine (Prozac) are effective in alleviating the depressive symptoms of SAD
and combine well with light therapy.
Other
psychotropic drugs e.g. lithium, benzodiazepines have not proved widely useful
in the treatment of SAD.
Since
lack of exposure to sunlight seems to be a key cause of Seasonal Affective
Disorder, light therapy can make a big difference in your mood. This consists of exposure to intense light under
specified conditions. Light therapy works by
suppressing melatonin secretion in the early morning, which can negatively
affect the biological clock or circaidian rhythm. Exposure to specific UV wavelengths (full spectrum) for a
designated period of time (usually in the morning) relieves most or all
symptoms in 80% of those affected.
Light
therapy, especially dawn simulation in which full spectrum light is gradually
increased in the morning, resets one ' s biological clock and keeps SAD in
check. Between opaque blinds and a dawn simulator, you can decide to have dawn
in your life every day at 6:30am - and your body gets used to that. This works well for those who have trouble
adjusting to the time change in winter.
You will feel happier, more interested in life and doing things."
Generally
a combination of light boxes with full-spectrum lights at intensities up to
10,000 lux and a dawn simulator work
best together for the prescribed phototherapy.
Light boxes are a box containing a set of special
fluorescent bulbs with a diffusing screen. The screen helps block harmful
ultraviolet (UV) rays. Patients are asked to read or relax close to a light box
for 30 minutes each morning.
In
a 1998 conference on positive and negative effects of ultraviolet light,
sponsored by the National Institutes of Health, Dr. Rosenthal, the Georgetown
University researcher who was part of a group that first coined the term
"SAD" in 1984 told
researchers and government officials he had encouraged some patients to try
tanning, and that indoor tanning seemed to improve their moods, raising
speculation that a formal study on the effect of tanning on SAD should be
conducted. Minimum use of a tanning bed
could be employed by patients – 10-15 minutes once a week, during the darkest
part of the year with the following cautions:
the light sources in tanning beds are high in ultraviolet (UV) rays,
which harm both your eyes and your skin.
Exposure to UV light increases your risk of skin cancer, including
melanoma, cataracts and premature aging.
Exercise
increases the body' s production of endorphins - chemical substances that can
relieve depression. In combination with
light therapy and whole, live, fresh foods it is essential to get regular
moderate outdoor exercise in the winter – morning & lunch time runs and
walks are a great way to add to your light exposure (vit D)and to your fresh air!
Winter sports are also wonderful things to investigate – skating,
skiing, snowboarding (no, it’s never to late to learn), and snowshoeing all can
boost the feeling of
well-being and increase blood flow. As little as three hours per
week of aerobic exercises can profoundly reduce the level of depression. Gentle
exercise and relaxation techniques such as yoga, pilates, swimming and
meditation or chi gung can all help to maintain harmony in body, mind and
spirit. One of the most energizing exercises is yoga. Yoga
exercises allow more oxygen to enter the system, relaxes the mind, stretches
the muscles, and improves blood circulation. Exercise alleviates mental stress
and increases blood flow to the brain.
The
mainstay of a healthy lifestyle is of course our daily diet, and it is
important to keep a special eye on what we eat/drink during the winter months.
Whole, live, fresh foods is a general rule of thumb to remember. It's a good idea to try to eat organic,
seasonally available foods as they are likely to be fresher, and they'll also
be better for you and the environment as they won't have been treated with
chemicals or flown half way around the world.
Eat
plenty of fresh fruit and vegetables, good quality proteins (beans, nuts,
seeds, chemical-free fish/animal products) and complex carbohydrates (whole
grains). Try to avoid too many cold, chilled or mucus-forming foods such as
dairy products in this season as they weaken the immune system. Instead have
lots of homemade soups, stews, and casseroles and eat steamed rather than raw
vegetables.
Also,
drink plenty of fluids (6-8 large glasses of water a day), ideally at room
temperature or above, to ensure adequate hydration and flush the body of
infection which SAD sufferers are more prone to.
It's
also important to keep your blood sugar stable. To maintain normal blood sugar,
eat small but frequent meals every two to three hours. A small snack, such as
fruit, is always a good choice. Healthy
proteins and minimizing simple carbohydrates such as sugar are also key points
in maintaining healthy blood sugar levels
Omega 3 Fatty Acids
Fish oils have been shown
to be deficient in people who suffer from SAD.
Omega-3 fatty acids are important for all around optimum brain function.
Good sources of Omega 3 fatty acids (and vitamin D) include cod liver oil,
salmon, mackerel, nuts and seeds. Cold water fish is also high in vitamin A and
B, which are key nutrients. Salmon oil
could be supplemented at 2000mg a day
Vitamin D
Supplementing with vitamin D can help alleviate SAD, as well. Low blood levels of vitamin D correlate with a higher incidence of winter time depression. Patients with SAD and low blood levels of vitamin D who supplement with vitamin D have significant improvement in their symptoms of depression. The recommended RDA of Vitamin D, is 400 IU.
B vitamins are also
effective in helping maintain adequate serotonin levels. The B-complex
supplement should contain the essential B vitamins, which are thiamin,
riboflavin, niacin, vitamin B6, vitamin B12 and pantothenic acid. B2
(riboflavin) is found in brewer's yeast, wheat, meat and dairy products. B6 is
found in lean meat, fish, brewer's yeast, wheat germ, peas, soybeans, and
cooked dried beans. If supplementing
with a B complex take a B Stress 100mg complex.
Tryptophan
Tryptophan, an amino
acid, has been found to relieve depression because it is the precursor to
Serotonin. Therefore increasing the
available levels of Tryptophan may help to increase the levels of serotonin
produced by the body. Tryptophan has been taken off the market in Ontario,
however, Tryptophan occurs naturally in many foods. Eating these foods with a
carbohydrate, such as potatoes, pasta or rice, can facilitate the brain's
intake of tryptophan. Foods with natural sources of tryptophan include: fish,
whole-grain cereals, vegetables, fruits, lean meats, and low-fat dairy
products. Another form of Tryptophan,
5-HTP has proven safe and effective in many patients. Recommended dose is 50-100mg a day of 5-HTP.
Phosphatidylserine
(P.S)
Phosphatidylserine (PS) ,
a natural substance derived from the amino acid serine, affects
neurotransmitter levels in the brain that affect mood. In a controlled trial,
older women given 300 mg of PS had significantly less depression compared with
placebo. 30 After forty-five days, the level of depression in the PS
group was more than 60% lower than the level achieved with placebo.
Other Supplements
Antioxidants such as vitamins A, C, E, selenium and zinc are ideal daily supplements (500 mg-1000mg in divided doses), and they can also be found naturally in many foods such as kiwi fruits, avocados, berries, nuts, and seeds. A high quality multivitamin is also a very good idea to begin.
Hypericum Perforatum
(St. John’s Wort)
Depression is associated
with low levels of serotonin, which is a neurotransmitter that establishes a
sense of psychological well-being. St.
John's wort, enhances levels of two neurotransmitters, serotonin and
norepinephrine, thus countering depression.
St. John's wort also increases melatonin levels, which helps seasonal
affective disorder and related depression.
Melatonin triggers sleep
and lowers body temperature. The result of the increase of melatonin caused by
St. John's wort is that day/night and sleep/wake cycles are regulated. Research
has shown that light therapy combined with a daily consumption of St. John's
wort has a strong antidepressive effect. St. John's wort is also known to
improve the ability to dream during sleep, which may be an important part of
stress management.
Many studies confirm the
effectiveness of St. John's wort. One study published in Germany found a 70%
response rate among 97 patients who received 100-120 mg of St. John's wort
extract. The researchers stated that, "Treatment resulted in an appreciable
improvement in the symptoms of depression, and the 70% response rate
corresponded to that of chemical antidepressants. The substances were extremely
well tolerated, and no side effects were reported by any of the patients."
(Fortschritte der Medizin, vol. 113, p. 408)
Clinical
trials suggest that the best results are seen after 4 weeks. Those using
prescribed antidepressant or antiepileptic medication should ideally seek the
advice of a practitioner. In the German Commission E monograph, the amount St.
John’s Wort taken is typically based on hypericin concentration in the extract,
which should be approximately 1 mg per day. For example, an extract
standardized to contain 0.2% hypericin would require a daily intake of 500 mg
(usually given in two divided dosages). Many European studies use higher
intakes of 900 mg daily and this has become the accepted daily dosage in modern
herbal medicine. Recent research suggests, however, that hypericin is not the
antidepressant compound in St. John ' s wort, and attention is starting to
shift to the compound known as hyperforin. As an antidepressant, St. John ' s
wort should be monitored for four to six weeks to check effectiveness. If
possible, St. John ' s wort should be taken near mealtime. Caution anyone on
any medication should consult their Doctor before taking this product.
Kava Kava (Piper
methysticum)
Kava (Piper methysticum)
is a natural remedy for depression. This plant has been used for years by South
Pacific islanders - in Polynesia, we find that a drink made of the root
has traditionally been used to lift the spirits. It is a calming plant that elicits a feeling of
well-being and contentment. In one
of several clinical studies, kava helped more than 50 people reduce both
depression and high anxiety levels - a difference was noticed after only one
week. And in a study conducted in Germany in which kava was given to women
suffering from anxiety, depression and other symptoms associated with
menopause, the symptoms were relieved, and the women reported an increased
sense of well-being. According to German researchers who measured the brain
waves of people subject to anxiety, kava has been as effective in treating some
forms of anxiety as the powerful tranquilizers known as benzodiazepines. And
unlike this drug and others used for similar purposes, kava does not dampen
alertness or lead to addiction. In fact, it improves alertness, vigilance and
memory. Kava is unfortunately no available currently in
Siberian
ginseng (Eleuthrococcus)
Eleuthrococcus
is what is called an “adaptogen” – meaning that it helps your body adapt to
times of stress (such as a prolonged light imbalance. In a study conducted in 1982, nurses who switched from a day to a
night shift were tested to see how efficient they were and how they reacted psychologically
as they struggled to adjust to their new routine. Some of them were given
ginseng to help them maintain emotional balance; another group was not given
anything. Those who took ginseng felt less moody and were much more steady
emotionally than those who did not take the herb.
Valerian
and Hops
Valerian
and hops are calming to the central nervous system. When volunteers took this
combination, several measurements showed that they experienced less depression
and anxiety. In fact, the herbs worked faster than if the subjects had been
given prescription drugs – hops and Valerian worked in only two weeks, as
opposed to the six weeks required for drugs. The herbs also caused far fewer
side effects. You should know, though, that if you are used to strong
prescription sedatives, herbs such as Valerian seem to have a harder time
taking effect.
Lemon
Balm
Lemon
Balm or Mellisa officinalis works through its lovely essential oils through the
oldest part of our brains – the limbic system to give us an over all feeling of
health, happiness and wellbeing. Best
used daily as leaves in a herbal tea combination, it can also be combined into
a tincture with other herbs and used effectively that way.
Ideal homeopathic remedies include actea racemosa, Arsenicum, Coffea, Lycopodium, Nat. Mur, Nux Vomica, Pulsatilla, Aveena Sativa, Kali phos, Ignatia and Sepia. Constitutional Homeopathics should be prescribed for you by a Naturopathic Doctor or a Homeopath after an extensive case- taking. Homeopathics are effective, strong medicines.
Chinese medicine incorporates a holistic approach that can benefit those each pattern is unique, so we individualize treatment for SAD depending on what the patient's symptoms are Our goal is to restore the balance between the organs, balance the yin and yang and get the chi (or energy) flow going. Tai chi, Qi gong and yoga are all practices that restore the proper movement of chi. A Naturopathic Doctor or licensed acupuncturist with training and experience in Chinese herbs can also prescribe a combination of acupuncture and herbs to ease the symptoms of SAD and boost your mood.
Aromatherapy helps
relieve depression by relaxing the body and reviving the nervous system. Some
of the herbal oils that are good for depression are geranium, rose, jasmine, frankincense, sage, orange, palmarosa,
neroli, yglang yglang and melissa; and citrus oils, such as bergamot, lime,
grapefruit and mandarin. An
aromatherapy blend can be made for you by an aromatherapist for use in your
home – used in a diffuser morning and evening these oils can help greatly with
depression. A caution to those using
aromatherapy combined with homeopathy – the strong smells of the aromatherapy
can antidote or counteract the effects of the homeopathic medicines you are
taking.
Some patients may require counselling and or psychotherapy to explore some of their issues that may be brought up during a depressive episode. Speak to your Naturopathic doctor for a referral. Art therapy and other non-talking therapies such as body psychotherapy or craniosaccral therapy may also be indicated.
·
Inspire yourself!
Decorate in bright colors and surround yourself with attractive and
interesting things such as pictures, quotes
or mementos that can lift your mood.
·
Dance in your kitchen! Another way of cheering up is to
play some music. Music has long been used in the treatment of mood states,
listen to what you enjoy and what makes you feel better. Better yet, if you
play an instrument, get it out and regale yourself with some tuneful melodies.
Just avoid playing songs in minor, weepy keys. Don't listen to depressing music
when you are depressed.
·
Stay out of department stores. Just as snapping at other
people can have a boomerang effect on your depression, so can shopping binges.
That is, while they can be loads of fun, they can come back to haunt you when
the bills come in.
·
Many depression triggers come from your own thinking. When
you're criticized or something doesn't go the way you planned, the brain goes
into overdrive with thoughts like, I'm the worst worker ever or I'm a terrible
parent You convince yourself of your faults and fall right into depression. One
way to get out of this negative-thinking rut is to ask yourself for proof. Stop
and ask yourself to back up your own statements with evidence. Where does it
say I'm a loser, a failure in life? If we dispute the ideas, then we see that
they aren't true.
·
Journal! Write
down your negative thoughts. Then you can study your thinking patterns and work
on challenging and changing them. A
tecnique called Junk Journalling is often very effective during depression –
write down everything you are thinking for 20 mins – use a timer with an alarm
and stop when it goes off – your writing doesn’t have to have proper punctuation,
neat handwriting or even be complete
thoughts – just write what you are thinking.
And when the timer goes off quit!
When you are finished you can keep what you’ve written and re-read it –
or you can throw it away – as junk – as an exercise to get at what feelings lie
deeper. Writing a journal can also help
you realize when bouts of the blues are coming. Sometimes, the low feelings
creep up on you, but with a journal you can analyze what you're feeling and
compare it to other times when you have felt low. Keeping a journal helps
people put their feelings in black and white rather than allowing them to
explain away their feelings and not pay any attention to them.
·
Get busy. Do you have a hobby? Take up knitting or sewing or reading. Invite a friend out for
tea, throw a dinner party, take pottery lessons. Be social and initiate social activities if possible. If you can keep yourself busy, it will help,
because staying active can prevent you from dwelling on whatever is making you
feel unhappy.
·
Avoid television.
It is easy to get sucked into watching 2-3 hours of television every
night – in general the programming is bad, the amount of violence is
unacceptable and most television shows
take place in such unrealistic, artificial “perfect” environments that they
make us feel inadequate. Research has
shown that mood, immunity, and wellbeing are all increased when television is
eliminated.
·
Avoid drugs, alcohol, and caffeine. Drugs and alcohol can
bring on depression or make it worse if it's already there, and if you use
caffeine to climb back to a high after you have experienced the lows of drugs
and alcohol, you're likely to mess up your health and sleep patterns. "
You start to drink alcohol to get to sleep. Then you start to rely on caffeine
to get you up. This can emphasize depressive symptoms, " . With those ups
and downs, you'll probably feel more lethargic and potentially depressed and
possibly anxious.
·
Avoid making major decisions. You can't really trust your
judgment when you're depressed,. Life decisions should be put off till you're
feeling better, lest you make the wrong decisions, which, of course, can only
drag you down further.
The treatment for SAD can be very effective, and under the guidance of a Naturopathic Doctor, very successful. It is always important to keep in mind that with the treatment of all mental/emotional disorders being under the care of a licensed professional is recommended rather than self diagnosis and prescriptions.