It’s that time of year again in the Midwest; it’s cold, frequently dreary, and dark for nearly 15 hours of the day. For many, this is a recipe for seasonal affective disorder, also known as SAD. Those who experience SAD have recurring depressive symptoms during a particular season, usually fall and winter. Some of the more frequent symptoms include hypersomnia (increased sleep), increased appetite, and a craving for carbohydrates.
Sunlight is needed for adequate serotonin production; serotonin is a neurotransmitter that is important for good mental health. First line treatment for SAD is bright light therapy. If the sun is out, at least 30 minutes of sun exposure, either by spending time outside or sitting near a window where the sun is shining in, is effective. It is even better to get some exercise out in the sun, since exercise can also improve mood. If it is a dreary day, consider therapy with a light box. If your flash would come on when you take a picture, the light outside is not bright enough to benefit your mood. Options include a 10,000 lux white light box for 30-60 minutes per day, or a 460 nm blue light box for 30 minutes. To put 10,000 lux in perspective, a sunny day can provide up to 50,000 lux, while a room bright with artificial light will only provide about 400 lux. A normal home would be 100-300 lux.
In a study of 96 patients with seasonal affective disorder, those patients who received light therapy had similar improvement in symptoms as the group who received the antidepressant Prozac. The light therapy, however, resulted in quicker initial improvement. Some studies also support a benefit of adding light therapy to an antidepressant for depression, even if it is not seasonal.
A light box is best used within an hour of awakening. Eyes are the only part of the body that need to be exposed to the light for effect. The box should be situated 20-30 degrees away from your straight ahead gaze. Each box will have different instructions regarding how close the box needs to be positioned.
It is suspected that low vitamin D may also play a role in Seasonal Affective Disorder. Vitamin D is actually a hormone, and is synthesized in the skin after exposure to UV light. If very little skin is exposed to the sun (without sunscreen), it is not a bad idea to take a Vitamin D supplement, especially if you have a low mood.
Carbohydrate cravings in SAD are likely a response to the low serotonin, as carbohydrate rich meals will increase the amount of tryptophan that crosses into the brain. The tryptophan will then be converted into serotonin, which elevates your mood. Foods that are high in protein or fat may contain more tryptophan, but without the carbohydrate, they will not easily enter the brain. To prevent these cravings from resulting in weight gain, it is a good idea to eat a reasonable carbohydrate (fruit, whole grain bread or crackers). While pastries and cookies appear more desirable, many of them actually contain too much fat to facilitate the entrance of tryptophan into the brain.
Good quality sleep, physical activity, and social connection are other measures that will positively affect your mood. At Raydiant Wellness, we are always happy to work with you to craft a personalized program that will allow you to maintain good spirits and achieve optimal health this winter.
November 30, 2020
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