Seasonal affective disorder (SAD) is a combination of biological and mood disturbances typically occurring in the autumn and winter months. SAD is characterized by recurrent episodes of depression, hypersomnia, carbohydrate cravings and weight gain.
About 5 percent of the U.S. population experiences SAD, with symptoms present for about 40 percent of the year, depending on where you live.
Light therapy, pharmacotherapy (antidepressants) and cognitive behavior therapy are common mainstream treatment options, but there are also a number of lifestyle changes that can be “affective” by increasing serotonin, a mood stabilizing neurochemical.
(Kurlansik, S. L., & Ibay, A. D. 2013) (Lurie, S. J., et al. 2006) (Young, S. N. 2007)
Mood Boosting Strategies:
- Diet
- Exercise
- Sunlight
- Supplements
Diet
Individuals with SAD frequently report carbohydrate cravings and note that carbohydrate ingestion energizes them.
In a study by Rosenthal, et al. 16 depressed SAD patients and 16 matched controls were fed two different isocaloric meals, one rich in protein and one rich in carbohydrates. The SAD patients reported activation following carbohydrate ingestion, whereas normal controls reported sedation.
(Rosenthal, N. E., et al. 1989)
Simple carbohydrate consumption can result in a temporary elevation in mood, however, elimination of the simple carbohydrates and refined sugar from the diet may result in a more permanent solution for mood stabilization.
The proposed mechanism by which carbohydrates exert their mood altering effect is through their influence on serotonin metabolism.
(Christensen, L. 1993)
Intake of n-3 long-chain polyunsaturated fatty acids found in cold water fish such as wild salmon, can affect mood via modification of neuronal cell membrane fluidity and the consequent impact on neurotransmitter function.
(Rogers, P. J. 2001)
Polyphenols, natural compounds found in plant-based foods that possess antioxidant properties, can reduce oxidative stress and aid in synaptic function. Because polyphenols have numerous mechanisms in the brain that can affect cognitive and mental health, a diet high in polyphenols (fruits and vegetables) can be used as a strategy to combat cognitive and psychiatric disorders.
(Gomez-Pinilla, F., & Nguyen, T. T. 2012) (Rechenberg, K. 2016)
Exercise
Exercise is an effective tool to ease depression due to:
- The release of “feel-good” brain chemicals including serotonin, endorphins and endocannabinoids
- The reduction of specific immune system chemicals, such as cytokines
- An increase in body temperature, which can have calming effects
The psychological effects of regular exercise include:
- Increases in self-confidence- Getting in shape can make you feel better about yourself
- Provides a distraction from the cycle of negative thoughts that can fuel anxiety and depression
- Facilitates social interaction, which can improve your mood
- Provides a healthy coping strategy
Utilising moderate to intense aerobic activity has a large and significant antidepressant effect and is strongly supported as an evidence-based treatment element for depression.
(Schuch, F. B. et al. 2016)
Middle-aged women participating in resistance training exercise have lower levels of depression and anxiety in relation to sedentary counterparts.
(Araújo, K. C. D. M. et al. 2017)
Natural Sunlight
Outdoor light exposure is a potential alternative or adjuvant to conventional artificial light therapy in SAD.
Individuals with seasonal affective disorder were treated for 1 week either with a daily 1-hour morning walk outdoors or low-dose artificial light. The latter treatment did not improve any of the depression self-ratings, whereas natural light exposure improved all self-ratings.
(Wirz-Justice, A. et al. 1996)
Supplements
Fish Oil
A meta-analysis of 13 randomized clinical trials concluded that supplementation with omega-3 fatty acids, found naturally in fatty fish, has a beneficial effect in patients with major depressive disorder.
(Bastiaansen, J. A. et al. 2016)
Hypericum
Hypericum perforatum (HP) is one of the oldest used and most extensively investigated medicinal herbs. Various clinical trials have shown that HP has a comparable antidepressant effect as some currently used antidepressant drugs used in the treatment of mild to moderate depression and certain forms of anxiety.
(Russo, E. et al. 2014)
In the last decade, research has revealed an extensive communication network between the gastrointestinal tract and the central nervous system, known as the “gut–brain axis.” Advances in this field have linked psychiatric disorders to changes in the microbiome, making it a potential target for treating mood disorders.
(Wallace, C. J., & Milev, R. 2017)
Vitamin D
SAD is prevalent when vitamin D stores are low. A prospective, randomized controlled trial found that increasing serum 25-OH D to more optimum levels was associated with significant improvement in depression and that vitamin D may be an important treatment for SAD.
(Gloth 3rd, F. M.,et al. 1999)
Summary of tips to beat SAD
- Increase omega-3 fats and vitamin D rich foods (e.g., salmon, tuna, sardines, egg yolks and mushrooms)
- Eat foods high in B6, B12, folate and magnesium to support serotonin production (e.g., leafy greens, avocados, asparagus, broccoli, bell peppers, chicken, salmon, sardines, shrimp, lamb, beef, liver, non-fortified brewer’s yeast, and dark chocolate)
- Enhance immune health with selenium rich foods (e.g., Brazil nuts and tuna)
- Focus on foods high in polyphenols (e.g., organic blueberries, cranberries, blackberries and raspberries, organic dark cocoa, and antioxidant spices, such as cinnamon and turmeric)
- Eat more animal protein for the tryptophan, a precursor to serotonin (e.g., grass-fed beef, free range poultry, wild seafood and pastured eggs)
- Consume foods high in probiotics to support the gut-brain axis (e.g., sauerkraut, kimchi and kombucha and grass-fed cultured dairy products like kefir and yogurt)
- Eat low glycemic carbohydrates and avoid white bread, pasta, rice, sugar and processed foods that cause a sugar “high” and subsequent crash
- Incorporate high intensity aerobic training and resistance training
- Get outside for a walk 30-60 minutes during the day
- Consider supplements as an alternative to pharmacotherapy, under the supervision of a qualified healthcare provider
References
Araújo, K. C. D. M., Deus, L. A. D., Rodrigues, F. B., Bezerra, M. E., Sales, M. M., Rosa, T. D. S., ... & Simões, H. G. (2017). Resistence exercise improves anxiety and depression in middle-age women. Journal of Physical Education, 28.
Bastiaansen, J. A., Munafò, M. R., Appleton, K. M., & Oldehinkel, A. J. (2016). The efficacy of fish oil supplements in the treatment of depression: food for thought. Translational Psychiatry, 6(12), e975–. http://doi.org/10.1038/tp.2016.243
Gloth 3rd, F. M., Alam, W., & Hollis, B. (1999). Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. The Journal of Nutrition, Health & Aging, 3(1), 5-7.
Gomez-Pinilla, F., & Nguyen, T. T. (2012). Natural mood foods: the actions of polyphenols against psychiatric and cognitive disorders. Nutritional Neuroscience, 15(3), 127-133.
Kurlansik, S. L., & Ibay, A. D. (2013). Seasonal affective disorder. Indian Journal of Clinical Practice, Vol. 24, No. 7, December 2013
Lurie, S. J., Gawinski, B., Pierce, D., & Rousseau, S. J. (2006). Seasonal affective disorder. American Family Physician, 74(9).
Rechenberg, K. (2016). Nutritional interventions in clinical depression. Clinical Psychological Science, 4(1), 144-162.
Christensen, L. (1993), Effects of eating behavior on mood: A review of the literature. International Journal of Eating Disorders, 14(2) 171–183.
Rogers, P. J. (2001). A healthy body, a healthy mind: long-term impact of diet on mood and cognitive function. Proceedings of the Nutrition Society, 60(1), 135-143.
Rosenthal, N. E., Genhart, M. J., Caballero, B., Jacobsen, F. M., Skwerer, R. G., Coursey, R. D., ... & Spring, B. J. (1989). Psychobiological effects of carbohydrate-and protein-rich meals in patients with seasonal affective disorder and normal controls. Biological Psychiatry, 25(8), 1029-1040.
Russo, E., Scicchitano, F., Whalley, B. J., Mazzitello, C., Ciriaco, M., Esposito, S., ... & Mammì, M. (2014). Hypericum perforatum: pharmacokinetic, mechanism of action, tolerability, and clinical drug–drug interactions. Phytotherapy Research, 28(5), 643-655.
Schuch, F. B., Vancampfort, D., Richards, J., Rosenbaum, S., Ward, P. B., & Stubbs, B. (2016). Exercise as a treatment for depression: a meta-analysis adjusting for publication bias. Journal of Psychiatric Research, 77, 42-51.
Wallace, C. J., & Milev, R. (2017). The effects of probiotics on depressive symptoms in humans: a systematic review. Annals of General Psychiatry, 16(1), 14.
Wirz-Justice, A., Graw, P., Kräuchi, K., Sarrafzadeh, A., English, J., Arendt, J., & Sand, L. (1996). ‘Natural Light treatment of seasonal affective disorder. Journal of Affective Disorders, 37(2), 109-120.
Young, S. N. (2007). How to increase serotonin in the human brain without drugs. Journal of Psychiatry & Neuroscience : JPN, 32(6), 394–399.
