Update: Natural Treatments for the Winter Blues

Last year around this time I wrote an article on Seasonal Affective Disorder (SAD). At that point, it was my most popular article yet. This doesn’t surprise me as 20% of our population is affected by SAD (1). If you’d like the full article, you can read it here. This year I wanted to update you on additional treatments and elaborate on testing. But first a quick recap.

What is seasonal affective disorder?

SAD is depression with a seasonal pattern. Mood changes typically occur during the winter months but can sometimes occur during the spring and summer.

Symptoms of SAD

Fatigue
Difficulty waking up in the morning
Increased need for sleep
Lack of motivation
Cravings sweets
A depressed mood

Hypothesized causes of SAD

Decreased light exposure (2)
Higher levels of daytime melatonin (3)
Vitamin D deficiency (4)

Conventional treatment

You may have guessed it… Antidepressants. Antidepressants, although necessary for some, can have nasty side effects and are often difficult to stop taking once you start. This is unnecessary as there are many well documented natural treatments for SAD.

Updated natural treatments for Seasonal Affective Disorder

Omega-3’s specifically DHA and EPA: omega-3s have long been studied for their affects on depression. One study, in particular, found a lack of season affective disorder in Iceland, which was remarkable when compared to other countries at similar latitudes with similarly shorter days and longer nights during winter months. Upon further investigation, these findings are thought to be due to the Icelandic diet which includes 225 lbs of fish per person per year. There is also a lower prevalence of seasonal affective disorders in Japan, which also has a diet high in fish at 147 lbs per person per year. The average American eats just 48 lbs of fish per year (5). That’s almost five times less than in Iceland and three times less than in Japan. Depleted levels of omega-3 have been found in depressive patients (6).

Nutrition to increase omega-3’s
Seafood is the most abundant source of the essential fatty acids DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid).
Chia, flax, hemp and walnuts are rich in ALA (alpha-linolenic acid) which is a precursor to EPA. However, this requires a few extra steps for your body to use and some people can have difficulty converting ALA to EPA.

Supplementating Omega-3
Good quality fish oil is a great way to increase your omega-3’s. I like this brand. Take 1-3 grams per day with food.
Algae Omega-3, this is a vegan form. Take 4 per day with food.

Acetyl-L-carnitine (ALC): is an amino acid (protein building block) that is necessary for the transportation of fatty acids across the inner membrane of mitochondria. In plain terms, acetyl-l-carnitine is needed for your body to use fatty acids to make energy. Supplementing with ALC has been found to significantly lower depression (7). Therapeutic dose ranges from 500-2000 mg per day (1-4 capsules of this one).

Lab tests

Diagnositc testing is helpful to assess the root cause of depression

Melatonin panel: this at home saliva collection test that looks at melatonin production morning, noon and night. This type of testing allows for evaluation of melatonin activity of a complete light-dark cycle.
Vitamin D 25-OH: a simple blood test can reveal your vitamin D levels, and therefore how much you should be supplementing. Even if you are deficient, I don’t recommend mega doses (for example, 50k IU once per week) of vitamin D. Instead, I recommend mimicking normal vitamin D production through smaller amounts (4-8k IU) given daily.
Organic acid testing: This is a urine test that evaluates for neurotransmitters, energy production (mitochondrial health), nutrient status, detoxification capacity and dysbiosis (yeast or bacterial overgrowth in the intestines which can be a root cause of depression).
Omega-3 levels: this is a blood test that can determine if you have adequate EPA and DHA levels.

Recap: Natural treatments discussed last year

Light therapy: Light therapy is one of the most well-studied therapies for SAD. Try sitting in front of a bright light box (like this one) for 20-60 minutes daily. The light should be no less than 10,000 lux and filter out ultraviolet rays. This type of light provides around 20 times more light than typical indoor lighting. It’s also helpful to spend time outside in the sunshine.
Vitamin D3: Take 1,000-2,000 IU of Vitamin D3 per day with food. If you are deficient, you will need a higher dosage. I highly recommend you get your vitamin D levels checked with a simple blood test. It’s important always to take vitamin D with food, specifically a meal that contains fat because it’s a fat-soluble vitamin, meaning it requires fat to be absorbed.
St. John’s Wort: Take 2-4 grams per day (or 2-4 capsules of this formula).
5-HTP: For those who have tried St. John’s wort without success, or should not take it due to the contraindications, I recommend 5-HTP. Start with 100mg (1 capsules of this formula). Can be increased to 200mg per day. Take with food.