Cloudy weather got you down?
Affective disorders are disturbances in mood or emotions that color one’s outlook for prolonged periods, whether negative or positive. Seasonal Affective Disorder (SAD) is described as “regularly occurring winter depression frequently associated with summer hypomania” (slightly lower than normal mood). Growing up and having practiced for several years in the cloudy, rainy Northwest, Dr. Justin Pollack has seen the pattern of SAD many times. According to the American Psychiatric Association’s “DSM-IV” a person would have depression if they had five out of eight of the following problems for over a month:- Poor appetite with weight loss, or increased appetite with weight gain.- Insomnia or hypersomnia.- Physical hyperactivity or inactivity.- Loss of interest in pleasure in usual activities, or decrease in sexual drive- Loss of energy and feelings of fatigue.- Feelings of worthlessness, self-reproach or inappropriate guilt.- Diminished ability or think or concentrate.- Recurrent thoughts of death or suicide.Light therapyWhile many cases of depression warrant the use of pharmaceutical drugs, natural medicine has many approaches that have been shown to help in scientific research and practice. Looking in the 17th edition of the Merck Manual, you will see that the standard therapy is to stick these people in the sun, or under ultraviolet bulbs. This is good, naturopathic medicine, supported by numerous older studies (1,2,3), but questioned in more recent research (4). We tell people to get outside in the sunshine for exercise every day. Exercise alone will raise endorphin levels, which makes people feel good enough they can easily get addicted to that feeling, with outdoor exercise having an even greater effect. Melatonin and 5-HTPMelatonin, a hormone produced by the pineal gland within your brain, may be a culprit in the winter blues. We see other mammals being very sensitive to changing light, with seasonal variations in activity levels, weight, appetite and sleep patterns (maybe bears just have SAD every winter). Melatonin is your hormone of sleep, and higher levels seem to drive down cortisol (one of your stress hormones), and incidence of many types of cancer. Your pineal gland produces this best when it is completely dark, and quickly disposes of it when it is light. Because both melatonin and serotonin (your “feel-good” hormone) are synthesized in the body from tryptophan, getting help with correct doses of this protein, or the hydroxylated form, 5-HTP, may help. Low melatonin levels, as well as high cortisol have been theorized in the causes of SAD (5). Low melatonin levels have also been theorized in a recent finding that suicidal behavior follows a remarkably consistent seasonal pattern worldwide, during the sunniest periods: June in the Northern hemisphere, and December in the Southern hemisphere (6). If we were to look for reasons why crazy things happen at the full moon, we might not need to look any further than low melatonin levels during the bright nights surrounding that time.Vitamin DVitamin D is produced by sunlight hitting a dehydroxy-cholesterol molecule circulating near the skin, then becoming activated by hydroxylation reactions in the liver and kidneys. In the winter, people spend less time in the sun and their vitamin D levels decrease. This prompted researchers to question whether vitamin D might help these SAD patients. An Australian study split a group of 44 SAD sufferers and either gave them 400 IU, 800 IU or no Vitamin D for five days during late winter. The more Vitamin D they got the better they felt (7). Another study tried a dose of 100,000 IU of Vitamin D on 8 of 15 subjects suffering from SAD. The remaining sufferers were treated with light therapy. Subjects were evaluated a month later. The light therapy had no benefit while the vitamin D improved all 8 subjects (8). Vitamin D has also been shown to be protective against osteoporosis and autoimmune diseases such as Rheumatoid Arthritis and Multiple Sclerosis. Fortunately, it doesn’t take much sun exposure to get your daily dose of vitamin D. The textbook “Understanding Nutrition” states that for most people, exposing hands, face and arms on a clear summer day for 10 to 15 minutes a few times a week, should be sufficient to maintain vitamin D nutrition. Herbal therapies and homeopathySt. John’s Wort received a lot of press a few years ago, but is falling out of favor after some unsuccessful studies. In our own practice, we have found that St. John’s Wort may work for some mild cases of the blues, but has little to no effect on most cases of outright depression. There are many other herbal remedies that can work on other levels to elevate low mood. Homeopathy, prescribed on a constitutional (whole person) level, often has great effects – but because it is very individualized medicine, it is not evaluated well by double-blind studies. Not just in the headMany cases of the blues, being tired or depressed all the time, are not just in a person’s head. Disorders of metabolism, hormone levels from the thyroid, adrenals or ovaries (as menopausal women can often attest), an abnormal overgrowth of candida yeast in the body, or other systemic physical problems from the heart to the liver, can give a person the blues. Getting some help to figure out these problems, and what is at their root, is always a good idea. Pharmaceutical drugs work wonders in many cases, but if that is all that is offered you may want to try something else first. We can help figure out what is causing the blues, and offer natural approaches to wellness.Dr. Pollack and Dr. Nearpass are the directors of the Mountain-River Naturopathic Clinic in Frisco, and they are the first N.D. practice in Summit County to come from department of education approved, 4-year graduate programs in naturopathic medicine. Dr. Pollack graduated from Bastyr University in Seattle, completed a residency in family practice at National College of Naturopathic Medicine, and Dr. Nearpass graduated from National College of Naturopathic Medicine in Portland. Both doctors have completed many hours of internships, and are well versed in treating the whole person with natural remedies: nutrition, herbs, classical homeopathy, hydrotherapy and wellness counseling. References: Rosenthal N, Sack D, Carpenter C, et al. Antidepressant effects of light in Seasonal Affective Disordes. Am J Psychiat 1985:142: 163-170; Rosenthal N, Sack D., Gillin C et al. Seasonal Affective Disorer: a description of the syndrome and preliminary findings with light treatment. Arch Gen Psychiat 1984; 41: 72-80; Kripke D, Risch S, Janowsky D. Bright white light alleviates depression. Psychiat Res 1983; 10: 105-112; McColl S, Veitch J. Full-spectrum fluorescent lighting: a review of its effects on physiology and health. Psychol Med. 2001; 31(6): 949-64; Miles A, Philbrick D. Melatonin and psychiatry. Biol Psychiatry 1988; 23: 405-425; Petridou E, Papadopoulos F, Frangakis C, et al. A role of sunshine in triggering suicide. Epidemiology 2002; 13(4): 492-3; Lansdowne A, Provost S. Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology (Berl). 1998; 135(4): 319-23; Gloth F, Alam W, Hollis B. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. Nutr Health Aging. 1999; 3(1): 5-7.
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