Battling the Winter Blues in Raleigh NC

Sunday marked the Fall time change ( if you haven't changed your clocks yet, chances are you've been pretty confused for a few days ;p) which means in one fail swoop we lost precious hours of daylight. Suddenly the sun is going down on our commutes home rather than after dinner. Not only is this irritating and confusing it also poses some health related concerns that require proacivitity...The imposing "winter blues" monster lurks around every shadowy corner and it's time to take action to keep it at bay.

In all seriousness though, the winter blues are a common condition among many. In definition, the winter blues are a mild case of Seasonal Affective Disorder a form of depression that occurs in relation to the seasons, most commonly beginning in winter. Signs of SAD include

• Significant, lasting, downturn of mood
• Apathy; loss of feelings
• Irritability
• Less energy
• Fatigue
• Boredom
• Overeating; weight gain
• Cravings for carbohydrates
• Sleeping too much; difficulty waking up or staying awake
• Less interest in being around other people
• Less interest in activities one used to like

There are several components of the fall time change in time and daylight hours that contribute to SAD. A few of the main culprits behind this disorder are the Pineal Gland, Melatonin, and Vitamin D and their relation to the lack of sunlight.

Pineal Gland and melatonin
“The pineal gland…was thought to be essentially non-functional until several important findings in the early 60’s revealed that the gland is highly metabolically active and that it exerts considerable control over reproductive physiology (Hoffman and Reiter, 1965). Since these early observations, knowledge of the cell biology of the pineal (Reiter, 1991) and of its physiological interactions (Bartness et al. 1994) has accumulated at a rapid pace. It is now clear that this endocrine gland, which for so many years labored in obscurity, may be the most widely acting gland in the body.” (145 Bittar) It's main function involves the wake-sleep cycle in the body. This cycle, known as the circadian rhythm, is governed in part by the regular rise and fall of hormones, especially melatonin. Melatonin is the master sleep hormone; it is produced in the pineal gland. Researchers have identified a regular ebb and flow to human physiology and behavior throughout a normal 24-hour cycle (Hirota T et al 2004). Our overall pattern of wake-sleep depends on the proper functioning of an internal circadian clock, which lies deep in the brain. This circadian clock works with photosensors in the eyes to sense darkness. When darkness falls, the body begins to secrete melatonin, which is one of the factors that cause sleep. Melatonin continues to be secreted throughout the night, although the levels alter, and toward dawn, melatonin secretion gradually diminishes, allowing for wakefulness in the morning.
When there is a problem with this system, sleep disorders and other psychological problems can occur.
To further explain the enormous effect light exposure has on the physiology and functioning of the body, we need to take a closer look at melatonin. Researchers have found that the pineals melatonin releasing system is disrupted in people with SAD. When SAD patients were compared with healthy controls, it was found that the SAD patients had consistently higher daytime melatonin levels during the winter months (6). High daytime melatonin levels would be expected to produce the symptoms of excessive daytime sleepiness and the lack of motivation and desire to hibernate, that is seen in SAD sufferers.

Vitamin D Deficiency:
Seasonal Affective Disorder (SAD) is prevalent when vitamin D stores are typically low. Broad-spectrum light therapy includes wavelengths between 280-320 nm which allow the skin to produce vitamin D. This study was designed to test the hypothesis that vitamin D deficiency might play a role in SAD. A prospective, randomized controlled trial was conducted in a group of 15 subjects with SAD. Eight subjects received 100,000 I.U. of vitamin D and seven subjects received phototherapy. At the onset of treatment and after 1 month of therapy subjects were administered the Hamilton Depression scale, the SIGH-SAD, and the SAD-8 depression scale. All subjects also had serum levels of 25-hydroxyvitamin D (25-OH D) measured before and 1 week after intervention therapy. All subjects receiving vitamin D improved in all outcome measures. The phototherapy group showed no significant change in depression scale measures. Vitamin D status improved in both groups (74% vitamin D group, p < r2="0.26;" p="0.05).">

To further strengthen the case that vitamin D deficiency causes some cases of depression, evidence should exist that the incidence of depression has increased over the last century. During that time, humans have reduced their sunlight exposure via urbanization (tall buildings and pollution reduce UVB ), industrialization (working inside reduces UVB exposure), cars (glass totally blocks UVB), clothes (even light clothing blocks UVB), sunblock and misguided medical advice to never let sunlight strike you unprotected skin.
All these factors contribute to reduce circulating 25(OH)D levels. Klerman and Weissman's claim that major depression has increased dramatically over the last 80 years is one of the most famous (and controversial) findings in modern psychiatry. Klerman GL, Weissman MM. Increasing rates of depression. JAMA. 1989 Apr 21;261(15):2229–35. Something called recall bias (a type of selective remembering) may explain some of the reported increase, but does it explain it all?

So what can we do about this?

Eat Well

Eating a diet high in processed food increases the risk of depression, research suggests.
What is more, people who ate plenty of vegetables, fruit and fish actually had a lower risk of depression, the University College London team found. Data on diet among 3,500 middle-aged civil servants was compared with depression five years later, the British Journal of Psychiatry reported. The team said the study was the first to look at the UK diet and depression. The UK population is consuming less nutritious, fresh produce and more saturated fats and sugars Dr Andrew McCulloch, Mental Health Foundation. They split the participants into two types of diet: those who ate a diet largely based on whole foods, which includes lots of fruit, vegetables and fish, and those who ate a mainly processed food diet, such as sweetened desserts, fried food, processed meat, refined grains and high-fat dairy products. After accounting for factors such as gender, age, education, physical activity, smoking habits and chronic diseases, they found a significant difference in future depression risk with the different diets. Those who ate the most whole foods had a 26% lower risk of future depression than those who at the least whole foods.
By contrast people with a diet high in processed food had a 58% higher risk of depression than those who ate very few processed foods. A great diet to follow is the mediterranean diet.

Phototherapy (lightbox therapy)

As shown in the Vitamin D Study above, light therapy is one option for treating Seasonal Affective Disorder (SAD). The use of a therapeutic light box is the most effective of light therapies. It has a specially designed light, that is placed near the patient. Providing a dose of 10,000 lux., usually for 30-60 minutes daily. The person stays by the light-box, with their eyes open and unshielded.

Personalized Nutrition/Supplementation

Nutritional consultation is required to create a specified supplement plan for your individual needs. Comprehensive Nutrition is a program that targets your specific health care concerns from a nutritional, dietary, and lifestyle vantage point. It involves regular nutritional consultations to create the balanced nutritional environment your body craves for optimal health and wellness. Nutrition is the basis of our bodies ability to function, to fight disease, and to thrive. If your body is not well there is most likely a large nutritional component to your condition. Working with your doctor (holistic health care practitioner) to assess your specific needs will help you to find the root cause of your discomfort as well as a means of relieving your fatigue, apathy, depression and sensitivity to seasonal sensitivity to light and rebuilding your health for the LONG TERM.

Lifestyle

• Keep a regular routine/schedule
• Have a regular pattern of sleep; get enough sleep
• Exercise regularly
• Do fun things

There is hope for feeling better. It just requires diligence and proactive concern for your health and wellness.

Battling the Winter Blues in Raleigh NC