Feeling SAD?

Damn. We Aucklanders are getting our share of terrible weather. That’s the problem with being smug and posting pictures of our awesome non-winter winter climate… eventually it comes back to bite us in the butt. Usually in spectacular fashion: this week has been almost torrential storm-like conditions, with power outages and garden furniture strewn across the driveway (or is that just me?) Naturally this dip in temperature to below 15 degrees comes with it a sense of gloom as the sun fails to make an appearance. Grey clouds are oppressive, huh? Does that make you feel a bit blue? It does me – once the temperature drops and I haven’t seen the sun in four days I feel utterly miserable, diagnose myself with mild depression, and more specifically Seasonal Affective Disorder – or SAD. It’s a particular type of depression that starts in the autumn and doesn’t let up until the daffodils are out. In reality, I don’t think I would be diagnosed with SAD, and population prevalence is in the realm of 1-12% depending on your location, a higher prevalence in areas with longer winter days and lack of sunlight hours (one reason why I couldn’t live in ‘middle England’; not only does it sound horribly dull (it’s up there with ‘original flavour’) but daylight hours are limited during winter. And I know it’s worse elsewhere). But I digress. However, I feel a bit blue all the same.

Interestingly, there are two types of seasonal affective disorders – some curious people feel more depressed in summer than they do in winter, therefore the reverse is true. That to me is like a fate worse than death, quite frankly. Up there with Man Flu. SAD is diagnosed by the presence of symptoms such as: 

  • Decreased energy levels
  • Difficulty concentrating
  • Fatigue
  • Increase in appetite
  • Increased desire to be alone
  • Increased need for sleep
  • Increased irritability
  • Increased anxiety
  • Weight gain

Scientists have pinpointed a few reasons why the lack of sunlight can disrupt our mood. This is largely due to our levels of melatonin – this is a hormone which plays a role in how our body regulates its sleep/wake cycle. The longer periods of darkness in the winter months may stimulate melotonin production and potentially people with SAD overproduce melatonin or are hypersensitive to melatonin in the winter months. While melatonin is recommended on an infrequent basis for people who struggle with sleep (for example, during periods of travel where jetlag can set it), too much melatonin can result in headaches, day time sleepiness, and depression.

Other evidence shows that decreased levels of neurotransmitters (chemicals that transmit signals between nerve cells) such as serotonin or dopamine may also play a role in triggering SAD. Low levels of serotonin in particular have been associated with carbohydrate cravings in people with SAD, and with sleep disorders and depression in the population at large. So not only does the reduced amount of serotonin trigger carbohydrate cravings (carbohydrate facilities the production of serotonin), this subsequent increase in food intake can lead to weight gain and further feelings of despair. Lose-lose, really. Even in those that don’t feel particularly blue during winter, the stodgy, starchy carbohydrates that can lead to weight gain and increased carbohydrate cravings are the warming foods we naturally gravitate towards.

As serotonin is largely produced in the gut I went searching for studies that looked for a link between digestion and SAD, as without the nutrients required to produce serotonin – including tryptohan which is an amino acid and key in the process – levels will be lower. I didn’t come up with any though, but with the clear link between the gut and brain, it makes sense that there would be.

Lastly I also found interesting relationships between SAD and other conditions. It’s not just weight gain that could be a problem – A Finnish study found there was a significant association between seasonal changes in mood and behaviour and metabolic syndrome, with risk of metabolic syndrome increased by 56% in those with seasonal affective disorder. The researchers noted that the metabolic syndrome is related to changes in the circadian rhythm – and that circadian, sleep-wake and seasonal cycles may each be regarded to reflect an intrinsic metabolic cycle. Sleep onset is a switch for the metabolic and cell repair systems from daytime to night-time settings and if the right signals aren’t there, the circadian clockwork relies more on the metabolic cycles producing time-giving signals needed for adaptation – insulin plays a role in this and helps set the circadian rhythm.

So what treatments exist for helping improve melatonin and serotonin levels and hopefully offset the low level depression that many people experience?

Light therapy: helps with regulating melatonin production and can indirectly affect serotonin levels by blocking the mood-lowering affects of acute tryptophan depetion. exposure to intense light in the early morning has been found to be most effective, as this suppresses melatonin. The treatment involves sitting in front of fluroscent lights which are installed behind a diffusion screen, and carrying out normal activities for anywhere from 30 min to 2 hours depending on the intensity of lights. The critical factor is that the light matches that of either early morning or just before sunset. he dosage most often found to be effective is 5,000 lux per day, given as 2,500 lux for two hours or 10,000 lux for 30 minutes. This isn’t just sitting in front of a desk lamp.

I talk about sleep all the time… but in addition to adequate sleep, getting up and going to bed at around the same time most days can also help regulate levels of melatonin, particularly combined with the light therapy as above.

Get outside and exercise: it might be the last thing you feel like doing but honestly – nothing is as energising and invigorating as getting outdoors, particularly in cold, windy, inclement weather. This helps boost serotonin levels by increasing availability of tryptophan to the brain. This is particularly important as we tend to spend a lot of time inside. The added bonus here is getting natural light – this helps boost overall mood.

Fight against the desire to stay at home and make plans with friends or family. It’s all too easy to hibernate, inevitably making you feel worse.

Diet: while there are foods that are high in serotonin or tryptophan, few actually cross the blood brain barrier to enable their action in the body to improve mood. Typically high protein foods containing tryptophan were recommended, though this doesn’t actually increase serotonin levels in the brain when studied  , as amino acids compete for transportation in the body and most protein containing foods are relatively lower in tryptophan than other amino acids. Hence perhaps changing the ratio of tryptophan to other amino acids is useful, and research has shown that supplementing with a dietary protein alpha-lactalbumin (a constituent of milk) can increase serotonin through this strategy. While interesting, it’s not very practical for people in every day life. Insulin helps set the circadian rhythm and perhaps a diet that focuses on high protein for breakfast and lunch, with small amounts of carbohydrate at night can maximise insulin secretion at night and help appropriately reset circadian rhythm. Unsurprisingly, the importance of a whole food diet rich in nutrients to support digestion and absorption of nutrients cannot be overstated given the link between serotonin and mood.

Oh, and hopefully the increased protein, the exercise and the sleep helps you combat those carbohydrate cravings. In addition to this, find some equally warming winter substitutes. It’s not like you need to completely avoid carbohydrates at all (see above re insulin) – it’s about avoiding Richard Dreyfuss amounts of the white stuff. That’s not going to make you feel any better I promise.

  • Mash: cauliflower mashed with butter or olive oil, herbs and seasoning.
  • Fries: slice swede and boil until a little bit soft. Dry off and coat in coconut oil and some almond flour and roast. Or just roast from raw.
  • Pasta: zucchini noodles (or as my friend Helen likes to call them: courgetti) or use leeks (cook)
  • Rice; cauliflower rice

There are certainly people who are diagnosed with SAD, and equally there are people (like me) who wouldn’t meet the diagnostic criteria yet still feel a bit less awesome. All of the above tips then will help you keep feeling awesome over the winter months. And we are almost half way through! That’s enough to make me feel happier :-).

 

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