Although H1N1 along with our annual “regular flu” are rightfully grabbing the headlines these days, now that it’s October we need to brace ourselves for the annual epidemic of seasonal affective disorder (SAD).
SAD has been recognized for years, but only recently has the “why” been understood. Symptoms can vary widely, but by far the most common is depression, ranging from feeling blue to depression that’s disabling. Other common symptoms include general lassitude, excessive sleep, and carb cravings with weight gain. People who have generalized anxiety, obsessive thinking, fibromyalgia, headaches, irritable bowel syndrome, or PMS often say the condition seems to get worse in winter.
When spring finally arrives, especially when we move our clocks forward and our days lengthen, people with SAD start feeling better in a matter of weeks. As they look back over another grim winter, the fortunate souls who were able to spend a week on a sunny vacation recall how they felt better just a few hours after arriving.
The mechanism behind SAD lies within the neurotransmitter serotonin, a brain chemical that acts as a stress buffer for our minds and bodies. Women’s serotonin levels are much lower than men’s, and as a result women are biochemically far more vulnerable to stress. Some women who have truly low serotonin levels (it’s genetic) seem to go through life like walking open wounds with everyone else waving a salt shaker.
There are all sorts of ways your body makes serotonin, but one of the most important involves sunshine passing through your eyes and stimulating your brain. Wintertime’s short grey days means lowered serotonin production, increased vulnerability to stress, and a worsening of all the low-serotonin disorders including depression and fibromyalgia.
Because of their lower serotonin levels, it’s no surprise that women suffer from SAD far more frequently than men. To compensate for falling serotonin, many chow down on carbs, which enhance serotonin production. It’s true that carbs are “comfort foods,” and we do seem to eat more of them in winter. If you eat the wrong kind of carbs or too much of them, however, the predictable weight gain can make you feel even more depressed.
Here are a few ways to beat the wintertime blues and blahs of SAD:
• Get outside every day, even when it’s cold. If the sun is shining, stay out longer. When you’re outside, avoid sunglasses for at least thirty minutes.
• Move your work area near a window.
• Keep your curtains and window blinds open throughout the day to let the light in.
• Walk briskly every day and do other types of exercise, such as lifting weights, several times a week. Do as much of your routine as possible outside or near a window.
• Avoid going from one indoor space to another without getting a little sunlight. Going from house to car to mall to home or from home to subway to office to subway and back home has you living like a mole. At each transfer point, stay outside for awhile in the light. Better yet, walk part of the distance.
• Carbohydrates will raise your serotonin, but don’t capitulate to the Ho-Hos. Have plenty of fresh fruit and veggies throughout your day and also some good whole grains–half a cup of oatmeal in the morning, half a cup of kidney bean salad at lunch, and half a cup of brown rice with dinner.
• Replace your home light bulbs with full-spectrum bulbs available in any hardware store
• Low levels of vitamin D are linked to all sorts of health problems, including susceptibility to flu, so take at least 2,000 IU of vitamin D daily. Levels of vitamin D plummet in wintertime because of reduced sunlight in contact with your skin.
• If you feel yourself slipping into mild depression or increased anxiety, consider St. John’s wort, 450 mg twice a day. It will raise your serotonin virtually without side effects. Don’t try it if you’re taking an antidepressant, though. Too much serotonin will result.
• If SAD is a regular event in your life, purchase a full spectrum light box. Place it in your work area and leave it on all day. Your brain will think you’re in Acapulco (light-wise) and ramp up your internal serotonin production.
• Budget a winter vacation if possible. Even ski resorts are sunnier than Chicago.
You can learn more about how serotonin affects your health and well-being in my book The Triple Whammy Cure. Read it on the beach and you’ll be astonished how good the book makes you feel.
David Edelberg, MD