Naturopathic
View
Seasonal Affective Disorder by Carolin Galvin,. B.Sc. N.D. Seasonal Affective Disorder (SAD) affects about 5% of Americans, predominantly women of reproductive age. Symptoms may include fatigue, lethargy, decreased sociability, decreased libido, oversleeping, increased appetite, starch and sugar cravings and weight gain. SAD is different from non-seasonal depression in that there is full remission and sometimes even a state of mild mania in the spring and summer months. Despite much interest and research since the mid 1980's, the mechanism behind SAD remains unclear. However, much insight has been gained and many hypotheses formed that are useful in treating this condition. There are three players that are thought to play a role in this disorder. Melatonin is a hormone secreted by the pineal gland, a small gland situated at the base of the brain. The pineal gland controls our circadian rhythms in response to the light and dark cycles of day and night. When our eyes take in sunlight our nervous system sends a message to the brain to stop the synthesis of melatonin. When it is dark, the pineal gland is no longer suppressed by the light stimulus and melatonin production increases. Melatonin makes us feel sleepy and affects mood. In fact, melatonin became popular in recent years as a sleep aid, particularly for those who's sleep patterns were disrupted by shift work or jet lag. Cortisol, a hormone produced by our adrenal glands is also thought to play a role since it increases as melatonin decreases. Serotonin is a neurotransmitter that is associated with depression and is thought to be involved in the symptoms of SAD. In fact, many anti-depressants increase serotonin. Interestingly, melatonin is made from serotonin. There are a few therapies that are found to be useful in the treatment of SAD. Firstly, and most debated, is light therapy. Bright light or full spectrum light or even better, good old-fashioned sunlight is used to alleviate symptoms. There is controversy in regards to whether or not this works, in which cases it is useful, and when and how to administer it. But for the most part, people with SAD benefit from this. One half hour to three hours of light exposure daily, administered at dawn or on waking and/or in the evening using bright light is a typical prescription for light therapy. There are manufacturers that make lamps specifically for this purpose. An alternative is to spend the time outdoors on sunny winter days. Expect a change in a few days. A second therapy is exercise. In a 1998 study (Lewy, Bauer, Cutler), light therapy and exercise were found to increase oxygen consumption and improve symptoms in patients with SAD. Non-seasonal depression and non-depressed subjects' oxygen consumption was minimally affected by light but did increase with exercise. Aside from this study, we know that exercise relieves stress and acts to elevate mood. Melatonin has been proposed as an aid to those suffering from SAD. Melatonin could be used to shift the wake-sleep cycle to normal. However, caution should be exercised since this hormone is thought to be part of the problem in the first place. Also, the long term effects of melatonin therapy are not yet known. Lastly, anti-depressant therapy, particularly of the class of pharmaceuticals called SSRI (selective serotonin re-uptake inhibitors such as Paxil, Luvox, Prozac, Zoloft, Serzone) have been useful in alleviating symptoms and may be an option in those unresponsive to light therapy. Some naturopathic alternatives should also be considered. A standardized extract of St. John's Wort would raise serotonin levels and provide symptom relief in mild to moderate cases. An extract form the plant ‘Griffonia', 5-HTP (5-hydroxy tryptophan) could be used as well to raise serotonin, (serotonin is 5-HT), although it should not be mixed with St. John's Wort. Gingko biloba may be useful particularly for those in their middle or senior years. Caution should be taken not to mix anti-depressant or anti-anxiety medications with some of these botanicals. There is hope for those who suffer from seasonal depression. Depression is a serious and potentially life-threatening disorder and should be treated as such, by a health professional. However, something as simple as sunlight could be all you need. Dr.Carolin Galvin, Bsc., N.D. Practices Naturuopathic Medicine in Fredericton, N.B. |