A Functional Medicine Approach to Seasonal Affective Disorder (SAD) Treatment and Management

Seasonal Affective Disorder (SAD) is a form of clinical depression that fluctuates in a seasonal pattern. It’s also referred to as “winter depression" or "winter blues."

• SAD is a recognized mental health condition and type of major depressive disorder.
• Integrating functional medicine practices with traditional medical treatments can often provide the most effective management of SAD.
• Functional medicine offers a holistic approach to treating SAD, focusing on individualized care and addressing the root causes of health issues.

By addressing lifestyle factors, diet, exercise, and mental health collectively, functional medicine aims to mitigate the symptoms of SAD and improve overall well-being.

The purpose of this article is to promote awareness, education, and support for individuals of all ages dealing with seasonal affective disorder (SAD) and shine a bright light on the possibility of long-term relief through innovating and functional medicine treatment modalities.

This article provides an opportunity to destigmatize seeking help for mental health conditions and develop a culture that values the importance of mental health, ultimately contributing to overall wellness and improved quality of life for everyone everywhere.

It's important to note that while a functional medicine approach can be beneficial, it should not replace traditional SAD treatments such as psychotherapy or medication, but serve as an adjunct treatment.

Key SAD Statistics

• It's estimated that about 1-2% of the population in the United States suffers from SAD, but the prevalence can be as high as 9% in northern regions.
• Women are more likely to be diagnosed with SAD than men.
• SAD is more common among people who live far north or south of the equator, thanks to abbreviated daylight winter hours and longer days during summer months
• SAD often starts in young adulthood and is less likely to occur as people get older. The average age of onset is around 20-30 years.

SAD Explained

Seasonal Affective Disorder (SAD) is a type of depression that's related to changes in seasons. It typically starts and ends at about the same times every year. Most people with SAD begin experiencing symptoms in the fall and continue into the winter months, feeling moody and drained of energy; however, some people may experience a less common form of SAD in the spring or early summer.

Cause

The exact cause of SAD is unknown, but it's believed to be related to the decrease in sunlight in fall and winter, which can disrupt your body's internal clock and lead to feelings of depression. Reduced sunlight can also cause a drop in serotonin, a brain chemical (neurotransmitter) that affects mood, and can trigger depression. Additionally, the change in season can disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood.

Another hypothesis is that a vitamin D deficiency from the lack of sunlight keep a part of the brain, the hypothalamus, from working properly, leading to a disruption of our circadian rhythms. When these rhythms are out of whack, it can affect our levels of melatonin and serotonin and other important hormones. Serotonin is a hormone that affects mood and appetite; not having enough serotonin is linked to depression.

Signs + Symptoms

Symptoms of SAD can differ among individuals. Typically, these symptoms may begin as mild and gradually intensify during the peak winter months, from December to February. As sunnier days of spring arrive, these symptoms often start to diminish. SAD can significantly impact daily life, affecting work, relationships, and overall quality of life.

• Feeling depressed most of the day, nearly every day
• Loss of interest in favorite activities
• Low energy and fatigue, lethargy
• Problems with sleeping (either insomnia or oversleeping)
• Difficulty concentrating
• Decrease in libido
• Changes in appetite or weight (often craving carbohydrates)
• Feelings of hopelessness, worthlessness, or guilt

Determining whether an individual is experiencing "traditional" depression or SAD can be challenging. The key indicator is often the timing of the onset of these depressive symptoms and when they occur.

Mainstay Treatment of SAD

• Cognitive-behavioral therapy (CBT)
• Talk therapy
• Medications like SSRIs

A Functional Medicine Approach to SAD

Functional medicine, which focuses on identifying and addressing the root causes of diseases and disorders, takes a holistic approach to the treatment and management of SAD. This approach often includes a combination of lifestyle modifications, dietary changes, and natural supplements, with an emphasis on overall health and wellness.

The practice of functional medicine often emphasizes the importance of diet in managing mood disorders. This can include eating a whole foods nutrient-dense diet and increasing intake of omega-3 fatty acids, found in fish oil, which are believed to play a role in brain health. Eat lots of lean protein, leafy greens, and fish to help keep hormones in check and boost serotonin levels.

Although used in conventional treatments as well, functional medicine also recognizes the benefits of light therapy for SAD, which involves exposure to artificial light to compensate for the reduced natural sunlight in winter months. Functional medicine often involves personalized treatment plans based on the individual’s unique health profile, including genetic factors, environmental exposures, and lifestyle factors.

Natural Practices to Alleviate SAD Symptoms

Design Your Environment

Designing your environment to increase sunlight exposure involves making changes to your living or working space to maximize natural light and enhance exposure. Position your furniture, especially where you spend most of your time (like your desk or favorite chair), near windows to get more exposure to natural light. Some indoor plants thrive in natural light and placing them near windows can create a pleasant environment encouraging you to spend more time in these sunlit areas.

Vitamin D Supplementation

Vitamin D, often referred to as the sunshine vitamin, is associated with depression. Many individuals suffering from SAD typically exhibit decreased levels of this vitamin. The exact reason for this correlation remains unclear to researchers. It's advisable to consult with your healthcare provider to ensure your vitamin D levels are adequate before you start supplementing with vitamin D. Given that a majority of adults experience some form of vitamin D deficiency, incorporating a supplement might not only enhance your mood, but also strengthen bone health and fortify your immune system.

Exercise

Regular physical activity is often recommended as part of a functional medicine approach. Consistent exercise has been shown to be effective in managing common forms of depression, and this applies to SAD as well. Engaging in regular physical activity boosts the release of endorphins that promote positive feelings, which can alleviate symptoms of depression and boost mental clarity. Furthermore, research indicates that the regularity and consistency of exercise are more impactful for mental health benefits than the length or intensity of the workout sessions.

Get Outside

Take advantage of the sunny days during the cold dark months and when there is a ray of sunlight aim to get outside. Dress properly and make an effort to absorb as much natural sunlight as you can to boost serotonin levels. Both your mind and body will be grateful for this. Extra credit goes to performing outdoor exercise, whether it's a HIIT workout, a nature walk, an early morning run, or playing fetch with your dog in the snow.

Light Therapy (Phototherapy)

When outdoor time is limited in winter, purchasing a light box could be beneficial. In fact, a significant number of individuals with SAD report an improvement in mood. Light therapy offers exposure to intense, artificial light during the toughest months. It's advised that those with SAD engage in light therapy every day, starting from the onset of symptoms until spring, when SAD typically subsides.

Typically, 15-30 minutes of daily therapy are needed, with individuals often noticing an uplift in mood within two to four days, and full benefits appearing within two weeks. Since symptoms of SAD can rapidly reappear once light therapy is discontinued, maintaining consistent treatment throughout the winter is essential. Light therapy is often most effective in the morning to avoid sleep disturbances at night.

Talk Therapy

Cognitive Behavioral Therapy (CBT), a form of psychotherapy aimed at transforming detrimental or negative patterns of thought, emotion, and action, can assist in reshaping your mindset to concentrate on constructive solutions rather than thoughts like, “I'm just going to cancel.” CBT is beneficial for a variety of depression and mental health issues, and there's increasing attention on its application for treating SAD. Indeed, research featured in the American Journal of Psychiatry suggests that for SAD patients, CBT might prove more effective over time compared to light therapy.

Practice Friluftsliv

Friluftsliv is a Scandinavian practice, particularly prominent in Nordic countries. It translates to "open-air living" or "free air life." This concept is deeply ingrained in Scandinavian philosophy and lifestyle, emphasizing the importance of spending time in nature for overall well-being and happiness; regardless of the weather. It's about embracing the snow and the cold, the rain, and the warm and shining sun.

Friluftsliv is not just about engaging in outdoor activities or forest bathing; it's about a deep appreciation and connection to nature. It's a mindset that values the spiritual and physical benefits of being outdoors, regardless of the weather or season. This concept encourages activities like hiking, biking, camping, skiing, or simply enjoying a quiet moment in a natural setting.

The philosophy behind Friluftsliv aligns closely with the idea of nature as a space for relaxation and rejuvenation, away from the stresses of modern life. It's believed to have numerous benefits for mental and physical health, promoting a sense of peace, mindfulness, and a deep connection to the environment. In Nordic countries, this connection with nature is often seen as a fundamental part of a balanced life.

Final Thoughts

Seasonal Affective Disorder (SAD) is a type of depression that occurs at a specific time of year, usually in the fall and winter when there is less natural sunlight. Its symptoms include feelings of depression, fatigue, lethargy, changes in sleep and appetite, and difficulty concentrating. Functional medicine offers a holistic approach to treating SAD, focusing on individualized care and addressing the root causes of health issues.

Regardless of the form it takes, depression can create a profound sense of loneliness. Building a support system by connecting with friends and family can help lighten the load. If you think you might be susceptible to seasonal affective disorder, it's important to contact your healthcare provider.

Thank you for reading this article.

MEDICAL DISCLAIMER

This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.