Say Goodbye to the Winter Blues

Do you get the “winter blues?” If so, you might be experiencing something called Seasonal Affective Disorder, or SAD.

Lack of sunshine and the short days of winter leave many struggling with SAD¹.

Here’s everything you need to know about seasonal depression and what you can do to beat it!

What is Seasonal Affective Disorder (SAD)?

Seasonal Affective Disorder (SAD) – yes, a perfect acronym! – is a type of depression marked by sad moods and low energy typically seen in the winter months^1,2.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), term official term for this disorder is “Major Depression, with a seasonal pattern¹.”

How common is Seasonal Affective Disorder?

Millions of Americans likely suffer from SAD yet don’t realize it².
Most often, SAD occurs during the winter months but can also occur at other times of the year¹.
Northern latitudes see more SAD².
In the US 1% of Florida’s population has reported SAD vs 9% of the population in Alaska¹.
Younger people are at higher risk of developing SAD³.
Occurs more frequently in women². Four times more likely than men, to be exact¹.
Many also struggle with other mental health issues like major depressive disorder, bipolar disorder, ADHD, anxiety, and a history of an eating disorder².

Symptoms of SAD include^1,2

sad moods
low energy
irritability
difficulty concentrating
insomnia
anxiety
social isolation
possible episodes of violent behavior
increased cravings for carbohydrates and sugars
weight gain
poor appetite and weight loss.

A doctor may diagnose you with SAD if the number of seasons experiencing depression, outnumbers the number of seasons without¹.

What Causes Seasonal Affective Disorder?

Seasonal Affective Disorder (SAD) is likely caused by a disruption in circadian rhythms (a fancy way of saying our body’s ‘internal clock’) which is associated with a delicate serotonin, melatonin and vitamin D¹.

Serotonin

Serotonin is a neurotransmitter believed to be a major player in cognition and mood.

Melatonin

Some individuals with SAD may also have an overproduction of melatonin, a hormone released in response to dark (our sleepy time hormone)¹.

Vitamin D

Vitamin D is an essential nutrient used in several body processes, including serotonin production^1,4.

NOTE

Genetics is a huge factor in how your body responds to environmental changes, even simple ones like the change of seasons. While metabolic processes are generally the same across all “healthy” humans, there can be significant differences in the efficiency of these systems. This is, perhaps, why some only have the “winter blues,” while others become crippled by depression.

Sunlight and its Role in SAD

Winter Blues and SAD start with sunlight, or the lack thereof.

Sunlight is involved in two ways:

Eyes Light hitting the cones and rods in our eyes causes the inhibition or activation of certain enzymes.
Skin Vitamin D production in our skin

Eyes

Normally, when our eyes sense that it’s dark, our cones and rods send messages to the brain to convert serotonin to melatonin, our sleepy hormone¹.

This results in two things. First, we have melatonin being produced at time of day when we still have to be functioning. Second, inadequate serotonin.

The comibnation leaves us feeling fatigued and a potenital dip in mood.

Skin

In the winter months, D production slows, particularly for those living in the north.

The angle of the sun, cold weather clothing, and limited daylight hours, prevent the sun exposure we need to produce adequate amounts of vitamin D.

Vitamin D and SAD

Vitamin D is an essential nutrient invovled in bone health, cardiovascular disease (CVD), depression, multiple sclerosis (MS), type 2 diabetes, cancer, and weight loss⁴.

Vitamin D is also involved in serotonin production⁷. Inadequate levels of vitamin D may lead to impaired serotonin production and therefore depressed mood. In fact, research has shown lower serotonin levels in people suffering from SAD¹.

Regarding depression in particular, research has found a correlation between vitamin D status and depression but is inconclusive on whether or not vitamin d supplementation abates symptoms. More research is needed^4,7.

Certain foods like fatty fish and mushrooms contain good amounts of Vitamin D but it’s difficult to get enough through diet alone. Therefore, most of our vitamin D is produced in our skin when sunlight’s ultraviolet (UV) rays meet our skin and trigger vitamin D synthesis. Because of lack of sunlight, people living in the northern latitudes may become deficient during the winter months.

Treatment Options

When going on a tropical vacation isn’t possible, you might need to take things into your own hands.

Common treatments for Seasonal Affective Disorder include antidepressant medication, light therapy, supplementation, and counseling. However, there are other, more natural things you can do to combat it at home.

Antidepressants

Serotonin Reuptake Inhibitors (SSRIs), such as Prozac or Wellbutrin, have been used since the 1980s. While effective, some experience side effects that result in discontinuation¹.

Counseling/Therapy

Therapy is always a good idea. We all have baggage to unpack.

Light therapy

Two types of light therapy exist.

“Light Therapy” Lamps⁶

Llight therapy products filter out ultraviolet rays and provide 10,000 lux of cool-white fluorescent light.
Work on circadian rhythm by essentially tricking our body’s hormone release of melatonin, our sleepy hormone.
Light therapy lamps are generally used for 10-60 minutes every day, preferably in the morning. It is not required that you stare into the light but the light must hit your eyes to gain benefit.
A 2019 Cochrane review looking at the efficacy of “light therapy” products determined that there is not enough clinical trial data to make a call on their effectiveness in the treatment of SAD. However, anecdotal evidence shows promising results⁶.

UV-B lamps

These lamps contain the type of bulb found in tanning beds. While they do mimic sunlight and promote vitamin D production in the skin, the use of these lamps may increase the risk of skin cancer and are therefore not recommended.

Exercise

Its no secret that exercise helps combat depression. Multiple research studies have confirmed that exercise induces a cascade of reactions that positively impact on our central nervous system.

Interestingly, there is a linear correlation with greater intensities providing greater benefits⁸.

Aim for 30 minutes of moderate exercise (moderate for you) most days of the week. Bundle up and take a walk. Hit the gym. Join an indoor sports league. Whatever you chose will work!

Hydration

It’s also no secret that staying hydrated can impact how we feel and the winter months is more important than ever.

The obvious signs that we might need to our increase water intake, like sweating, may be less frequent during winter months.

Further, dry heat can also impact our hydration status without us being aware.

Lastly, the tendedncy to drink more caffienated beverages for energy may also negatively impact on our level of hydration.

Aim for 64 ounces per day and pale yellow urine.

Sources of Vitamin D

Food Sources⁴

Fatty fish like salmon, trout, tuna, and mackerel as well as mushrooms are good sources of dietary Vitamin D.

Beef liver, egg yolks, and cheese also contain small amounts of vitamin D.

Additional dietary sources inlcude

Fortified milk (but not cheese or ice cream) or alternative milk products
Fortified Orange Juice
Cereals and oatmeals fortified with vitamin D

Vitamin D Supplements⁴

Fish liver oils are long standing tradition in many cultures aorund the world.

One tablespoons pf cod liver oil provides 1,360 IU vitamin D as well as 250–500 mg of Omega-3 fatty acids.

In pill or capsule form, Vitamin D is available over the counter and is often much more palitable. They can provide anywhere from 1000 IU to 5000 IU per serving.

A few things to note about supplements.

Supplements are not regulated by the Food and Drug Administration (FDA) and can therefore contain varying amounts of the compound being sold. Some may contain the exact amount on the label, some with less and some with more concentration.
Depending on several factors, the amount of vitamin you absorb or utilize will vary and there is no way of knowing.
Supplements may interact with certain drugs. It is best to discuss the use of supplements with your health care provider before starting.

A note about Magnesium^3,4,5,8

Magnesium has many roles in the human body; namely our metabolisms, bone health, and vitamin D production and activation.
Most Americans do not consume enough magnesium.
Research is currently investigating the effectiveness of simultaneous magnesium and vitamin D supplementation on the reduction of osteoporosis and diabetes risk. More data is needed but early results look promising.
While blood levels are tightly maintained, chronic low intake may cause a person to have suboptimal levels.
Inadequate magnesium may impact vitamin D production
Simultaneous supplementation of magnesium and Vitamin D has proven to be more effective than taking either alone.
The recommended daily intake of magnesium for women over 30 years is 320 mg.

How much do I need?

For all adults over 19 years the Recommended Daily Allowance (RDA) is

15 mcg or 600 IU

The maximum daily intake

100 mcg or 4,000 IU

Toxicity⁴

Vitamin D can become toxic if taken in amounts greater than 4000 IU per day. Do not exceed this amount unless under the supervision of a health care provider. You should always speak with your doctor first before taking any supplement. They can recommend a dose to meet your needs.

The Bottom Line

If you get the “winter blues” every year, you may have Seasonal Affective Disorder (SAD).
In the winter months, we have inadequate amounts of serotonin-related to vitamin d deficiency slowing its production as well as its conversion to melatonin by activated enzymes.
SAD is marked by symptoms of depression following a seasonal pattern and is commonly seen in northern latitudes.
Severity can vary from person to person. If depression symptoms interfere with activities of daily life, it is time to seek help.
Possible treatments to improve symptoms include:
- Antidepressants
- Counseling
- Light therapy
- Supplementation
- Exercise
- Hydration
Talk with your doctor about what Seasonal Affective Disorder treatments are best for you.
Increasing vitamin D intake through foods is a great first-line treatment option. Foods high in Vitamin D are fatty fish, mushrooms, and fortified products like milk or OJ.
Vitamin D (D3), along with magnesium, can offer greater benefits but should be discussed with your health care provider as there are potential negative effects, particularly with medication interactions.
The recommended daily dose of vitamin D should not exceed 4000 IU.

Disclaimer: Symptoms of SAD can mimic other health issues such as decreases in thyroid function, and antidepressant medications have side effects that you may not tolerate¹. Please remember, this blog is intended to educate, not diagnose or treat any illness. Its sole purpose is to provide information that should absolutely be discussed with your healthcare provider. Together, you and your healthcare provider can explore symptoms and treatment options that are best suited to you and your unique health needs.

What Will You Do to Improve Your Seasonal Affective Disorder?

If you are still reading at this point, thank you! I wanted to share a personal bit about Seasonal Affective Disorder.

Every year, December through April, I struggle. I hate where I live, that it’s dark when I get up, that it’s dark when I get out of work, and that it’s just dark all the time. There’s nothing to do, and even if there was, I don’t have the motivation to do it. Last year was particularly bad.

So bad I finally sought help.

I was officially diagnosed with Seasonal Affective Disorder! Surprise!

While I struggle with depression related to years of untreated ADHD, it becomes so much more difficult to manage in the winter months.

Now, I take medications, schedule regular exercise, and supplement with Vitamin D, B12, and Magnesium. Staying well hydrated is always a challenge for me and I may forever be working on this goal. But for me, these seem to make the biggest difference and improve my mood.

Happy Winter Solstice, Witches!

References

Melrose S. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depress Res Treat. 2015;2015:178564. doi:10.(1)155/2015/178564
National Institute of Mental Health. Seasonal Affective Disorder. Accessed January 20, 2022 https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder#part_6691
Huang W, Ma X, Liang H, Li H, Chen J, Fang L, Yang Q, Zhang Z. Dietary Magnesium Intake Affects the Association Between Serum Vitamin D and Type 2 Diabetes: A Cross-Sectional Study. Front Nutr. 2021 Nov 25;8:763076. doi: 10.3389/fnut.2021.763076. PMID: 34901114; PMCID: PMC8656460
Office of Dietary Supplements, National Institute of Health. Vitamin D Professional Fact Sheet. Accessed January 20, 2022
Office of Dietary Supplements, National Institute of Health. Magnesium Professional Fact Sheet. Accessed January 20, 2022
Nussbaumer-Streit B, Forneris CA, Morgan LC, Van Noord MG, Gaynes BN, Greenblatt A, Wipplinger J, Lux LJ, Winkler D, Gartlehner G. Light therapy for preventing seasonal affective disorder. Cochrane Database Syst Rev. 2019 Mar 18;3(3):CD011269. doi: 10.1002/14651858.CD011269.pub3. PMID: 30883670; PMCID: PMC6422319.
Laura M. Huiberts, Karin C.H.J. Smolders. Effects of vitamin D on mood and sleep in the healthy population: Interpretations from the serotonergic pathway,Sleep Medicine Reviews, Volume 55, 2021,101379,ISSN 1087-0792, https://doi.org/10.1016/j.smrv.2020.101379.
Schuch FB, Vancampfort D, Firth J, et al. Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies. Am J Psychiatry. 2018;175(7):631-648. doi:10.1176/appi.ajp.2018.17111194

Say Goodbye to the Winter Blues

What is Seasonal Affective Disorder (SAD)?

How common is Seasonal Affective Disorder?

Symptoms of SAD include^1,2