How to Combat Seasonal Depression

This article originally appeared in Paleo Magazine.

If you repeatedly experience depression symptoms along with sleepiness and fatigue during the winter months, you might be suffering from seasonal affective disorder. Read on to learn about what causes seasonal depression and some tips for preventing and beating it naturally.

Seasonal depression is common in winter, but there are ways to ease your symptoms and improve your mood—without waiting for the sun to come out. Check out this article for tips on fighting seasonal depression. #healthylifestyle #wellness #chriskresser

Winter Blues and Seasonal Depression

Does winter bum you out? If you experience depression-like symptoms winter after winter, you may be suffering from seasonal affective disorder (SAD). Symptoms of SAD generally include:

Depressed mood
Fatigue
Irritability
Difficulty concentrating
Excessive sleeping (hypersomnia)
Carb cravings

SAD prevalence increases as geographical latitude increases in the United States. (1) For example, only 1.5 percent of adults in Florida develop it, but almost 10 percent of New Hampshire residents do. (2)

Important note: Depression can be a serious, life-threatening illness. If you or someone you love is depressed, please seek help from a licensed professional. Do not stop taking antidepressants without the knowledge and support of your doctor, and never stop these types of medications cold turkey.

What Causes SAD?

Less sunlight during winter is a major contributor to SAD. Sunlight is the most potent regulator of our internal circadian rhythms, which control melatonin, cortisol, core body temperature, blood pressure, and more on 24-hour cycles. (3) For example, cortisol should peak when you wake up and taper off before bedtime to prepare you for sleep.

When days are shorter, we’re exposed to less sunlight during the morning, and we turn on more artificial lights in the evening. Disrupting natural light exposure patterns messes with our circadian rhythms, increasing sleepiness and depression.

Less sunlight exposure and/or disrupted circadian rhythms may mediate other factors associated with or involved in the progression of depression, such as:

Lower vitamin D3 levels, from less sunlight exposure (4)
HPA axis dysregulation, from cortisol rhythm disruption and/or from stress due to holidays or financial worries at the end of the year (5)
Elevated inflammation, from too many sugary, refined, processed foods, not enough exercise, not enough sleep (6)

Tips for Combating Seasonal Depression

Antidepressants are among the most prescribed meds in the United States, but up to half of people with major depression do not respond well to them. (7) When they are effective, antidepressants take weeks to confer noticeable benefits, they often have side effects, and one has to slowly wean off of them. (8) This time frame doesn’t align well with a disorder that only occurs seasonally.

Antidepressants can be life-saving and effective, but not for everyone. When possible, I refer patients to the natural methods of combating seasonal depression described below.

Bright Light Therapy

Bright light therapy (BLT) involves daily exposure to a special light from a lightbox for 10 to 20 minutes. Usually morning exposure is most effective, but the ideal timing can vary from person to person. (3) An ideal light box provides full-spectrum light at 10,000 lux, and some models sell for around $100.

BLT improves: (9)

Mood
Sleep
Circadian rhythms
HPA axis activity

BLT has been proven effective for treating both SAD and non-seasonal-related depression, with about a 70 percent positive treatment response. (10) Some evidence indicates that combining light therapy with antidepressants adds no benefits over light therapy treatment alone for SAD. (11)

Although BLT results typically take one to two weeks to take effect, some users experience improvement after a single session. (12) Side effects are rare but can include headache, eye strain, and sleep difficulties. When stopping treatment, a gradual weaning is recommended.

Dawn Simulator

Our ancestors didn’t have alarm clocks; humans evolved rising with the sun. A dawn simulator, as its name indicates, mimics a sunrise, by gradually increasing the light it emits during the 30 minutes leading up to a set alarm time. (13) Compared to those who used a traditional alarm clock, people who used a dawn simulator in one study had higher cortisol levels at 15, 30, and 45 minutes after waking up. (14) If in tune with its natural rhythm, cortisol should be highest in the morning.

Dawn simulators have been shown to be effective for treating SAD and may even offer a lower chance of SAD recurrence compared to BLT. (11, 15)

Negative Ion Generator

Negative ions are naturally produced in nature by plants, sunlight, and moving water. Some evidence indicates that less exposure to negative ions and greater exposure to positive ions from electronics, pollution, and allergens may contribute to depression, anxiety, and other cognitive and behavioral disorders. (16)

If you’re deep in the trenches of SAD, spending time meditating near a waterfall might not be possible, but a high-density negative air ion generator can substitute. Similar to a light box, a negative ion generator should be placed near your body for a brief time each day, preferably in the morning. Negative ion generators have been shown to be effective for both seasonal and non-seasonal depression and can even have a mood-boosting effect in non-depressed individuals (17, 18, 19, 20)

Negative ion generators have very few known side effects, but a relapse of symptoms is likely if you stop treatment abruptly.

Gut Therapy

The gut and the brain communicate with each other through several pathways. (21) For instance, intestinal microbes synthesize neurotransmitters that can signal with the brain directly through the vagus nerve. In fact, about 90 percent of the body’s serotonin is produced in the gut, not in the brain. (22)

The evidence connecting gut problems to depression is growing:

Disrupted gut microbiomes have been associated with depression in humans (23, 24, 25)
Transferring fecal microbiota from depressed humans into mice increases their depressed behavior (26, 27)
Probiotics have reduced anxious and depressive symptoms in mice (28)
Antibiotics have alleviated depressive symptoms in some cases (29)

In short, a healthy gut will support a healthy brain. How to heal your gut is beyond the scope of this article, but the general framework involves the following:

Treating any underlying chronic infection
Consuming a variety of probiotic and prebiotic foods
Avoiding inflammatory foods like industrial seed oils, refined carbs, and excess refined sugars
Managing stress

Cognitive-Behavioral Therapy (CBT)

The mind is a powerful thing. CBT helps people recognize and correct negative or inaccurate beliefs through positive self-talk and self-compassion. If you tend to be a “glass-half-empty” type of person, this therapy might be especially helpful for you.

In the scientific literature, CBT repeatedly proves effective for treating depression and other psychological disorders. (30) Compared to light therapy, CBT resulted in lower SAD recurrence in a large clinical trial. (31) CBT and bright light therapy combined may offer greater benefit than either alone. (32)

Go Out Anyway

Humans are social creatures. Our ancestors lived in extended-family groups all year long. But in our modern world, cold and gray winters can isolate us. Too much isolation is a common depression trigger, and may be one contributing factor to SAD.

Choose to embrace the beauty of winter. Even in winter, you can get fresh air, a little bit of sunshine, and quality time with loved ones:

Take a brisk morning walk
Pursue a winter sport, like skiing, snowshoeing, or ice skating
Go sledding with your kids (or adult friends!)
Take a nature hike by a river or other flowing body of water for the extra negative ion exposure

Exercise in general may help ward off depression and lower inflammation. (33) If you can exercise outside, you will get the added mood-boosting benefit of sunlight. (34)

Consider Eating More Carbs

If you’re on a very-low-carb diet and struggle with SAD each winter, you might want to experiment with adding more high-quality carbs to your diet. Increasing carbohydrates may improve serotonin synthesis and transmission by increasing tryptophan uptake into the brain. (35, 36). Tryptophan depletion is common in SAD, and this could be one reason why many people with SAD crave carbs.

You could also try boosting tryptophan levels with these foods:

Pastured eggs
Wild fish
Pastured poultry
Seaweed
Spinach

Supplements

If lifestyle and diet changes aren’t enough, certain supplements may help relieve symptoms of SAD, depending on your specific needs. Work with a Functional Medicine practitioner to determine if any of the following might be appropriate:

CBD oil: CBD oil hasn’t been studied for treating SAD specifically, but evidence shows it can be helpful for reducing inflammation, treating anxiety, and helping sleep problems. (37, 38, 39)
St. John’s wort: This herb activates serotonin and GABA receptors. St. John’s wort reduces depression symptoms as well as antidepressants but with fewer side effects. (40) Do not take St. John’s wort concurrently with SSRIs or while doing light therapy.
Vitamin D3: If you live in the northern half of the United States, the sun during winter months doesn’t provide enough UVB to make adequate vitamin D3. (41) Consider a D3 supplement if your levels fall below 35 ng/mL.
B vitamins: Vitamins B6 and B12 are needed for serotonin synthesis. (42) Since they are water soluble, overdose is unlikely.
Herbs: Motherwort, rhodiola, eleutherococcus, saffron, and chamomile can help ease symptoms of depression. (43, 44, 45)