Natural Treatments for Seasonal Affective Disorder
Does the onset of winter, and the shortened length of daylight fill you with dread? Seasonal affective disorder typically begins in the fall and persists through the winter, as the period of light phase shortens.
The symptoms of SAD are depression, excess sleeping, a withdrawn feeling, lowered sex drive, a general slowing down, and craving carbohydrates. In the summer, these same people feel elated, active and energetic.
Contributing Factors It is important to rule out some simple factors which are known to contribute to depression in general, including nutrient deficiency or excess, drugs (including prescription, illicit, alcohol, caffeine, nicotine etc.), hypoglycemia, aspartame consumption, hormonal imbalances, allergy, environmental factors and microbial factors. Any one of these can exacerbate the symptoms one may feel with SAD and should be addressed.
Although there may be other contributing causes responsible for this effect, light exposure seems to be the most logical explanation. The antidepressant effects of full spectrum light in SAD has been demonstrated in well-monitored, controlled studies.
The body's internal clock, known as the circadian system, is regulated by the pineal gland. This gland is controlled by the presence or absence of external light, and synchronizes and coordinates the natural rhythms of body function.
When the dark-light cycle is altered, or a person ignores it and keeps irregular hours to work and rest, the body's internal rhythms become off balance. Travel time between time zones often results in jet lag, which can be a disorienting and debilitating condition caused by the upset of the body's internal clock.
Effects of Melatonin and Serotonin
Melatonin is a pineal hormone that is secreted at night and sets and maintains the internal clocks governing the natural rhythms of the body. Clinically, melatonin has been used in rhythm disturbances and sleep disorders. It is also corrects daytime fatigue ('jet lag') caused by the sudden changes of our light/dark environment.
Although melatonin may be useful for jet lag and other sleep disturbances, a warning is needed here. Melatonin administration that prolongs the nocturnal melatonin rise may exacerbate SAD and other types of depression. The use of Melatonin in general should be cautionary as we are still unsure of the long term effects on the circadian rhythm.
Brain serotonin levels are increased by Melatonin. Low central serotonin levels have been linked with many compulsive disorders including impulsive violence, alcoholism, compulsive gambling, bulimia, overeating and other compulsive behavoirs. Support of serotonin via nutrients can elevate mood, reduce aggression, increase the pain threshold, reduce anxiety, relieve insomnia, and help with obsessive-compulsive syndromes.
The serotonin elevating effects of folic acid and B12 are not fully understood but are responsible for the antidepressive effects of these nutrients.
Low levels of B vitamins in general are associated with depression and behavioral changes, so a supplemention with a multi containing high doses of all B vitamins should be considered.
The antidepressant effect of full-spectrum light is probably due to balancing of the altered circadian rhythm of Melatonin synthesis and secretion by the pineal gland. Light boxes are used in the majority of SAD cases using the complete balanced spectrum of sunlight. The patient sits about 18" from the box keeping the head and eyes toward the box while reading or doing other tasks. Most studies find early morning sessions from 30 min to 2 hours using varying intensities of light bring improvement with a week.
Hypericum perforatum (St. John's Wort)
The antidepressant effect of Hypericum perforatum has clearly been established in clinical trials over the past 10 years.
The plant originated in Europe, western Asia and North Africa, and is now widely distributed throughout temperate areas of the world.
The red pigment hypericin from the flower is the main active consitituent. The antidepressant quality of hypericum of through the photosensitizing effect of hypericin. It has been found that hypericum treatments lower the amount of light necessary to obtain a therapeutic effect and that normal daylight may have a similar effect to intensive light therapy when incorporated with hypericum treatments.
Studies on the effect of hypericum on melatonin release by the pineal gland may also reveal a possible mechanism for its antidepressant activity, along with modulation of serotonin receptors, the inhibition of enzymes which break down catchecolamines such as adrenaline and noradrenaline and the suppression of inflammatory mediators.
Hypericum has a MAO type A inhibition effects, although moderate, and should be avoided wherever phamaceutically appropriate.
For an antidepressant effect, a standard extract dose of hypericin 2.7 mg/day is necessary. This is the equivalent of 3 ml per day of a fluid extract (1:1) or 15 ml daily of a 1:5 tincture.
