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Seasonal Affective Disorder (SAD)

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Are the winter blues keeping you down? It's known that many people have a change in mood with gloomy, overcast weather, particularly in Fall or Winter time every year. This could very well be Seasonal Affective Disorder (SAD), a term that is not it's own diagnostic entity, but rather a subtype of of another disorder that describes seasonal fluctuations in mood within major depressive disorder or bipolar disorder. Both men and women experience this, and even kids! It is however 5x more likely in women though.


Seasonal Affective Disorder Presentation


Common presentation of SAD may include initiating or worsening of depressive symptoms during the fall or winter months with vast improvement or even complete remission in spring or summer. Those affected may also have concurrent anxiety, somatic symptoms like muscle pain, manic or hypomanic symptoms, restlessness, and/or atypical depressive symptoms such as weight gain, slowness in movement and hypersomnia, all while withdrawing from other social activities and people.


Mechanism


The exact mechanism is unclear although circadian rhythms and various neurotransmitters such as Serotonin and Dopamine have been implicated in SAD. Changes in daylight during the Fall and Winter months may create a shift in both the sleep-wake cycle and hormone levels such has melatonin.


Management of SAD


Always see a provider to get properly evaluated first. However, there are some strategies that may mitigate symptoms if one does have SAD as a diagnosis. It's especially important to increase vitamin D levels before moving into the fall/winter months, given that less sunlight is available and D commonly decreases during this time since the sun helps create it through the skin. Bright light therapy machines are great and one that preferably yields an intensity of 10,000 lux. I like the Aura Day Light Therapy Lamp. This can be done 30 minutes daily in the AM. Some research shows dopamine support to be effective, which can be either done with Bupropion (medication) or natural agents to enhance dopamine such as L-tyrosine, DL-phenylalanine or Mucuna Pruriens, known to have some L-dopa content. Other options for SAD may include 5-HTP for serotonergic support, adaptogenic herbs for energy and cortisol regulation, stabilizing blood sugar with healthy dietary choices that include fiber, adequate protein and good fats such as avocados, olives, grass-fed meat and nuts. And lastly, avoiding sensitivities and allergens like gluten, dairy and the annoying lectins found in most grains, beans, and nightshades (tomatoes, peppers, potatoes and eggplant). These wreak havoc on your gut and are drivers of unnecessary inflammation in some, or even most people.



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