Seasonal Affective Disorder Protocol

 

                As I’m sure you’ve noticed, it’s that time of year again. The leaves are taking on those familiar shades of yellow, red, and brown. I hope you’re able to get out and enjoy that spectacular spectacle.

This time of year may bring about fond memories from our days of youth, cuddled up with cups of steaming something or rather, our favourite hoodies, and sitting around a much-needed fire.

For others, this time of year may not be so cozy and inviting; for some, the changing of the seasons invites a sense of dread and anticipatory feelings of “here we go again.” Our expectation that the loss of long sunny days surely means even longer days and nights struggling with feelings of malaise, loss of pleasure and motivation, and a desire to both curl up in a ball and run away.

If you identify with the latter, you’re far from alone; in fact, 5-10% of the general population (that’s 11-36 million people in North America) will suffer from some degree of what is called Seasonal Affective Disorder. That number is even higher in people who already have pre-existing degrees of depression, somewhere to the tune of 10-25%. I am one of these millions of people, so I must open with a resounding “I know how you feel, and I am here to offer some help”.

Seasonal Affective Disorder appears to have several possible causes, with the most scientifically convincing stemming from reductions in exposure to sunlight that influence our sleep/wake cycles and serotonin production. In line with this theory, countries closest to the Earth’s poles, like Canada and Northern Europe, that have a significant loss of light during the fall and winter months seem to be hit the hardest with huge upticks in self-reported suffering.

Sun exposure, or high lumen/lux (bright) light sources, influence the functioning of our bodies in several ways, but most notably in regard to today’s topic, through something called circadian rhythm.

Circadian rhythms work on a 24-hour biological clock that dictates to your cells when certain biological processes are set to occur, like when we should be sleepy, wide awake, active, or relaxed. For example, processes like the release of chemicals, like melatonin, the sleep molecule, follow a circadian rhythm.

Our circadian rhythm is set through several incoming streams of information, with light exposure as the most powerful.

How it works:  

As light enters our eyes and stimulates the retina, messages are sent through a neuronal highway that is distinct from the primary visual information highway that informs us of what we’re looking at. This unique “light” pathway sends signals to parts of the brain like the suprachiasmatic nucleus of the hypothalamus that communicates to the rest of the brain and body when to do certain tasks (like telling the pineal gland when to release melatonin)

This is all really neat neurophysiology, but what happens when our exposure to sunlight (that helps reinforce when to do what) begins to dwindle while the length of day doesn’t change?

We still have to get up to go to work at the same time (usually still dark), come home at the end of the day (usually dark) and try to enjoy our evening.

Our brain and body get mixed messages. The lack of sunlight is telling us it’s time for sleep, while our world is telling us it’s time for work or dinner.

So that’s the short and sweet of where many scientists believe Seasonal Affective Disorder comes from, so what can we do about it?

Thankfully, there are a number of things we can do to start… dare I say… enjoying the winter.

I’ll split these tips and tricks into two camps; what we can do and what we can take.

What can we do?

Exercise:

                Although light is the most powerful stimulus for entraining our circadian rhythm, it’s not the only stimulus. Even the simplest of exercises, like going for a walk first thing in the morning, can be a very powerful trick to help tell your body, “nope, it’s actually time to get up; turn on the go-go juices, please.” This doesn’t have to mean that you go throw on your parka at 7 AM and go walk through the dark snowy streets of your neighbourhood. This could mean doing a few laps up and down the stairs in your home or doing some push-ups and squats. It doesn’t have to be a full workout (although I wouldn’t advise against doing one in the morning), but any movement that gets your heart beating will help to entrain your brain and body that now is the time to get up.

Cold/Heat:

                Another strong stimulus for influencing your circadian rhythm is temperature. Did you know that your body is typically warmest in the middle of the day and coldest in the middle of the night? This undulating temperature phase is another process entrained through your circadian rhythm. This may be a little confusing, but by taking a cold shower first thing in the morning, you are sending signals to your brain (pre-optic anterior hypothalamus) that it’s time to heat the body up. Your body does this through a number of processes, such as releasing adrenaline and cortisol, which appear to have a delayed release schedule in people with SAD and depression. So by taking cold showers frequently at similar times in the morning, your body begins to anticipate the cold and will begin releasing adrenaline and cortisol at that time.

Sleep:

                Try to stick to a fairly strict sleep schedule. Our circadian rhythm (and much of the brain and body) isn’t a huge fan of constant fluctuations in daily routines, especially when it comes to sleep. Our biological clock and all the cells that follow it function at their best when we do more or less the same basic things (eat and sleep primarily) at similar times.

Sun:

                Sunlight as a currency becomes much more valuable to those of us who struggle with degrees of SAD and depression, so making efforts to get sunlight as early as possible is critical. Previous research has indicated that at least 10 minutes of early sun exposure (20-30 minutes if it’s cloudy) will help ensure that your circadian rhythm doesn’t experience a drastic phase shift that may exacerbate depression symptoms. I’ll also note that if you work a job where you don’t see the sun all day, a SAD lamp can serve as a replacement for natural sunlight. Buying one for your desk at work or your kitchen or bedroom isn’t a bad idea. They seem to work best if you aren’t looking directly at it but with it facing you; for example, have it in your bedroom while you get dressed or in your kitchen while making breakfast.

What can we take?

Caffeine:

                I’ll first start with something that would benefit you if you didn’t take, or rather, taken at specific times of the day. Caffeine is very good at what it does; it keeps us awake despite signals that it’s time for rest and can significantly disturb the quality of our sleep for up to 8 hours after ingestion. So, try to avoid reaching for that 2nd-3rd cup of joe at 5 pm.

Food:

                I know skipping breakfast seems to be the choice for many of us for the sake of convenience or otherwise, but food is another strong stimulus for dictating our circadian rhythm. If you don’t usually eat breakfast, try having even a small meal upon waking. Something as simple as a hard-boiled egg, protein smoothie, or low-sugar Greek yogurt can be a great way to get your engine revving. This alone can have a positive impact on reducing some depressive symptoms.

Melatonin:

Although I really don’t recommend becoming reliant on exogenous sources of melatonin for a number of reasons, if you’re in a pinch and are having difficulties getting to sleep, you can benefit from 1-3 nights of 3mg of melatonin 20-30 minutes before you’d like to fall asleep.

Fish Oil:

                Fish oil appears to be another great option for staving off symptoms related to seasonal affectivity and depression by influencing serotonin production and metabolism. Since serotonin is a major player when it comes to sleep/wake cycles, ensuring we have all the materials needed for its functioning is a great idea. A number of studies have identified that fish oil actually demonstrates anti-depressant effects for non-SAD depression as well.

Creatine:

Creatine has been researched extensively within the physical performance circles and recently has also been identified as a chemical with potential anti-depressant effects through its ability to increase energy supply (by increasing ATP) in the prefrontal lobes, which are areas of high energy demand. In fact, brain scans of depressed brains appear to show reduced metabolic activity in the prefrontal lobes, which is thought to result in much of the reduced cognitive function associated with depression, such as impacted decision-making, attentional control, and aspects of motivation. Chemicals, such as creatine, appear to reduce these effects in some people, especially women.

These suggestions appear to be the most frequently studied and validated efforts that can be made to stave off SAD-related symptoms. Of course, there are a lot of other ideas and theories circulating the internet that are well within your grasp if you feel this list is incomplete. However, I do hope some of this is new and useful knowledge that you feel capable of putting into practice.

Additional recommendations that I really want to highlight here are traditional anti-depressants (like SSRIs) and/or psychotherapy. There seems to be, at least in my experience, an idea that seasonal affective-related depression isn’t really a thing that is worth doing anything about, but this couldn’t be further from the truth. Anything that gets in the way of you enjoying your life, especially seasons as wonderful as fall and winter, is worth putting some focus on – SAD isn’t a life (or seasonal) sentence.

 

References

Bakian, A.V., Huber, R.S., Scholl, L. et al. Dietary creatine intake and depression risk among U.S. adults. Transl Psychiatry 10, 52 (2020). https://doi.org/10.1038/s41398-020-0741-x

Hibbeln, J. R. (1998). Fish consumption and major depression. The Lancet, 351(9110), 1213. https://doi.org/10.1016/S0140-6736(05)79168-6

Kurlansik, S. L., & Ibay, A. D. (2012). Seasonal Affective Disorder. American Family Physician, 86(11), 1037–1041.

Ma, M. A., & Morrison, E. H. (2022). Neuroanatomy, Nucleus Suprachiasmatic. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK546664/