Winter Blues?

Natural Supplements for Seasonal Affective Disorder

Posted Jan 21, 2015

Many people suffer from low moods in the winter.  It may be related to Seasonal Affective Disorder (SAD) affects approximately 10% of individuals who live in climates that are less sunny (vs. 1.4% of individuals in Florida).  Symptoms of SAD include sleeping too much, lack of energy and low moods or depression.  Usually symptoms clear up when the weather changes.  Other symptoms include difficulty waking up, trouble concentrating, decreased sex drive, decreased appetite and weight gain or loss.

Light therapy is a common and effective treatment for SAD, which is now considered as a subset of different forms of depression.  The use of bright light (10,000 lux) for up to one hour per day has been shown to be effective and can work after just one week.

Physical activity is also effective for SAD.  Being active at dawn and dusk may help reset the sleep/wake cycle of those with SAD.

Below are also four supplements you can use to help life your moods during cold, dark winter weather:

B-Complex vitamins help your body convert proteins from your diet into the neurotransmitters (serotonin, dopamine, etc.) needed for mood and energy.  B-complex vitamins also support heart health and improve your response to stress and help boost energy levels.  While most B vitamins have some benefits for mental health, in terms of depression, the most important B vitamins include vitamin B6, B9 (folic acid) and B12 (Office of Dietary Supplements).

Causes of B-vitamin deficiencies include: Crohn’s disease and bariatric surgery that causes malabsorption, being elderly, or a strict vegetarian.  Those with alcoholism, obesity, eating disorders, substance use disorders, autoimmune diseases, renal disease necessitating dialysis, HIV infection, liver disease may also be deficient in B-vitamins.

Medications that can cause deficiencies of B-vitamins include: seizure meds, corticosteroids, isoniazid (for tuberculosis), metformin (for diabetes), peptic ulcer and gastroesophageal reflux (GERD) medications and birth control pills.

Good sources of B-vitamins include beef, poultry and organ meats, tuna, nutritional yeast, brewer’s yeast, whole grains, potatoes, bananas, lentils tempeh, beans, dark leafy vegetables, fortified cereals and molasses.  Vitamin B12 is not available from plants, which makes B12 deficiency a concern for strict vegans.

Cautions:Taking any one of the B vitamins for a long period of time can result in an imbalance of other important B vitamins. In particular, if given in excess, folate can mask deficiency of vitamin B-12.  For that reason, using a B-complex supplement is best.   There is some evidence that high levels of folic acid may provoke seizures in patients taking anti-seizure medications. 

Vitamin D deficiency is particularly likely in the winter when low levels of sunlight and lack of stored vitamin D exacerbate borderline or low vitamin D levels.  Vitamin D deficiency is thought to be rampant especially in vulnerable populations such as African-Americans, the elderly, children, the obese, pregnant women and breastfed babies. 

The link between vitamin D and depression has been under study.  Postpartum depression, for example is associated with low levels of vitamin D in small studies (Ellsworth-Bowers ER, 2012).   In a study of depressed adolescents, low vitamin D levels were present in 34% (less than 20 ng/mL), marginal levels in 38% (20-30 ng/mL).  Low levels of vitamin D are significantly associated with psychotic features in teens with depression (Gracious BL, et al. 2012).   Vitamin D was shown in a pilot study to reduce depressive symptoms in individuals with seasonal affective disorder (SAD).

You can have vitamin D levels tested by a simple blood test.  If you are struggling with depression, keeping your level above 60 ng /mL is recommended.

Dosage:  The suggested upper limit for adults is 2,000 IU per day of vitamin D3.  However, if this does not produce a healthy blood level of vitamin D, higher doses can be used under the supervision of a health care practitioner

Cautions:  Vitamin D toxicity is very rare and the toxicity is related to high calcium levels that occur with too much vitamin D causing calcium deposits in the kidneys.  IF you have kidney problems or high blood calcium, you should speak with you physician before taking vitamin D.  Otherwise, vitamin D is usually safe if taken in regularly recommended dosages.

St. John’s Wort (Hypericum perforatum) is thought to have an antidepressant effect due primarily to its action on serotonin.  St. John’s wort is widely prescribed in Germany for mild depression, especially in children and adolescents (Fegert JM, et al. 2006).   Research has shown that SJW is as effective as conventional therapies for major depressive disorder and is superior to placebo with fewer side effects than conventional anti-depressants (Linde K, 2008).   SJW has been shown to be effective for mood, anxiety, and depression-related insomnia.

SJW should be considered as a stand-alone treatment for mild-moderate depression.  In wide use in Europe, fewer than 1% of those taking SJW had side effects. More studies are needed to confirm the efficacy of SJW for more severe depression.

Dosages: Most studies used dosages of 300 mg of an extract (standardized to .3% hypericin) three times daily.

Cautions: Side effects of SJW include its potential to lower the efficacy of certain medications including birth control pills, medications for migraines (Imitrex, Zomig, other triptans), alprazolam (Xanax), the cough medicine Dextromethorphan (Robitussin DM and others), Digoxin, Fenfluramine, Demerol and other medications.  SJW may also cause photosensitivity (more likely to sunburn).  If you have been diagnosed with bipolar affective disorder or you are on prescription antidepressant medications, you should only take SJW under a doctor’s supervision.

Fish oil is a well-recognized mood support supplement. Consumption of fish in the diet or supplementation of omega-3 fatty acids is safe and cost-effective and has been shown to benefit heart disease, reduce suicide risk, and reduce symptoms of depression and bipolar disorder.  It has been shown to be safe in children and adults.  Higher consumption of fish is also associated with lower rates of seasonal affective disorder (SAD) and postpartum depression, as well as predicting overall higher mental health in general (Kendall-Tackett K, 2010).

Foods high in omega-3 fatty acids include fish, leafy greens, soy, nuts and seeds.

Supplements of fish oil should contain both EPA and DHA in approximately equal amounts.  For mild mood changes, take 2,000 – 3,000 mg daily. 

Cautions:  Theoretically, fish oil may increase bleeding time so if you take a blood thinner, you should ask you physician before taking fish oil.

Don’t suffer in silence.  If you notice you have the “winter blues” seek help from you medical professional.