A Medical Condition Involved In The Winter Blues

The following is a reproduction of a Millennium Health Centre editorial article which appeared in the Seaway News newspaper in Cornwall, Ontario, Canada. The content is shortened to accommodate a newspaper space allotment. As such, it is not academically cited with references. These are available, so please feel free to email your questions.


Dr. Stephen F. Jones B.Comm., N.D.
Doctor of Naturopathic Medicine

So, the holidays have past, the bills are on the kitchen table and its colder than you know what outside. The result is that you may be feeling a little blue, tired or outright depressed. Well, the reason may be due to the cold, the darkness and the holiday (financial) hangover, or it could be a recognizable medical condition that researches believe 5-10 % of us suffer from quite dramatically and possibly 90 % of us suffer from to some extent (published in the Journal of Affective Disorders, 2001). The condition is know as Seasonal Affective Disorder, or simply SAD, and while it is a very real, recognizable and treatable condition, it is rarely diagnosed for patients.

Those of us lucky enough to live in Northern latitudes where we see prolonged periods with limited sunshine and early evening darkness are more prone to suffer from SAD. The condition sets in with the onset of autumn, often worsens during the height of the winter and disappears with the onset of spring sunshine and the lengthening of the days. The symptoms can include feeling depressed, feeling constantly tired with difficulty waking, carbohydrate cravings (such as bread, bagels, pasta and the like), low libido (sex drive) and a generally depressive mood with a decreased desire to partake in social activities. For some, however, the condition can be much more serious with impaired function at work or school, increased absenteeism and even an increase in suicidal thoughts. Simply put, SAD is a reality that patients and their physicians need to consider in examinations and take serious with respect to treatment.

The question, then, is simply what can be done to treat this common condition. Well, the usual approach is to prescribe anti-depressants and little else. Medications such as Prozac and Celexa are members of a family of drugs called "S.S.R.I.'s" (stands for Selective Serotonin Re-Uptake Inhibitors). Avoiding a biochemistry class, these medicines prevent the re-absorption of a chemical called serotonin in the brain, allowing for this serotonin to stay around and do its job. Its job is to promote restful sleep, to make us feel happier and to modulate pain if we have any. In short, the more serotonin you have, the less likely you will feel tired and/or depressed. Sounds good right?

Well, the 'problem' is that these medications come with some very real side effects and DO NOT help our bodies actually manufacture more serotonin. They prevent its re-absorption, but do not stimulate the production of more serotonin. Why is this important ? Its important because SAD has been linked to a deficiency of serotonin (as discussed in several medical journals including the Archives of General Psychiatry, 2002, Psychiatry Research, 2003). If you don't have enough Serotonin to start with, limiting its re-absorption may make little difference to the SAD patient.

So, what can you do ? The answer is to turn to nature. That's right, all of you 'natural medicine' nay-sayers may be shocked to realize that the number one medically accepted treatment for SAD is 'light therapy'. Exposure to an artificial light source at specific time intervals has been clinically proven to increase the body's production and regulation of not only serotonin, but also melatonin and other brain chemicals involved in controlling SAD (as published in such medical journals as the Archives of General Psychiatry, 2002 and Biological Psychiatry, 2001). Not only has this treatment shown results with respect to eliminating the fatigue and depressive mood of SAD patients, light therapy has also been shown to decrease suicidal thoughts in the most seriously affected patients (J Clin Psychiatry, 2000). The problem is that patients do not like sitting in front of the artificial light sources (they prefer flying to Florida…..).

So, should light therapy prove difficult, a doctor familiar with its use may prescribe a natural medicine that is directly converted into serotonin in the human body. That is to say, it leads to an increase in the actual levels of serotonin in the body (as published medical journals such as Psychiatry Res., 1990). This medicine, called 5-hydroxytryptophan (or simply 5-HTP), has been shown to be as effective as Prozac in relieving general (non-SAD) depression (published in the journal Psychopathology, 1991) and to increase the most important phase of sleep (called REM sleep) which is believed to be decreased in SAD (as published in the journal Brain Res, 2001).

While beyond the length of this column, other treatments include the use of Vitamin D, St. John's Wort and even something called high-output negative ionizers. While melatonin is not available in Canada, research has also demonstrated its significant ability to reverse the symptoms of SAD. Saliva tests should be conducted first, however, before this treatment would be considered.

Don't suffer this winter. Consult a physician familiar with the above treatments and start 2004 as healthy and happy as you wish to be.

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