Continuing on from from Part I here are some more ideas for SAD (seasonal affective disorder) sufferers, or for anyone wishing to lift their mood in the autumn and winter months.
Numerous studies point toward the general mood enhancing effects of exercise. A 30 minute walk during the day may help to lift the mood. Studies specifically investigating SAD have found that light therapy in conjunction with daily exercise seems highly beneficial in reducing SAD symptoms (1,2,3). There seems to be an apparent additive effect of exercise and light on mood and health-related quality of life in individuals suffering with SAD. Trying to get out for a lunchtime walk, when the light is at its best in the winter, may really help to lift mood. Walking with a friend can help motivation and provide time for talking which can help clear the mind.
A review was published earlier this year (4) which looked at the association between vitamin D and mood disorders in women. The researchers reviewed published study data and found that there was an association between low vitamin D levels and higher incidences of seasonal affective disorder (as well as major depressive disorder). The authors conclude that further studies are warranted in order to asses the association in more detail.
I have previously mentioned that in the UK many of us do not get enough vitamin D. Supplementation with vitamin D may be useful to improve mood in SAD sufferers (5,6). It has been suggested that the seasonal symptoms of SAD may be due to changing levels of vitamin D3, the hormone of sunlight, and that supplementation with vitamin D may lead to positive changes in brain serotonin levels (a ‘feel-good’ brain chemical). In one study subjects were given 400 IU, 800 IU, or no vitamin D3 for 5 days during late winter. Results showed that vitamin D3 significantly enhanced positive feeling and there was some evidence of a reduction in negativity (5). In another study, 30 days of treatment with vitamin D proved highly effective in resolving depression in a group of SAD sufferers (6). Taking 400-800IU daily may be helpful to SAD sufferers during the winter months when sunlight is scarce.
Good diet, food cravings and blood sugar balance
Carbohydrate cravings are often reported by individuals suffering with SAD. This could be due to the fact that carbohydrate increases the uptake of an amino acid (building blocks of protein) called tryptophan. Tryptophan is used in the synthesis of serotonin, the good mood brain chemical. If serotonin levels are good then appetite is often normalised and cravings are less likely occur.
Regulating blood sugar levels with diet may also be helpful to SAD sufferers with disordered eating and cravings. I wrote about this in more depth on the 8th and 10th of September. Balancing blood sugar levels through eating a healthy diet that provides a slow and steady supply of energy throughout the day may help to prevent cravings and fatigue. A diet rich in vegetables and fruits, healthy fats (especially omega 3 fatty acids from oily fish, fish oil or flax seed oil supplements) and proteins (from nuts/seeds, eggs, lean unprocessed meats, fish and pulses/beans) may help to minimise blood sugar imbalances and cravings. Vegetables and fruits are great sources of unrefined carbohydrates as are wholegrains with a low glycaemic index (GI). Please read my previous posts for more detail on glycaemic index and eating to minimise cravings. If you feel that your diet is inadequate you may wish to consider taking an omega 3 fatty acid supplement (a fish oil or flaxseed oil supplement) and a good quality multivitamin-mineral supplement (I prefer ‘food state’ supplements).
Women suffering from the eating disorders bulimia or binge eating disorder may find that their conditions are more difficult to control in the winter time. There is some indication (7) that light therapy can help minimise these symptoms in autumn/winter and aid mood and carbohydrate craving. Investing in a light box or daylight alarm clock may prove useful. For help and information on eating disorders please visit the BEAT website. BEAT is a charity (the working name for the Eating Disorders Association) for people with eating disorders and their families.
Cognitive behaviour therapy / counselling
Finally, if you feel distressed and unable to cope with the depressive/mood symptoms associated with SAD you may well want to look at a form of counselling called Cognitive Behaviour Therapy to help. There is indication (8) that this form of therapy is very useful in individuals dealing with SAD and low mood in winter. For more information and useful links please visit the Royal College of Psychiatrists.
Wishing you all a happy winter!
(1)Leppamaki S et al. 2004. Drop-out and mood improvement: a randomised controlled trial with light exposure and physical exercise. BMC Psychiatry. 4:22
(2)Partonen T et al. 1998. Randomized trial of physical exercise alone or combined with bright light on mood and health related quality of life. Psychol Med. 28:1359-1364
(3)Leppamaki SJ et al. 2002. Bright light exposure combined with physical activity elevates mood. J Affect Disord. 72:139
(4) Murphy PK&Wagner CL. 2008. Vitamin D and mood disorders among women: an integrative review. J Midwifery Womens Health. 53(5):440-6.
(5) Lansdowne AT et al. 1998. Vitamin D3 enhances mood in helathy subjects during winter. Psychopharmacology. 135(4):319-323.
(6)Gloth FM et al. 1999. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J Nutr Health Aging. 3:5-7
(7) Lam RW et al. 2001. An open trial of light therapy for women with seasonal affective disorder and comorbid bulimia nervosa. J Clin Psychiatry. 62(3):164-8
(8)Rohan KJ et al. 2007. A randomised controlled trial of cognitive behaviour therapy, light therapy and their combination for seasonal affective disorder. J Consult Clin Psychol. 75:489-500
Written by Ani Kowal