In December of 2010, we spent two weeks in the Northwest. There were only a few days when there was sun. After a week that was cold, gloomy & rainy, I found myself sinking into a deep depression and I felt like I would go crazy if it went on much longer. I didn't know what was wrong. The first day that there was sun, I felt I just had to get out in it. As soon as I did, I felt better. Then there were several more days of gloomy weather and the depression came back. I didn't think that much about it until the Spring of 2011 when we had lots of gloomy whether at my home in Colorado. Again, I felt that I was to go crazy if it didn't stop. To make a long story short I discovered I have Seasonal Affective Disorder (SAD).
Since I made this discovery I have done some research on this disorder and found out that SAD was first described and researched by Dr. Norman Rosenthal while working at the National Institute of Health. He is the pioneer of light therapy to treat it and the author of the most popular book on SAD “Winter Blues” (Rothenthal, 2012). SAD is mainly a seasonal depressive disorder which develops in the late autumn or early winter and subsides in the spring. An estimated 10 to 20 percent of cases follow this seasonal pattern. Young adults and women are more likely to experience SAD. The rate of serotonin production is lowest in the winter which can affect mood. Studies have shown that people exposed to light therapy have shown marked improvement in depressive symptoms probably because insufficient light appears to cause a worsening of mood among SAD-vulnerable patients. These people seem to have an increased production of melatonin with the onset of longer winter nights. Studies suggest that the disorder may be an inherited disorder. Individuals with SAD experience fatigue, hypersomnia and increased appetite prior to developing depressive symptoms. Exercise and light therapy have been shown to be very effective treatments for SAD, especially morning outdoor exercise (Roecklein & Rohan, 2005). Dr. Rothenthal estimates that SAD affects approximately six percent of the population (fourteen million Americans). In his book, “Winter Blues” he focuses on how light therapy can be used to treat SAD (Rothenthal, 2012). In addition to light therapy, several supplements have been shown to help with the disorder. I have chosen to discuss 5 supplements which I feel would best help. They are Vitamin D, St. John’s Wort, SAM-e, Evening Primrose Oil and Magnesium.
Vitamin D
Vitamin D is a fat-soluble vitamin and because sunlight is one of the main sources of Vitamin D, researchers have studied it to see if supplementary Vitamin D also has an effect on depression and mood. Vitamin D is also involved in immune and neuromuscular function. Some research has found that diet and sunshine are not supplying all the Vitamin D that Americans need and supplementation may be necessary (Reynolds, 2010). “The Third National Health and Nutrition Examination Survey found that likelihood of having depression in people with vitamin D deficiency is significantly higher compared to those whose levels are sufficient.” (Gullotti, 2011). Many experts believe that at least 1000 IU of Vitamin D is needed per day to avoid deficiency. Caution should be taken to avoid mega dosing. Doses should not exceed 20,000 IU from all sources (Schlenker & Roth, 2011).
St. John’s Wort
St. John’s Wort (Hypericum perforatum) is an herb which has been widely used as a treatment for depression. It has been called “Nature’s Prozac”. Several studies have shown that it as effective as anti-depressant drugs. It appears to support serotonin, dopamine and norepinephrine. The ingredient in St. John’s Wort that seems to be responsible for much of the anti-depressant properties of herb is Hyperforin and studies show that the clinical effects of St. John’s Wort on depression correspond with its Hyperforin content (Moore, Goodwin, Jones, Wisley, Serabit-Singh, Willson, Collins & Kliewer, 2000). Also according to Mosby’s Handbook of Herb’s and Natural Supplements, hyperforin and adhyperforin which is found in the reproductive parts of the plant are the two constituents which may responsible for St. John’s Wort’s antidepressive properties (Skidmore-Roth, 2011). Results of over 20 trials have shown it to be as effective as anti-depressants for mild to moderate depression, with fewer side effects. It has also been used for a long time in folk medicine to treat sadness, worry, nervousness and poor sleep (Wong, 2011) which are some other symptoms of SAD. The recommended dosage for St. John’s Wort is 300 mg. hypercium extract, standardized to 0.3% tid. (1 to 3 capsules daily.) St. John’s Wort should not be given to children and those who are on anti-depressants (Skidmore-Roth, 2011).
SAM-e ( S-adenosyl-L-methionine)
SAM-e has been available by prescription in Europe as an anti-depressant for many years and available in the United States over-the-counter since 1996. SAM-e has been tested as an anti-depressant because of its role in making neurotransmitters. Several studies which have been conducted for depression both in the United States and in Europe show that SAM-e is more effective than anti-depressants and significantly more effective than a placebo and that the side effects are mild and transient. New research shows that SAM-e may be able to replace SSRI’s such as Prozac because when they failed to improve symptoms adding SAM-e improved the symptoms. SAM-e is also a good alternative for people who suffer from the hypersomnia associated with SAD because it produces alertness (Sahelian, n.d.). The recommended dosage for SAM-e is 200 - 400 mg daily. SAM-e should not be used during pregnancy or nursing, by children or by persons with bipolar disorder or Parkinson’s disease (Skidmore-Roth, 2011).
Evening Primrose Oil
Evening Primrose Oil is rich in essential fatty acids which are effective in treating depression (Steady Health, 2010). Fatty acids are needed for normal brain function and studies have linked low levels of fatty acids to depression. Because fatty acids are needed for normal brain function this might also help with the difficulty concentrating associated with SAD. Countries with high consumption of fish have depression rates 10 times lower than countries that don’t (Wong, 2011). The main essential fatty acid in Evening Primrose oil is GLA (gamma linoleic acid). When GLA is lacking, the nerve cell membranes do not function properly (Skidmore-Roth, 2011). The recommended dosage for Evening Primrose Oil is 1g containing 100 mg GLA (1 to 2 capsules daily). Patients who are pregnant or nursing should use caution and those who have seizure disorders should not take Evening Primrose Oil (Skidmore-Roth, 2011).
Magnesium
Magnesium is essential for good health because it is the fourth most abundant mineral in the body and is needed for more than 300 biochemical reactions including serotonin production, nerve function and energy metabolism (Office of Dietary Supplements, n.d.). Its numerous health benefits include the treatment of insomnia and depression (Newsmax, 2011). The UTL for Magnesium is 350 mg per day (Office of Dietary Supplements, n.d.). Magnesium should not be taken with antacids or laxatives containing magnesium because of the danger of magnesium toxicity. People with kidney failure should not take magnesium supplements because they will not be able to remove any excess magnesium.
Conclusion
While there are other supplements that could be useful for SAD such as 5-HTP, Folic Acid and Vitamin B6 (Wong, 2011), I chose these five because I think that they best support the depressive symptoms of SAD and are mood enhancers, support normal nerve function, supply nutrients essential for serotonin production, nerve function, energy metabolism, immune and neuromuscular function.
References:
Mayo Clinic Staff. (2011). Seasonal affective disorder. Retrieved from http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195/DSECTION=symptoms
Roecklein, K. A., & Rohan, K. J. (2005, January). Seasonal affective disorder. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004726/
Moore, L. B., Goodwin, B., Jones, S. A., Wisley, B. G., Serabit-Singh, C. J., Willson, T. M., Collins, J. L., & Kliewer, S. A. (2000, April 26). St. John’s wort induces hepatic drug metabolism through activation of the pregnane x receptor. Retrieved from http://www.pnas.org/content/97/13/7500.full
Skidmore-Roth, L. (2011). Mosby’s handbook of herbs & natural supplements. (4 ed.). St. Louis: Mosby.
Wong, C. (2011, September 26). Depression remedies. Retrieved from http://altmedicine.about.com/od/healthconditionsatod/a/Depression1.htm
Steady Health. (2010, August 30). Herbs for sad. Retrieved from http://ic.steadyhealth.com/herbs_for_sad.html
Gullotti, J. (2011, December 22). Vitamins and herbs: Don't let the winter blues make you sad!. Retrieved from http://ezinearticles.com/?Vitamins-and-Herbs:-Dont-Let-the-Winter-Blues-Make-You-SAD!&id=6774639
Reynolds, D. (2010, March 4). Can vitamin d help with seasonal affective disorder. Retrieved from http://www.emaxhealth.com/1506/25/35930/can-vitamin-d-help-seasonal-affective-disorder.html
Schlenker, E. D., & Roth, S. L. (2011). Williams\' essentials of nutrition and diet therapy. (Tenth ed.). St. Louis, Missouri: Mosby.
Newsmax. (2011, January 20). Top 5 health benefits of magnesium. Retrieved from http://www.newsmax.com/FastFeatures/Magnesium-health-benefits-supplements/2011/01/20/id/369647
Office of Dietary Supplements. (n.d.). Dietary supplement fact sheet: magnesium. Retrieved from http://ods.od.nih.gov/factsheets/magnesium/
Rothenthal, N. (2012, February 14). Biography. Retrieved from http://normanrosenthal.com/biography.html
Sahelian, R. (n.d.). Sam-e supplement benefits. Retrieved from http://www.raysahelian.com/sam-e.html
Vitamin D
Vitamin D is a fat-soluble vitamin and because sunlight is one of the main sources of Vitamin D, researchers have studied it to see if supplementary Vitamin D also has an effect on depression and mood. Vitamin D is also involved in immune and neuromuscular function. Some research has found that diet and sunshine are not supplying all the Vitamin D that Americans need and supplementation may be necessary (Reynolds, 2010). “The Third National Health and Nutrition Examination Survey found that likelihood of having depression in people with vitamin D deficiency is significantly higher compared to those whose levels are sufficient.” (Gullotti, 2011). Many experts believe that at least 1000 IU of Vitamin D is needed per day to avoid deficiency. Caution should be taken to avoid mega dosing. Doses should not exceed 20,000 IU from all sources (Schlenker & Roth, 2011).
St. John’s Wort
St. John’s Wort (Hypericum perforatum) is an herb which has been widely used as a treatment for depression. It has been called “Nature’s Prozac”. Several studies have shown that it as effective as anti-depressant drugs. It appears to support serotonin, dopamine and norepinephrine. The ingredient in St. John’s Wort that seems to be responsible for much of the anti-depressant properties of herb is Hyperforin and studies show that the clinical effects of St. John’s Wort on depression correspond with its Hyperforin content (Moore, Goodwin, Jones, Wisley, Serabit-Singh, Willson, Collins & Kliewer, 2000). Also according to Mosby’s Handbook of Herb’s and Natural Supplements, hyperforin and adhyperforin which is found in the reproductive parts of the plant are the two constituents which may responsible for St. John’s Wort’s antidepressive properties (Skidmore-Roth, 2011). Results of over 20 trials have shown it to be as effective as anti-depressants for mild to moderate depression, with fewer side effects. It has also been used for a long time in folk medicine to treat sadness, worry, nervousness and poor sleep (Wong, 2011) which are some other symptoms of SAD. The recommended dosage for St. John’s Wort is 300 mg. hypercium extract, standardized to 0.3% tid. (1 to 3 capsules daily.) St. John’s Wort should not be given to children and those who are on anti-depressants (Skidmore-Roth, 2011).
SAM-e ( S-adenosyl-L-methionine)
SAM-e has been available by prescription in Europe as an anti-depressant for many years and available in the United States over-the-counter since 1996. SAM-e has been tested as an anti-depressant because of its role in making neurotransmitters. Several studies which have been conducted for depression both in the United States and in Europe show that SAM-e is more effective than anti-depressants and significantly more effective than a placebo and that the side effects are mild and transient. New research shows that SAM-e may be able to replace SSRI’s such as Prozac because when they failed to improve symptoms adding SAM-e improved the symptoms. SAM-e is also a good alternative for people who suffer from the hypersomnia associated with SAD because it produces alertness (Sahelian, n.d.). The recommended dosage for SAM-e is 200 - 400 mg daily. SAM-e should not be used during pregnancy or nursing, by children or by persons with bipolar disorder or Parkinson’s disease (Skidmore-Roth, 2011).
Evening Primrose Oil
Evening Primrose Oil is rich in essential fatty acids which are effective in treating depression (Steady Health, 2010). Fatty acids are needed for normal brain function and studies have linked low levels of fatty acids to depression. Because fatty acids are needed for normal brain function this might also help with the difficulty concentrating associated with SAD. Countries with high consumption of fish have depression rates 10 times lower than countries that don’t (Wong, 2011). The main essential fatty acid in Evening Primrose oil is GLA (gamma linoleic acid). When GLA is lacking, the nerve cell membranes do not function properly (Skidmore-Roth, 2011). The recommended dosage for Evening Primrose Oil is 1g containing 100 mg GLA (1 to 2 capsules daily). Patients who are pregnant or nursing should use caution and those who have seizure disorders should not take Evening Primrose Oil (Skidmore-Roth, 2011).
Magnesium
Magnesium is essential for good health because it is the fourth most abundant mineral in the body and is needed for more than 300 biochemical reactions including serotonin production, nerve function and energy metabolism (Office of Dietary Supplements, n.d.). Its numerous health benefits include the treatment of insomnia and depression (Newsmax, 2011). The UTL for Magnesium is 350 mg per day (Office of Dietary Supplements, n.d.). Magnesium should not be taken with antacids or laxatives containing magnesium because of the danger of magnesium toxicity. People with kidney failure should not take magnesium supplements because they will not be able to remove any excess magnesium.
Conclusion
While there are other supplements that could be useful for SAD such as 5-HTP, Folic Acid and Vitamin B6 (Wong, 2011), I chose these five because I think that they best support the depressive symptoms of SAD and are mood enhancers, support normal nerve function, supply nutrients essential for serotonin production, nerve function, energy metabolism, immune and neuromuscular function.
References:
Mayo Clinic Staff. (2011). Seasonal affective disorder. Retrieved from http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195/DSECTION=symptoms
Roecklein, K. A., & Rohan, K. J. (2005, January). Seasonal affective disorder. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004726/
Moore, L. B., Goodwin, B., Jones, S. A., Wisley, B. G., Serabit-Singh, C. J., Willson, T. M., Collins, J. L., & Kliewer, S. A. (2000, April 26). St. John’s wort induces hepatic drug metabolism through activation of the pregnane x receptor. Retrieved from http://www.pnas.org/content/97/13/7500.full
Skidmore-Roth, L. (2011). Mosby’s handbook of herbs & natural supplements. (4 ed.). St. Louis: Mosby.
Wong, C. (2011, September 26). Depression remedies. Retrieved from http://altmedicine.about.com/od/healthconditionsatod/a/Depression1.htm
Steady Health. (2010, August 30). Herbs for sad. Retrieved from http://ic.steadyhealth.com/herbs_for_sad.html
Gullotti, J. (2011, December 22). Vitamins and herbs: Don't let the winter blues make you sad!. Retrieved from http://ezinearticles.com/?Vitamins-and-Herbs:-Dont-Let-the-Winter-Blues-Make-You-SAD!&id=6774639
Reynolds, D. (2010, March 4). Can vitamin d help with seasonal affective disorder. Retrieved from http://www.emaxhealth.com/1506/25/35930/can-vitamin-d-help-seasonal-affective-disorder.html
Schlenker, E. D., & Roth, S. L. (2011). Williams\' essentials of nutrition and diet therapy. (Tenth ed.). St. Louis, Missouri: Mosby.
Newsmax. (2011, January 20). Top 5 health benefits of magnesium. Retrieved from http://www.newsmax.com/FastFeatures/Magnesium-health-benefits-supplements/2011/01/20/id/369647
Office of Dietary Supplements. (n.d.). Dietary supplement fact sheet: magnesium. Retrieved from http://ods.od.nih.gov/factsheets/magnesium/
Rothenthal, N. (2012, February 14). Biography. Retrieved from http://normanrosenthal.com/biography.html
Sahelian, R. (n.d.). Sam-e supplement benefits. Retrieved from http://www.raysahelian.com/sam-e.html
