In winter it can be common for many of us to experience low mood, especially during the heart of the colder and darker days. But is it just some passing “winter blues” or could you be experiencing Seasonal Affective Disorder (SAD)?

Winter blues can be characterised by lethargy, having difficulty finding the energy to go out or feeling more gloomy than usual. However, winter blues shouldn’t hinder your ability to enjoy life. So if what you are feeling begins to affect all aspects of your life generally you may be facing SAD. SAD is a type of depression associated with the change in seasons that usually begins in the autumn and persists through the winter months.

Seasonal Affective Disorder (SAD)

Winter blues are quite common and can even be seen as a natural part of the seasonal cycle – winter is after all a time to turn inwards, spend time around the “hearth” and rest. The Danish art of Hygge captures particularly well the beauty of this season and of the inwards-turning process – but more on that later.

Though there is no clear dividing line between winter blues and SAD, SAD is seen as a more persistent state, more broadly disrupting your ability to go about your life normally – whether it is getting motivated for work, getting out of the house or even socialising. SAD can show up as a variety of different symptoms or just a small cluster but often it is present for a couple of years in a row during the winter months.

Symptoms include:

• feelings of depression – in other words feeling sad, low, tearful, hopeless and despairing, having suicidal thoughts, or alternatively apathetic (feeling nothing); it can also be characterised with alternating bursts of hyperactivity and cheerfulness, then low mood or depression
• lethargy, fatigue (including “mental fatigue” such as lack of willpower), difficulty taking initiatives or lack of energy for everyday tasks
• problems concentrating or focusing, memory issues
• sleep problems – such as sleeping for longer than usual or not being able to fall asleep
• increased inability to cope with everyday stresses, including increased anxiety or panic attacks
• overeating – particularly “comfort eating” or snacking more than usual
• lowered immune system during the winter, with an increased tendency to catch colds, infections and other illnesses
• loss of interest in sex or physical contact
• withdrawing from social and relationship activities including feeling irritable around people, and isolation from friends and family
• greater drug or alcohol use
• loss of interest in activities you typically enjoy, including exercise
• problems with performing at work or school

Causes

In terms of external triggers SAD is generally believed to be linked to the lack of sunlight during the winter months, though the exact causes are still unclear. Reduced sunlight can disrupt your Circadian cycle (internal clock) which controls sleep, appetite, sex drive, temperature, mood and activity through the hormonal system. The Circadian cycle is affected in part by the production of melatonin, a hormone triggered by daylight and darkness that makes you feel sleepy, and which also impacts on another hormone called serotonin which affects mood, appetite and sleep (among other things). Of course, having a terrain that is sensitive to such changes also plays a role in developing SAD and its degree of severity.

Like other forms of depression, SAD has also been reported to have been triggered or made worse by:

• a major or traumatic life event, including a loss or bereavement, or an assault
• physical illness
• a change in diet or medication
• dysbiosis (unbalanced gut flora) including after courses of antibiotics or other medications
• the use (or withdrawal from) drugs and alcohol

Some Options

Herbal medicine can offer some very effective options for SAD and winter blues. I will discuss a number of herbs that can help here but this is a condition where a personalised consultation is much more effective because of the complexity and individuality of triggers. However, here are some tips to help manage your winter blues or SAD.

Let’s start with some lifestyle changes you can make:

• Change your perspective: instead of letting the thought of shorter, colder and darker days get you down, think about it as a period to make time for things, including rest, relaxation, self-care, looking inward, getting cozy, increasing your intimacy with your self and your loved ones, and making your house a home. I found that the Scandinavians, who have very little light in the winter, have a great perspective on winter. In particular, the Danish “art” of Hygge, on which I wrote in January last year, offers a variety of solutions for changing your perspective and making winter cozy and even fun. You can see that article here.
• Avoid stress and take time for yourself or engage in activities you enjoy: if winter is a stressful time for you, plan ahead to move those activities or chores that stress you in winter to other seasons. Make winter a time to pamper and care for yourself instead by scheduling regular little moments such as a massage. Learn to use the time inside to learn to meditate or relax, take up a long-held interest or a class, or just spend time catching up on reading.
• Find support resources: Knowing you are not alone is important – take advantage of the winter to catch up with family and friends, maybe even schedule calls on a regular basis.  Make (and keep) plans with friends and family to help you stay connected to your loved ones. Get out and get social – find groups such as exercise buddies, or reading or knitting groups. If you need more support, there are many support groups out there for people who suffer from SAD, low mood or depression.
• Maintain a regular schedule: during the winter months supporting your Circadian rhythms can help keep your hormones in balance and regulate your mood. In particular it is important to keep your meal and sleep schedules the same to help normalise your Circadian rhythms.
• Physical activity: Staying physically active during the winter is essential. It helps balance out nervous system function, lift mood and increase energy.  Research consistently shows a strong exercise-mental health connection, particularly for those with depression and anxiety. That’s why experts often refer to exercise as nature’s antidepressant. Exercise can increase serotonin and endorphins, which both affect mood. Moderate exercise of 20-30 minutes at least 3 days a week will help provide a mood boost and get you started on the right footing.
• Sunlight: Spending time outside in daylight hours helps regulate your Circadian rhythms and melatonin production. Take a walk during your lunch break, play with your kids in the snow or try an outdoor winter activity like hiking, skiing or ice-skating – even if it isn’t a sunny day: it’s about helping your body differentiate between daytime and nighttime. Being in nature has been shown to be especially helpful for regulating Circadian cycles, sleep patterns and stabilising nervous system function. If you can afford it, plan a holiday in a sunny place during the heart of winter – it also gives you something to plan and look forward to. But be aware that sometimes coming back home can make symptoms slightly worse.
• Healthy diet: since gut and mental health are linked, a healthy diet and a balanced gut flora are very important in mood disorders.  Structure your eating patterns around three meals a day, at the same time every day. Make sure you are getting plenty of healthy fermented foods and an array of seasonal vegetables. Avoid the urge to overindulge in simple, refined or processed carbohydrates, sweet foods stimulating drinks and alcohol. Discuss vitamin D and B levels with your health practitioner.
• Use a light box: A light box is a specialist device containing bright fluorescent bulbs which mimic sunlight and has been found to be an effective treatment for SAD because it increases your exposure to light during the winter months. Light therapy can be particularly helpful in regulating the release of melatonin. When undergoing light therapy, follow your clinician’s advice to ensure you are using an appropriate “dose.” This will help the treatment be most effective, while also lowering your risk for side effects (e.g., agitation and headaches). Light boxes are usually at least 10 times the intensity of household lights. You can use your light box at any time of day, although it’s best to use it before evening time and avoid it in the hour or so before you go to bed as the effect of the light may make it hard to sleep. If you have existing eye problems, you should check with your optician that a light box is safe for you to use.
• Talking therapy including cognitive-behavioural therapy: A recent study in the American Journal of Psychiatry suggests that CBT can actually be a more effective long-term treatment for SAD than light therapy.

Herbs

For conditions such as this one, I like to use a trio of herbs which work to regulate the stress response and improve serotonin distribution and efficacy. These herbs are:

• St. John’s Wort (Hypericum perforatum): this is a well-known herb for use in mood disorders and it is very effective. However, it is important not to use it if you are taking contraceptive pills, or any other form of conventional medical treatment regularly (I’m not taking about the occasional use of aspirin or over-the-counter NSAIDs like Ibuprofen). This is because it is also a liver herb and works with the liver’s metabolic processes which break down medicines to make them effective. Furthermore, St. John’s Wort takes 6-8 weeks of continuous use to really regulate serotonin efficacy and needs to be used at a relatively high enough dose (and like any herb be of good quality).
• Rhodiola (Rhodiola rosea): this adaptogenic herb not only helps your body deal with stress and anxiety better but also helps it regulate the efficient use of serotonin. Furthermore, it works at the mitochondrial level to improve energy uptake and use.
• Agrimony (Agrimonia eupatoria): Agrimony is a herb with specificities for the liver and pancreas – specifically I use it in combination with Rhodiola to help manage serotonin use in the body and improve pancreatic function especially in relation to its enzymatic function. So this herb also helps with regulating the digestive cycles, and the breakdown and absorption of micro-nutrients.

In addition to the above herbs, there are many other “nervines” – herbs which support the nervous system –  which can also be useful here. For instance:

• Vervain (Verbena officinalis): this is a helpful herb which combines nervine, adaptogenic and digestive actions. On an “energetic” level it is also considered a grounding herb, which can be explained by its actions on the nervous system.
• Saffron (Crocus sativus): Saffron shows promise as a herb for anxiety and low mood. Due to its price, I tend to use a supplement by Viridian which associates it to vitamin B6 and magnesium – both particularly indicated to support nervous system function. You can find that supplement here and don’t hesitate to use my practitioner’s code TERRA10 and get a discount.
• Chamomile (Matricaria recutita or chamomilla): Chamomile helps calm the nervous system but is also a great anti-inflammatory and digestive herb. It can be particularly indicated for people with anxiety or low mood linked to dysbiosis.
• Motherwort (Leonurus cardiaca): I include this wonderful herb in the mix because not only does it act on the nervous system directly but also calms central thyroid-related hormones (TRH and TSH) which have a role in seasonal and mood disorders. Avoid regular long-term use if you have thyroid function disorders without first checking with a herbalist.

In addition to the herbs above, ensuring you have adequate levels of vitamin D, Omega 3 and B vitamins is also important to support mood in the winter months. Remember that if you are taking supplements quality is essential – otherwise there is no point in spending the money. These are the brands I recommend in those supplements:

• Vitamin D click here or here
• Vitamin B complex click here
• Omega 3 click here or here

Please don’t hesitate to use my TERRA10 practitioner code to receive a 10% discount if you wish. I do not receive any financial incentive to promote any of these brands.

I hope this article can help make the winter season more enjoyable to you and if you have any questions don’t hesitate to get in touch!