Natural Approaches for Seasonal Affective Disorder and Supporting Winter MoodNov 07, 2022
Winter can be a tough season when it comes to mood and energy levels. What can you do to help support your system during this time? There are actually lots of natural and inexpensive strategies that can help. In the video below, Drs. Henry Emmons and Tim Culbert talk about the most powerful strategies to consider. These include:
- Foods to eat to keep your system nourished.
- Exercise strategies that are particularly helpful to boost mood and energy levels.
- Using light therapy to support mood, energy levels, and sleep schedules.
- Supplements you can consider adding (after speaking with you doctor) to support mood during the winter months.
See the full transcript below the supplements.
Supplements for Supporting Winter Mood
Please note: The following product links go to our partner store, Fullscript (with an ongoing 10% discount for you + free shipping on orders over $50). You must have an account to view products and shop. Create your free account at: https://us.fullscript.com/welcome/nmh/signup or click here to learn more about Fullscript.
SAM-e | Neurotransmitter Support
SAM-e 400mg (S-adenosyl-L-methionine) is a naturally-formed molecule in the body. SAMe contributes to the synthesis, activation, and metabolism of neurotransmitters, proteins, nucleic acids, phospholipids, hormones, and some drugs. It can offer a lot of mind-body benefits, but we especially like it for its support for a healthy mood.*
NeuroCalm™ is designed to promote activity of GABA and serotonin, which may help support healthy mood, cravings, and feelings of calm, satiety, and satisfaction.* NeuroCalm™ contains PharmaGABA™, a form of GABA naturally manufactured via a fermentation process, which is considered more effective than chemically produced synthetic forms. Support for the production of calming neurotransmitters is also provided by L-theanine and taurine.*
PureGenomics B-Complex is designed to address the nutrient requirements of common genetic variations in the methylation pathway with a unique blend of B vitamins in highly researched and activated forms. Methylation is a key regulator of genetic expression and cellular function. Healthy methylation is vital for cellular health, DNA synthesis, hormone and neurotransmitter production, and energy metabolism. Optimal levels of B vitamins have been associated with cellular, cardiovascular, neurological and psychological health.
OmegAvail™ Hi-Po provides a potent 1600 mg of EPA/DHA per serving (two softgels), and also includes lipase, a digestive aid to ensure maximum absorption. Lipase also helps to prevent any fishy aftertaste, known as repeat, that sometimes occurs with fish oil supplements. Omega-3 has been shown to help many body functions, including supporting mental focus and healthy, stable moods. It can also be helpful as a tool to address seasonal or cyclic mood concerns.*
*Note: Some of the supplements discussed in this article can cause side effects, but many people tolerate them much better than prescription medications. They are generally considered safe, however, they should not be started without your doctor’s knowledge and supervision. If you are taking medication already, be sure to talk with your doctor before adding any of these items. If you are considering going off medication, remember never to stop your medication suddenly—always consult with your doctor about how to safely taper off any psychiatric medication. See terms.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Tim: So let's talk a little bit about, um, what is seasonal affective disorder And really, uh, people that actually have the diagnosis of S.A.D. [seasonal affective disorder] have what we think of as a variation on a diagnosis called major depressive disorder, M D D. And what it really is, is it's just a seasonal variation on that.
And typically, but not always, people will get the, um, initial symptoms almost, uh, routinely in the fall or the winter. And then they can have basically a spontaneous remission in the spring or the summer months. And even if they don't do anything to treat themselves, oftentimes it will get better. About 6% of the population in the US actually has the more severe version of, and the diagnosis of seasonal affective disorder.
But I think it's really interesting that probably up to 20% of the population [00:01:00] might have a milder version. And I can tell you in my practice, I was just telling Dr. Emmons that, um, in the last few weeks, things have got a little crazy and I see more and more kids coming in with sleep disturbance, irritability, low energy, and just general, um, difficulties I'd say with, um, managing their life day to day and, and a lot of difficulty with, the way that they're feeling and the way that they're focusing.
In part because of that low energy level. And so we know it's a really common problem, but what we wanna talk about a little bit tonight is, you know, going beyond the, um, conventional treatments, which I think are very good and very necessary, I'll show you those in a moment. But really moving into some of these expanded options, some of the integrated therapies that also are very, very effective.
And in, in some ways I think they're much more, uh, gentle and natural in a way that can be very helpful. And let me also frame it like this. We know that over 50% of adults [00:02:00] that state that they have either anxiety or depression also state that they use complementary therapies. So I think it's important to point out that healthcare consumers are already there.
They are already using complementary and alternative therapies, or what we call integrative or natural therapies for depression or anxiety. And so I think we really owe it to our healthcare consumers to catch up to them and really identify what's best and what's most effective. Now, I will say in terms of conventional therapies, these are quite effective.
So people that are more severe can be on psychiatric medications. Most commonly, for SAD, people use SSRI medications [serotonin reuptake inhibitors]. Medications like Prozac and Zoloft, which are the brand names are usually quite effective.
Um, also Wellbutrin gets used a bit, and then Effexor is another one that you, you read about. And so medications can be [00:03:00] quite effective, especially in the short term for more severe symptoms. Now, psychotherapy is also very, effective. It's called cognitive behavioral therapy. So again, I think either alone or in combination.
These conventional therapies are very good and very helpful.
One thing at Natural Mental Health we've been working on for many years is this idea of a comprehensive model laying out treatment options within the integrative health realm, if you will, cuz I think it's very confusing.
There are vitamins and supplements and diet changes and exercise regimens. There are healing technologies, there are mind body skills, things like mindfulness meditation, uh, there's yoga. There's uh, this idea that we should spend more time in nature called ecotherapy. Uh, there are also wonderful aromatherapy, uh, options,
essential oils. So the bottom line is I think it's hard for people to know what to do when. So what we've tried to do at NMH is really create a model that makes sense to people. And we [00:04:00] call it the restore, sustain, and flourish model.
So the first step we always believe is to restore what you need, and that means to recover from the symptoms.
So tonight we're gonna talk a lot about the restore domain in this model: supplementation phototherapy fall nicely into both the Restore and the Sustain domain. The second domain, Sustain is all about preventing a recurrence and then maintaining health for a longer period of time without any problems.
And then finally, once we get people stable and recovered, what we really want to do is bring people to that place where they have optimal mental health. They're really flourishing.
Henry: So Those of you who are here in the room, let me ask you something, How many of you feel emotionally better at this time of year? Better in late fall, early winter? Nobody. Um, anybody feel better physically at this time of year? How many of [00:05:00] you in this room would say that you do feel better, either physically or emotionally in the spring?
Yeah. So, you know, nearly a hundred percent. This is just kind of normal really. It's just how we're built. We are mammals, we are really, kind of, consigned to the rhythms of nature. We have to live within those rhythms. And if you live north of a line that goes through Atlanta in, in the United States, you're gonna experience seasonal changes.
And for almost all of us, not everybody by the way, but for almost all of us, that means fall, winter, there's a drop typically in mood and energy. And, and then spring, summer, there's usually a rise. Now actually, I work as a psychiatrist and I do see a subset of people, it's not a huge percentage, but there's a definite [00:06:00] subset who feel the, the worst in the, early spring, late winter, early spring, somewhere between February and April.
It's not that unusual. And, and the way that they typically feel worse is, um, they feel kind of agitated. They feel more, um, restless and, and sometimes their mood, they would describe their mood as depressed, but really there's an edge to it. There's some irritability. There's just a lot of extra energy. And so that, that time of year when energy is coming back, for most of us, for, for those people, it's, it's not good.
It's coming back, but not in a good way. Uh, but for, for the vast majority of us, probably 80, 90% this, it's just a time when there's a, a lull, a a dip in energy, motivation, and mood. And it, it's so common as to be really considered normal. But even people who don't [00:07:00] have purely seasonal affective disorder, but they have some other form of depression or just a mood problem, almost always it gets worse at this time of year.
Um, it's, it's such a common problem that I just know now if I'm treating somebody, this is not when you want to come off a medication. It's not when you want to try to, you know, change, change a treatment or drop something that you've been doing that's been helping you. You don't ever wanna do that at this time of year.
So what's behind this? I, I mentioned that, you know, if you're north of a certain latitude, you're prone to this. Um, this is a, a picture here, this is the minneapolis skyline. You can kind of tell from the picture that there's snow, that the leaves are bare and there's trees.
And even though it's beautiful and you can see the sunset, it's happening at about four o'clock, four or 4:30 in the afternoon. And that is the problem, that the days [00:08:00] are short. It doesn't really have much to do with sunlight or getting vitamin D through the sun, although that is a factor that happens in the winter, but that's not really what causes seasonal affective disorder.
It is because the days are so short that it changes our circadian rhythms. Circadian rhythm is really important for mood because all of our hormones are tied to these circadian rhythms, this 24 hour cycle, and that includes the stress hormones. It includes the hormone melatonin. Melatonin is very closely linked to the hormone or neurotransmitter serotonin.
And so you've got all these changes that are occurring simply because the day is short. And one way to think about it that I think probably makes a lot of sense to many [00:09:00] of you at this time of year is that your body feels like you want to hibernate, like, like you're shutting down. And if maybe if we lived in such a way that we could do that, that we really slept more and rested and weren't as active and you know, weren't doing things all the time in the winter, maybe we would feel fine.
Maybe it wouldn't cause something like depression. I'm really not sure because nobody lives that way. And if you tried to, you probably wouldn't feel good because you'd be so out of sync with the rest of the world. So, um, I want to kind of emphasize this about, melatonin cause it's sort of a, it's sort of an unfortunate trick of mother nature and that is that when we produce a lot more melatonin as we are doing at this time of year, melatonin is produced from the same [00:10:00]pool as serotonin.
And so melatonin goes up, serotonin goes down. And it's, it's unfortunate because then you're really tired and you wanna sleep a lot more and at the same time your mood drops and you're not as resistant or resilient to stressful things. That's a lot of what, what serotonin does. So you're kind of getting tired and sleepy and also
much less able to just face the normal day-to-day stressors that we all have to face. Coupled with that, another sort of unfortunate trick is because so many of us lose our energy and motivation at this time of year, what's the first thing to go is exercise usually, cause it takes some motivation and it takes some energy just to be able to get out and do that.
There's typically a sleep disturbance, uh, or at least a change in sleep. Um, let me just ask again if I want you to, to raise your hands. How many of you [00:11:00] get really sleepy, like you could go to bed sleepy right around this time of night? Not just when I'm talking, but just routinely this time of night. , how many of you just so, Yeah, maybe, maybe about a quarter to a third that again, there's a subset of people who really notice about
two hours after sunset, just feeling so sleepy that you could go to bed. How many of you go to bed at seven o'clock? Yeah. Nobody. And so then when you do want to go to bed at 10 or 11 o'clock, what happens? A lot of times it's not that easy to go to sleep then because your melatonin is all gone. It's, it's, it's out, out there now at this time of night, and then it's not there to kind of set your onset of sleep when you actually want to go to sleep.
For me, I remember this very clearly as a, as a kid and as a, you know, high [00:12:00] schooler and college. I actually still do this to some extent and that is, um, over Christmas break, you know, when you're not getting up to go to school or work, it's so easy for me to just keep staying up later. and later, and then tending to sleep in.
That's just kind of what our bodies want us to do and it's easy to stay up later because you got no melatonin signal at that time of night to put you to sleep. Low vitamin D I did mention that, that um, it's not really the cause of seasonal affective disorder, but because there is no way to make vitamin D at this time of year from sunlight, even if you go out in the middle of the day, even if you take your jacket off, if you have some skin exposed, the angle of the sun is so low you're not making any vitamin D.
So between roughly October and April, Vitamin D, just unless you're really doing something, you're kind of careful to keep it [00:13:00] at a good level, it's gonna drop, and if it drops low enough, it's almost always associated with further problems with mood as well as aggravating things like chronic pain or inflammation and a whole host of things.
Vitamin D is a hormone. It's not really a vitamin, it's a hormone that's involved with a lot of physical things.
So, seasonal affective disorder, probably more than any other kind of common psychiatric condition is best done as a preventive thing. And it is, it is actually quite preventable. It's not totally, for some people, they're going to, this is gonna happen no matter what. Um, is anybody. actually from the south?
Any of you grow up in a, in a southern, you know, like below that line? So my experience, I, I grew up actually not that far from here, so I don't have this personal experience, but [00:14:00] among my patients, I very commonly see people who grew up in the south have a much harder time with seasonal affective disorder.
I think it's because you're just not, you know, maybe, um, your body hasn't evolved or developed to, to be able to kind of flow with that as much. And it just seems like it's, it's the hardest for those who didn't grow up here. But, but it can happen to any of us living here, even if you're doing all the right things.
But I want to do, I do want to talk about what are the right things and what can you do to prevent it. Um, and then we'll add to that a little bit later. Some natural therapies that I, I think can also be quite preventive. It's best to start these preventive measures probably early, early September, at the very least by the fall Equinox, which is September 20 or 21.
So it's not too late if you, if you haven't really fallen into a [00:15:00] depressed state yet. It's not too late by any means to, to do these things. But really just thinking for the future, if you got this pattern, start your prevention by early to mid-September. And I'm gonna talk about these three things.
What do you need to do to, to nourish yourself? How would you eat in order to prevent this? What would you do to move your body? How would you best do that? And then what kind of rest or or recovery do we need? So with food, I want to talk about two different aspects of, or actually two different approaches to diet, depending on whether you are still preventing or whether you've gone into a depression
and you need to think about getting out of it. So if you're preventing think about how your body wants to eat in the winter. You want foods that are probably more nourishing, that are warm, [00:16:00] that are kind of heated, not just cold foods. Like you'd normally, you would switch from fresh salads and fresh fruits and vegetables cuz those are plentiful in the summer to the autumn where you're eating a lot of cooked, uh, vegetables and, and probably not as many fruits cause nature doesn't provide those at that time of year.
So you want to think about what nature is providing. So lots of comfort foods, stews, soups, vegetables like squash and, you know, kind of the fall vegetables, apples, but particularly thinking about stewed or cooked apples or something rather than just always, uh, getting things kind of cold or raw.
So you want your foods to be well cooked, you want 'em to be, um, you really have a lot of sustenance or nourishment and, and to really give you a sense of comfort. What you don't want to do, and this is unfortunately what our bodies kind of tell us to do, but you don't wanna listen to this. And that is, you don't wanna start eating a [00:17:00] lot of kind of quick acting starches, sugary foods, desserts. You know, Halloween for me, that's always a, a time when I, I switch just, just like that from having a pretty good, careful diet to, you know, as soon as I get started on the sugar, candy thing.
I'm gone for weeks on it. This year I did pretty good, but, but put a, you know, bowl of Snickers and heath bars in front of me and I'm gonna eat 'em at this time of year. So, you know, it's, you really, really want to guard against that because that is almost the worst thing you can do diet wise as far as getting back into this.
Cuz when you start, you know, craving and giving into sugar cravings, it absolutely sets this thing into a cascade. So think about, you know, foods that have fiber, like the root vegetables, but also that are cooked and comforting. That's if you're preventing. [00:18:00] If you have fallen into a winter depression, mostly what you're trying to do then is to trick your body into thinking it's summer, not winter.
And so with diet, that means going back to the kind of foods that you might have eaten in the summer. So then you would do the fresh, green salads, fresh fruits if you have access to them. Lighter, a much lighter diet, not as, not the heavy comforting foods, but a much lighter filled with more, more, uh, water, more liquid, um, and, and just more freshness if you will.
So maybe then it's uncooked or more raw foods and, and some meats. But, but lean meats not a lot of heavy foods.
In terms of movement, um, this is probably the most, most effective lifestyle thing you can do to prevent seasonal depression, and that is to exercise kind of early in the fall [00:19:00] before you have to make a huge effort to get to it.
You gotta get into the pattern as soon as you can and don't let it stop. Because if you wait until you start feeling depressed, it's really hard to get going with a new pattern like this that you have not done before, or hadn't been doing recently. So you gotta, you gotta get started at least by September and try to stick with it.
And here's the other sort of ironic thing about seasonal depression. The symptoms are so much about sluggishness and lethargy, but, but the movement needs to be more vigorous, which is kind of the antithesis of what your body wants you to do. So in this case, you probably do wanna do something that involves, um, more intense bursts of activity, such as going to an exercise class or a spin class cycling kind of thing where you go through, uh, this more [00:20:00] intensive interval kind of work. That's really good at preventing this.
Um, you wanna do some strength training and you wanna do some aerobic, but aerobic is probably not quite as effective for this as the more intensive bursts of activity. Probably best to do something at least three or four days, maybe even five days a week. If you can do that coupled with a, maybe a two or three of the supplements we'll talk about later,
it's a really, really good start at prevention. And then, um, finally I'll just mention this about, about rest and remember that that seasonal depression is mostly about changes in circadian rhythm. And so to counter that, you've gotta be incredibly diligent, absolutely stay on top of your sleep pattern, your sleep schedule.
So what I mentioned, you know, used to happen to me, um, like over the holiday, the, the winter break, is I really get off my [00:21:00] sleep schedule. And you'll notice if you do that almost immediately, you'll feel more sluggish. You just get more lethargic, even if you're getting more sleep. So you wanna limit your sleep and you especially want to get up at the same time every day.
That's actually more important than the time that you go to bed at night. If you do get up at the same time every single day, you're gonna find that you get sleepy at about the same time at night. We're gonna talk a little bit about how to kind of coax or, or trick ourselves into getting sleepy at the right time.
But, but just especially remember with your sleep, don't let yourself sleep more than eight hours, cuz if you do, you're gonna feel more tired. So it's, it's, uh, mistake to think that you want to give your body what it wants at this time of year. If you do that, you'll just make it worse. You'll get more tired.
And then, um, keeping your sleep schedule just as regular as you possibly can. [00:22:00] To do that, Tim is gonna talk a lot more about light therapy, but to, to keep this regular circadian rhythm, you really need to pay attention to lights. And there's, two aspects to this. I'm gonna talk just about more, more regular lighting,
Tim's gonna talk about therapeutic lighting. So the first thing, we have pictured here, this is called the wake up light, or people call it a dawn simulator. And I have one of these by my bed. I actually use it all year long. I don't need it in the summer cuz I just wake up. But in the winter it's super nice to have. If you have any teenagers at home, this is a really great thing for them because it takes no time, no effort, no thought.
Once you set it up, it just works every day. And it's not foolproof, but it's really pretty, pretty good. So what happens is, and you can change this a [00:23:00] little bit based on the settings, but most, I think with the automatic setting is that you set the alarm at a certain time and it starts to brighten, gradually gets brighter and brighter and brighter for about a half hour, actually it's exactly a half hour, I've timed it.
And then the alarm goes off and you can set the alarm, different sounds, or you can have just a regular alarm sound. And for me, the light either just has to come on a little bit or get maybe in the middle of that brightening and I, and I will wake up. I've just kind of entrained now to wake up with that light.
But it's a really nice thing to give yourself at least a little bit of bright light first thing in the morning because your, your body thinks that means the sun is rising. It's just a trick. Just like we can trick our bodies with our diet and staying really active, we can trick it by thinking the sun is rising earlier than it is.
[00:24:00] The second part of this, which I think is really important, and that is for your last two hours before bed, keep your lights in your home incredibly dim. So if, if any of you are are campers or, or maybe when you're kids, you went camping, if you remember, about an hour and a half to two hours after sunset because you have so little light, you just get really sleepy.
If you're just left with maybe candlelight or, or just a little bit of natural light, you will get incredibly sleepy within two hours of sunset. In the winter, you know, because sunset's such a different time, it's a problem. Tim's gonna give us a solution for that. But in the last hour to two before bed, think about keeping the lights in your home almost as dim as you would if you were camping, campfire, [00:25:00] candlelight, that level of dimness.
So the light that I have pictured here, which is just a standard, um, bed bedside or, or sofa lamp, it's probably too bright for you at that time of night. Um, I have become really diligent about this and I swear it has helped me fall asleep with no other help better than anything else I've tried. So really, really low lights.
That means if you read, which I would encourage, read at night, it also helps me fall asleep. But do it with a Kindle or with a book Light, Light that just hooks over your book. Or you can get glasses now that will filter out the blue spectrum light. They're not that expensive. Um, or another option is that you can get, um, light bulbs that filter out the blue light.
But even if you do [00:26:00] that, even if you get those filtered lights, still don't have the light too bright because it still will give you a signal that you're supposed to, you're not supposed to go to sleep yet.
Tim: Well, let's talk a little bit about photo therapy. So photo therapy is the therapeutic use of light. It's interesting to note that over the last several hundred years, that, um, sunlight, for example, has been commonly used as a therapy a medical therapy, it was called Helio therapy. An example would be before antibiotics.
People with tuberculosis for example, in Europe would be sent to these, spa-like, hotel, um, setups and called sanatorium. And they'd spend a lot of time outside, in fresh air and sunlight. Some of the, I'd say medical visionaries also from hundreds of years ago, talked a lot about the idea that light, light therapy, and color therapy, as well as vibrational therapies would be something that will be really moving into the mainstream in the [00:27:00] next several decades.
And they were very much right about that. It's very true that, you know, phototherapy and light therapy a hundred years ago would definitely be considered an alternative therapy. But it is very much the case that, um, therapies that use lights are, are very common. So, for example, you see over on the right hand side of this slide, the electromagnetic spectrum.
It goes from the very short wavelengths to the very long wavelengths. And, just for example, you might have heard of a instrument called a gamma knife. It's used to, um, resect certain brain tumors, um, x radiation of course has been used in radiation therapy also for solid tumors, but also just to image our bodies as part of mainstream medicine.
And then in the ultraviolet spectrum, we have a lot of use of light for dermatological conditions. And then as we're gonna talk about, for seasonal affective disorder. And then in the higher light spectrum, some other options as well. But it's really [00:28:00] interesting to note that the human body and the human brain are wired in a way that we have photoreceptor molecules in many cells in our body.
So on the skin, these photoreceptors are particularly tuned, in the case of, um, creation of the activated form of vitamin D called vitamin D3, to a certain wavelength, we have to have a sunlight in the UVB spectrum, it's called to activate vitamin D. And the, um, eyes, the retinas, we have these photoreceptor molecules that very much respond to, or are sensitive to red, green, and blue light.
And it's interesting what Henry said about, um, seasonal affective disorder being related to the shortening of the days. And then we have this message sent to our brain that, oh, you know, the days are shorter, there's more darkness, so we should produce more melatonin. Well, that happens in a gland in the brain called the pineal gland.
And it turns out, this is really [00:29:00] interesting, that the pineal gland has photoreceptors in it that respond to this specific wave length of light and blue light at 470 nanometers. So the smart people that started designing these phototherapy lights, designed them so that they in particular have light within that, or right at that spectrum.
So seasonal affective disorder, um, as we'll find out a little bit about phototherapy has actually been as good in some studies as, uh, moderate doses of antidepressant medication. So that's pretty impressive. And I'll tell you a little bit about the details of that in just a moment.
But what's really great about phototherapy is that we're now finding that it can be used for lots of other things. So even for non-seasonal depression and people that are maybe not fully responding to either, uh, psychotherapy or, or psychiatric medication, you can also use, um, phototherapy as an adjunct, a very effective.
It's also been really great for, [00:30:00] um, antenatal depression, pregnant moms, who have mood issues where they don't necessarily want to be on a prescription antidepressant, very effective in that situation as well. Uh, for senior citizens, old farts like myself, it's just great, uh, day to day, especially in the winter for enhancing mood and improving sleep cycles or patterns, even if you don't have SAD.
And by the way, um, for teenagers, phototherapy is great for those teens that have trouble with sleep phase delay, where they wanna go to bed late and then get up late. You can use phototherapy as a way to reset those cycles. And then, um, in general, I'd say that the great thing about phototherapy is that it's really gentle.
It's really, um, natural and it typically doesn't have many side effects. Uh, the side effects you most commonly see listed there are even not that, um, common in terms of their occurrence, but it would include nausea, agitation, headache, and eye strain, things like that. And so the [00:31:00] important thing is you want to use phototherapy correctly.
Um, there are a lot of daylight lamps out there and other, um, lighting options that talk about full spectrum light and, and daylight. But the important thing is that you do purchase a phototherapy light that's designed for that purpose that's meant to provide phototherapy. Um, typically those are rated in terms of the level of light intensity in a unit called a lux, l u x.
And so you really wanna buy a phototherapy lamp that is a, at least, uh, 5,000 to 10,000 lux and that most of the good ones are at 10,000 lux, typically. This is a blue spectrum of light. It's usually between 470 and 500 nanometers. And they design it just to, uh, emit that, uh, spectrum of light. And when you use the phototherapy light, the important things are these:
Number one, you wanna have it within about 18 to 24 inches of your face. Typically you don't wanna look right at it, but, um, [00:32:00] it turns out that typically it would not harm you to actually look at it. But, uh, most of the time if you can, you want it just hitting your face tangentially within 18 to 24 inches of the face.
Secondly, you really wanna do this in the morning, first off, usually before 8:00 AM. And then, you also wanna at least do it for 20 minutes to 30 minutes minimum. And if you use those guidelines that you see on this slide, you oftentimes within one or two weeks even, fairly immediately, you'll notice 'some really excellent benefits for people that have that feeling of, uh, sluggishness or sleepiness early in the evening,
as Henry mentioned, you can also do a second burst of phototherapy treatment in the late afternoon. Let's say between three and 5:00 PM and typically a shorter amount of time, I'd recommend more like 10 minutes, maybe 15 minutes.
Audience Question: Will that alter the melatonin?
Tim: That's the idea. So anytime your, [00:33:00] um, eyes are exposed to light and it signals the pineal gland immediately you will have a reduction in melatonin production. That's exactly the way it works.
Henry: Yeah, you did you say much about side effects?
Tim: Uh, we just mentioned, you know, that the most common things, and even these are fairly uncommon agitation, headache, um, eye strain, nausea.
Henry: Yeah, I actually think it's not that uncommon to feel a little revved up from photo therapy. So it's like some people, for example, would think it's a good idea to just have it at your desk, at your office and leave it on all day.
I've tried that and after a while, I'm a little, I'm a little bit, you know, wired. Um, it's almost like you've had a little too much caffeine. I don't know if any of you ever saw the, the TV show, Northern Exposure. You remember that? It's, it's a long, it's an old show, but, but they had a, a guy, a guy who had one of these visors, you know, and he wore [00:34:00] it all the time.
It was a light, bright light visor, and he, over, over a period of a few weeks, he got more and more manic. It was really pretty funny, but it is possible actually for somebody with bipolar illness or, um, or just somebody who may have a tendency to get a little bit agitated moods from time to time that it can be sort of overstimulating.
It's pretty unusual, but it can happen. And I think you just need to, to think a little bit about the dose, how much time you're, you're spending in front of it.
Tim: Yeah. And I think 20 to 30 minutes is typically really adequate for most people. Um, these come by the way in all shapes and sizes. You know, it's important to find one that fits your lifestyle.
It is the case that when you have this on, by the way, you can be doing anything you want to do. So commonly I'll be sitting there in the morning and, you know, I'll eat breakfast, I'll do some email, I'll read a book. But you can definitely do other things while you have this illuminating your face.
Henry: A lot of times to my [00:35:00] patients, I'll recommend this product or something similar. It's called a, the Phillips Go Light Blue, and they're on Amazon for typically between a hundred and $130. Uh, one thing I would say is that it's kind of nice to get, uh, one that has a battery, has a lithium battery now, so it lasts a while just cuz it gives you more flexibility, but they're of course a little more expensive.
Um, also just to let you know, um, I recently learned about, uh, a new company that's based here in the Twin Cities that has really nice looking light therapy products for about half as much as that, it's called Circadian Optics. Apparently it was featured on Shark Tank. I did not see it on Shark Tank, but that's, that's where this person had heard about it, that told me.
And um, and they really are nice looking, so you could have it maybe at an office desk or something. They don't look boxy or weird, you know, they're just, look, they're kind of attractive [00:36:00] and, um, they're 10,000 lux and they're just a really reasonable price.
Audience Question: Audience question: Can you wear glasses with the lights?
Henry: Wearing glasses is fine as long as you don't have those, um, glasses that filter out the UV or the, or the blue light. So you wouldn't wanna wear sunglasses, obviously polarized, but, you know, regular glasses should be fine.
You know, um, Tim said this with the research is just really getting clearer on this, but phototherapy is helpful for virtually everybody, whether you have seasonal effective disorder or not.
I think it's so helpful for sleep. Just if your only problem is that you have trouble sleeping, super helpful to get bright light in the morning, and then the really dim lights at night. It's really helpful for energy, for focus.
So, I'm gonna talk a little bit about supplements. This is sort of the recipe that I would give my patients at the beginning of the season, so [00:37:00] September, October, up till now to start these things early before the symptoms set in.
And basically there's just these four supplements. Some are more important than others, and I'll go through 'em one at a time. But it's having an activated B vitamin, a product called an adaptogen, Omega 3 and vitamin D. Couple that with light therapy and exercise, and you have a really strong prevention plan.
So let's go through these, um, preventive supplements, one at a time. The B vitamins are for almost everybody. They are kind of energizing. For some people they're even a little bit too energizing. But if you're, if you're having this pattern of seasonal depression, that is not gonna be a problem cuz you're, you get so sluggish, you know, with, with that. So the B vitamins should be activated, like the product [00:38:00] I'm talking about here called Activate.
This is a product on our website. They should be activated, meaning that they have been converted to the type of B vitamin that your body can use. That's important for 15% of people or so who genetically are not as able to do that conversion in their body. And so I just think it makes sense for everybody, unless you know that's not a genetic trait that you have,
it just makes a lot of sense to get these B vitamins already activated. So they're really important Ones are b6, b12, and folate or folic acid. It's much more economical to get them together in a b complex like this product Activate. And remember they can become stimulating,
you don't wanna take 'em at night. The second product, how many of you have heard of adaptogens? It is a type of herb that doesn't work like a medicine, but it, it helps your body to [00:39:00] adapt or adjust in a, in a much more broad way.
So some adaptogens are helpful more for your stress system. Others are doing more perhaps for immunity, others for kind of energy and so forth. This product that we call Adapt combines four things together that are just really helpful at keeping the body working better and keeping it energized. The one I especially like for the winter prevention is called rhodiola.
And by and large, even though it helps with energy, it's not stimulating like, you know, making you feel revved up. It's just a kind of a nice, steady, gentle, um, sort of energy.
Virtually all of these things that I'm mentioning are October through April. Um, Omega three, our product is called Strengthen, is probably not the one that if, if you're, if you're trying to save money, [00:40:00] it's probably not quite as important as the others, but it is good for so many things if you don't get a lot of it in your diet,
take a supplement that's really concentrated like this that has about 2000 milligrams a day of the Omega 3s, especially the important ones, which are EPA and DHA. Those EPA is a little more for the heart and turning down inflammation. DHA is a little more important for your brain. I think it's best to get a product that has both in a concentrated form.
And then the fourth of these, um, which I just think all of us living here should be taking is vitamin D. Adults, 5,000 units a day in the winter is not too much. Um, kids, maybe 2000 would be a better amount, maybe even a thousand for younger kids. Now, if you know that your level is already between 70 and a hundred, if you've had a vitamin D test [00:41:00]done recently, cuz remember it's gonna drop in the fall and winter,
if you're really good, you probably don't have to do this. But I can tell you from some research that I did a few years ago with a program on depression, that almost everybody had low vitamin D levels at all times of year, even in the summer. I don't think you need to take this in the summer, so long as you get a little bit of sun exposure and it doesn't take much.
And then, um, obviously prevention doesn't always work, and so what do we do then? What kind of approaches can we take if somebody needs treatment but doesn't want to do medications, or let's say they're on medications but they're not enough, the meds aren't working well or they can't tolerate sort of higher doses.
So I'm gonna talk a little bit about how do you support the key neurotransmitters, especially serotonin and dopamine.
So the first product I'll talk about is basically a serotonin support, it's [00:42:00] called Relaxed Mood. And the way I think of it is that this is really just giving you everything you need to make serotonin really easily and efficiently, all in one little package. Serotonin, I'm, I'm sure you know cuz it's so often talked about, really important for mood, but especially mood that is anxious.
Um, also really important for being able to, um, deal effectively with stress and to sleep. And it's also good for a lot of different forms of anxiety. So, um, this is actually not my, my go-to supplement for winter depression because most people also have a lot of trouble with energy. But this would be, be best for somebody who's focused, maybe needs to be more on sleeping better or calming down anxiety. So it's really serotonin focused.
This is a little more [00:43:00] like if you think about a medication like Effexor or Wellbutrin, things that are a little more energizing. That's more analogous to this. It's a, a product that does still address serotonin, cuz that's important for almost anybody with a mood issue.
But in addition to that, it's also supporting, uh, dopamine receptors particularly, and then a little bit of norepinephrine. But dopamine is probably the key thing for people who have fall into that more sluggish pattern. Low energy, low motivation, and wanting to sleep too much. Mostly you wanna focus on boosting dopamine levels.
Um, SAM-e, how many of you have heard of SAM-e? How many have taken SAM-e? So a few. So SAM-e is a really interesting product. It's really not, um, it's not a medicinal thing so much. It's more of a adjunct, but a really good one. In fact, this [00:44:00] can be used really successfully with medications and antidepressant medications. There's even some research done in the mainstream psychiatric literature that it, it's a helpful thing to add to an antidepressant that's no longer working well.
And the reason that seems to help with that is because SAM-e does a really unique thing, which is it it donates a methyl molecule in the process of making energy and making neurotransmitters. So it's a really important chemical step that has to happen. And this, SAM-e is a form of methionine that, that donates this, this methyl molecule. And it's helpful for people with joint problems. I've actually taken it myself for some joint issues and found it to be quite helpful. Uh, people with liver problems, it can be helpful for that. And then also with, um, making the neurotransmitters and helping with mood.
Audience Question: Audience question: Can you get enough B's through food?
Henry: Yeah, It, it absolutely is [00:45:00] possible. It's possible to get the amount you need for prevention. Might not be possible to get enough to use as a treatment, but for prevention, yes, you can get it in food, but you do have to pay attention because a lot of the good B vitamins come from fresh leafy greens, but they do have to be fresh.
You have to eat, you know, quite a bit of them. And they, they have to be picked pretty recently, you know, probably less than two or three days. Um, or a lot of the, the B vitamins, they're, they're not stable and they just don't, they don't last. Also, people who, who are more of a vegetarian, uh, oriented diet, they gotta pay special attention to get enough b12 and maybe B 6 you can do it, but it's a little bit trickier.
Um, and then I, I also think people who, in the winter, most of us don't eat quite as well as we do in the summer. Partly just cuz of availability [00:46:00] and, and partly cuz we get lulled into those, you know, the carbohydrate craving cycle. So, if you're still prone to winter depression, I would do it, B complex, they're not expensive and um, it can be super helpful.
Well, if you have a, a little more time in you, Tim, is, is gonna tell us about his favorite topic.
Tim: Well, it's interesting, you know, I had, um, seen online that there were many, many, many articles about the use of CBD oil and seasonal affective disorder.
And, you know, that's an, a topic that I'm familiar with for other reasons. Uh, in, in terms of we use CBD now a lot with kids with autism, with, uh, generalized anxiety disorder and certainly for kids with insomnia, also kids with a chronic pain. But I had not seen that much, um, you know, literature, research literature on the use of it for SAD. Now, um, as you probably all know, it's really [00:47:00] interesting to me, this whole field that it wasn't until the late 1980s and the early 1990s that scientists figured out that we have these receptors in our brain for these, uh, compounds called cannabinoids.
And they are found in the Cannabis plant. And, we have not only these receptors in our brains for cannabinoids, but we also have chemicals in our brains as well that are called endo cannabinoids that are our own internal compounds that help us with regulating and kind of maintaining a homeostasis in a lot of these, uh, various functions in the body.
Things like mood regulation, uh, pain modulation, the way the immune system is, is regulated. And also it, these endocannabinoids, have an effect on reproductive hormones. So really interesting stuff. And we didn't, we didn't know much about it until the, you know, maybe mid 1990s in terms of the fact that mammals are all wired for these compounds.
Now, I found it [00:48:00] confusing though. When you look at this stuff online or in the store, there are a variety of products, right? You have Hempseed oil, CBD oil, and then there's also THC, the psychoactive one. So I just wanted to help people understand what these products are, and I'm gonna focus mostly on the therapeutic benefits of CBD oil cannabidiol.
But hemp seed oil is certainly another product you can get from the hemp plant, and it's very useful, but it's mostly used for nutritional purposes. And also it can be applied topically to the skin. It's very good for improving the quality and the aging of your skin.
It contains, uh, protein omega-3 fatty acids and really good levels of vitamin E. So that's why it's so good for your skin. Now, CBD oil, cannabidiol, is the product that comes from mostly it's now derived from the hemp plant, um, which is still part of the cannabis family, but that's the one that's legal in 50 states.
And I think it's hard for people to understand this because they haven't heard enough about it. Now, [00:49:00] legally, CBD oil has to have less than 0.3% THC in it. So that's why it's really not psychoactive when you, you use it. And it has more of an indirect interaction with these cannabinoid receptors in your brain as opposed to a direct interaction, which is what THC has.
Now THC is the psychoactive component that's found in the cannabis plant. Um, medical marijuana has been in the mental health field, been used primarily with ptsd, with, uh, kids with autism that are very aggressive. And it can also be used for, um, people with Tourette's disorder, where conventional medications are not, um, helping them.
And so, um, in terms of applying CBD oil for seasonal affective disorder, I think it's very good for lowering anxiety and I think it's really safe. And, and kids, you know, probably ages, uh, six to seven and up.
Um, there's not a lot of published research articles on this yet in terms of kids, but the [00:50:00] World Health Organization feels that it is a very safe compound, and they publish several papers on this. It can help people to sleep better and as we talked about, and Henry mentioned, sleep cycles can be poorly regulated when you have, um, a seasonal affective disorder.
And CBD, uh, indirectly helps to regulate melatonin. Also, by the way, the CBD does interact with the serotonin receptors, and that's why we think it helps to lower anxiety in people with anxiety or people with SAD. And then interestingly, it can help to increase energy levels. We know that it, it does increase this internal chemical we have called an endo cannabinoid, uh, named anandamide.
And anandamide is an important chemical, for homeostasis, for regulating things in the body. So we think that it gives you actually more energy by kind of smoothing things out. And then finally, um, the question, you know, can CBD oil really regulate mood? Can it improve your mood? I've not seen, uh, good evidence of that yet, but because [00:51:00] it does interact with the serotonin receptors, it's possible.
And I think the jury is still out on that component. So the bottom line is I do think CBD oil is really good for adjunct symptoms related to SAD, but maybe not, uh, for depression itself, at least quite yet. But I think the research is ongoing.
Audience Question: Are there drug and supplement interactions to be concerned about?
Tim: Yeah, there can be, you know, drug to herb and drug to vitamin interactions. A couple of examples, Um, products that have 5HTP, 5 hydroxytryptophan, uh, the Relaxed Mood product that we talked about has that in it. Those can interact with, you know, 5HTP is the precursor, uh, amino acid for serotonin,
so if you're taking a serotonin medicine like, you know, Prozac, Paxil, um, Zoloft, etc., those can interact. So you do have to be careful with those kinds of, um, medication options. Um, with CBD oil, there's been, um, some interest in and some study on the fact that CBD oil can also [00:52:00] interfere with the metabolism, if you will, of SSRI medications.
It can slow that down cuz they might compete for the same, uh, liver enzyme that metabolizes these things. So, you, you can still use CBD oil with SSRI medications, but I would start with very, very small doses. Typically five to 10 milligrams and then move it up from there. You know, CBD oil, for most people, I think it's reasonable to start in general at 10 to 15 milligrams in the morning.
Um, if you're, you wanting the effects during the day, or you can use it up to three times daily. It just kind of depends on how long it lasts for you. I've seen some people need a once a day dose and it improves things across the day, including their sleep.
And I will say this, you know, I think we didn't talk about this tonight, but essential oils are fabulous for, um, improving energy level and certainly, you know, things like peppermint, uh, black pepper, are some of the oils that can be quite helpful for giving you energy. And then, you know, things like [00:53:00] vetiver and bergamot can help to, uh, modulate mood in a positive direction.
Well, I, I threw this in here. So, you know, the idea is that if you take the time to winterize your car, why not winterize your brain as well? We hope we give you some ideas about that tonight.
Henry: Um, we're really happy to be sharing information like this. Go home and turn your lights off.