With a particularly virulent influenza season receiving all of the media and medical attention this winter, those of us who have been feeling a little "down" or even down right depressed can feel a bit minimized.

"At least I don't have the flu", you say as you drag yourself out of bed, too fatigued to face the day.

Are you finding yourself feeling unhappy and gloomy most or all of the day? Does the thought of getting out of bed leave you in tears? Do you find yourself withdrawing from friends and family members preferring solitude over your usual social outings?

Perhaps you dread the fall or winter season because you know that with winter comes a feeling that something about you is just "not quite right".

Maybe you find that you're craving carbs and starchy or sugary foods and that you've gained weight. Maybe you have trouble concentrating and find that your work is suffering. Or maybe you've found that you're sleeping in a bit too much and still waking unrefreshed.

If you are experiencing any of these symptoms, you may have a disorder called Seasonal Affective Disorder or SAD. Seasonal Affective Disorder is a condition in which you find your mood, energy, concentration, and sleep negatively affected with the changing of the seasons.

A diagnosis of SAD requires a full medical work-up with your primary care provider because it can mimic other disorders like hypothyroidism and chronic fatigue syndrome.

Despite the vastly more common form of SAD occurring in the fall and winter, some people experience SAD during the summer and spring.

If you suffer from SAD, you're not alone. The Cleveland Clinic estimates that 500,000 people in the US suffer from SAD and additional 10-20% may suffer from a milder form of the seasonal depression sometimes referred to as the "winter blues".

It may be tempting to just think of SAD as a temporary seasonal phase but this isn't the case. Seasonal Affective Disorder is a very serious form of depression that needs to be treated so that you can stop dreading the dark days of winter and start feeling your absolute best no matter the time of year.

If you have been diagnosed with SAD or you just find yourself suffering from the "winter blues", then there are some natural options that can help alleviate your suffering.

Vitamin D: Research shows that people who suffer from depression are usually low in vitamin D as measured by serum 25-hydroxyvitamin D (25-OH D), the vitamin D level in your blood. Low levels consist of less than 20ng/ml while sufficient levels are between 30-40ng/ml.

Sufferers of SAD may need vitamin D levels to be greater than 75 nmol/L but always less than 150ng/mL (which indicated vitamin D toxicity).

Research is showing that taking vitamin D prophylactically as well as during the winter season can help to alleviate SAD [1]. Although it isn't yet clear how vitamin D affects mood, it's now known that vitamin D is able to pass through the blood-brain barrier and there are vitamin D receptors widely throughout the brain which stimulate serotonin [2].

While taking 400-600 IU is usually recommended, taking up to 1000 IU a day for several months can greatly increase the vitamin D levels in your blood [3].

Since taking too much vitamin D can be fatal by causing too much calcium in the blood, it is always recommended that you have your vitamin D levels tested by your primary health care provider before taking large amounts of vitamin D for prolonged periods.

Light Therapy: Light therapy is usually very helpful in alleviating SAD with up to 70% of sufferers finding relief. Research has shown that all intensities of light ranging from bright (3300 lux) to dim light, all of which received positive effects.

Further research shows that using light therapy in the morning or a morning-evening combination for up to two hours has the most beneficial effect [4].

Whether with ultraviolet light or not, no specific wavelength of light was more beneficial than another.

Curcumin: Curcuma longa, or turmeric, is a powerful anti-inflammatory spice usually used for pain management but it can be helpful in decreasing the symptoms of SAD through decreasing the inflammation associated with the condition.

Those who suffer from SAD have been found to have an increase in inflammatory cytokines, chemicals secreted by cells of the immune system [5]. Curcumin, helps to activate the body's own anti-inflammatory and anti-oxidant pathway to reduce inflammation.

Using the spice tumeric alone isn't the best way to introduce curcumin into your diet since you would have to use a lot of it and it's not readily absorbed for use in the body. Adding fat, like coconut oil or ghee, can be more helpful in allowing the body to absorb the tumeric although to get the benefits of the spice you'll have to take quite a bit.

If you don't like the taste of tumeric or you don't want to eat it regularly, you can also buy a high quality supplement either through your naturopathic doctor or your health food store.

Serotonin-rich diet: SAD is believed to be caused by a decrease in the brain's amount of serotonin, a neurotransmitter that affects mood. Serotonin is synthesized in the body through a chemical process involving the amino acid tryptophan and vitamin B6.

Diet is emerging as important in retag SAD especially in regards to replacing low serotonin levels [5].

A diet rich in tryptophan and B6 can help to ensure that your body is producing enough serotonin to keep the SADness (you see what I did there :) at bay. Foods rich in tryptophan include: milk, poultry, red meat, oats, pumpkin seeds, chick peas, spiraling, and chocolate.

Foods rich in B6 include: avocados, bran, bananas, carrots, hazelnuts, walnuts, salmon, tuna, and shrimp.

While Seasonal Affective Disorder is debilitating, you can start taking your life back with these natural tips and start enjoying the winter season again.

References

1. Melrose S. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression Research and Treatment. 2015;2015:178564. doi:10.1155/2015/178564

2.Khamba ND, MPH et.al, B. (2011). Effectiveness of Vitamin D in the Treatment of Mood Disorders: A Literature Review. Journal of Orthomolecular Medicine, 26(3), pp.127-135.

3.Moyad MD, MPH, M. (2009). Vitamin D: A Rapid Review. [online] Medscape. Available at: https://www.medscape.com/viewarticle/589256_8 [Accessed 7 Feb. 2018].

4.Gupta et.al, A. (2013). Role of Serotonin in Seasonal Affective Disorder. Eur Rev Med Pharmacol Sci, 17(1), pp.49-59.

5.Song, C., Luchtman, D., Kang, Z., Tam, E., Yatham, L., Su, K. and Lam, R. (2015). Enhanced inflammatory and T-helper-1 type responses but suppressed lymphocyte proliferation in patients with seasonal affective disorder and treated by light therapy. Journal of Affective Disorders, 185, pp.90-96.

6.Shabbir, F., Patel, A., Mattison, C., Bose, S., Krishnamohan, R., Sweeney, E., Sandhu, S., Nel, W., Rais, A., Sandhu, R., Ngu, N. and Sharma, S. (2013). Effect of diet on serotonergic neurotransmission in depression. Neurochemistry International, 62(3), pp.324-329.