This year's winter onset seems to have hit people particularly hard. The most common comment I'm hearing from the clinic to the subway is, "I can't BELIEVE how dark it is at 4:30pm. It's just so depressing." Allopathic medicine calls this S.A.D., or seasonal affective disorder, a type of depression that's related to a change from fall to winter.
Asian medicine calls it normal.
S.A.D. tends to be especially fierce around the beginning of November when we change the clocks and lose an hour of sunlight at the end of the day. However, the predisposition to sadness in fall is a natural reaction to the seasonal shift rather than a cause for concern - even if the feeling is a bit jarring. The change in mood is consistent with Asian medical theory which recognizes fall as the season of the Lung, the body system associated with sadness and grief.
In winter, we're suppose to gain a few pounds and sleep more. Really. It's alright.
As microcosms of nature, we're deeply affected by our surroundings. A tendency toward sadness, a pulling inward of emotion, is appropriate as the weather turns harsh. We're wired to feel emotion - grief, sadness, worry and anger are all not only normal but healthy and meant to be experienced. Seasonal emotions only become a problem when we're unable to either settle into the emotional change or to transition out of it. If contemplation and rest blossom into isolation and depression, your natural winter cycle becomes seasonal affective disorder.
When the biomedicine of S.A.D. is paired with the theory of Yin and Yang, natural strategies for managing the emotions of winter emerge.
One of the things we see in winter is a decrease in our levels of vitamin D and an increase in our levels of melatonin. Vitamin D is considered very yang (active) and melatonin is extremely yin (passive). We're designed to slow down in winter and move into a much more yin state. The pineal gland releases melatonin in response to a lack of sunlight as a signal to sleep - less sun means more melatonin.
When melatonin goes up, vitamin D goes down - and vice versa.
When the sun sets, melatonin production goes up and your body wants to conk out. When the sun sets at 4:30pm but your bedtime is 11:30pm, you're working against 7 hours of melatonin release. At a time when our bodies want to slow down and hibernate, holiday obligations speed up.
Parties, shopping, travel and holiday events create tension between what your body needs (yin) and the social obligations you feel pressured to meet (yang). This tension expresses itself as stress which depletes your body and contributes to exhaustion - which many of us combat with carbs, sugar and caffeine (CSC).
Because we're exhausted and depressed, we hit up the coffee shop to tank up on pumpkin lattes and cookies - which tax our adrenals, pancreas, and central nervous system. In order to avoid the sugar and caffeine crash that we know is coming, we keep eating various forms of CSC. But the more we ingest, the harder we fall - and the greater the depression.
10 Ways to Help Survive Winter with a Smile
Most of the advice for S.A.D. refers to light therapy and anti-depressants; however, outside of moving to Florida, the best way to combat winter is through recognizing what your body needs and conciously balancing it out. When you're able to prime your endocrine system, balance your hormones, maintain a reasonable schedule, embrace the yin of the season and create a support network - winter is MUCH more manageable.
1. Balance Your Melatonin Yin and Vitamin D Yang
When melatonin is high, vitamin D is low - so the trick is finding a happy balance in the middle of the see-saw. Properly timed exposure to blue light paired with correct vitamin D supplementation can make or break a winter.
The Melatonin Merengue: Melatonin is a hormone produced by your body and regulated by the pineal gland located inside your brain. Melatonin is released in response to a change in sunlight - when the sun sets, the lack of blue light found in sunlight signals your pineal gland to release melatonin into your system which then winds you down for bed. Blue light is emitted not just by the sun, but by computer screens, televisions, iPads, iPhones and other devices - which are all known to inhibit sleep since blue light inhibits melatonin release.
Ideally, you should be crawling into bed about 2 hours after sunset - but that means if you live in NYC, you would be going to bed at 6:30pm. Pick a decent bed time that works for you and find ways of bringing blue light into your environment up to 2 hours before sleep. You can purchase blue light wavelength light bulbs to place in rooms such as the living room or kitchen where you're most active. However, keep regular bulbs in places where you wind down. Be sure to keep blue light emitting devices out of those areas, and if you like reading on a device before bed, you can install free software such f.lux which automatically adjusts your screen to remove blue light after sunset so that your pineal gland can do its job.
In winter, I encourage you to purchase blue light wavelength light bulbs that are kept on in rooms where you hang out until 2 hours before bed. If your home or apartment only has ceiling lights, purchase a table or standing lamp to use in addition to the overhead light. If your'e an early riser and are waking before dawn, be sure to turn these lamps on in the morning as well.
Up Your Vitamin D: Vitamin D is magic; when our blood serum levels of vitamin D fall below a certain level, not only do we feel it physically, but we feel it emotionally as well. Symptoms include fatigue, lack of concentration, headaches, poor sleep, and low grade depression among other things. Standard allopathic treatment for vitamin D deficiency is a 50,000 Iu's taken once a week for 6 weeks. This strategy works for some people while for others it will barely shift their numbers - especially if they have autoimmune or digestive problems.
Functional medicine recommends 6,000 - 10,000 Iu's taken daily, preferably in liquid form for up to 3 months - ESPECIALLY in winter. For every 25 pounds of body weight, you can take 1,000 Iu's of vitamin D; however, don't exceed 10,000 Iu's per day. Be sure to take your vitamin D in the morning so that it doesn't affect melatonin production in the evening or rev you up before bed. You can purchase liquid vitamin D from Emerson Ecologics; however, Designs for Health is my preferred brand - their Vitamin D Synergy has vitamin K to help support the liver in converting the D to a usable form.
2. Get Lit
When given the right amount of UVB exposure, our bodies know exactly what to do - produce vitamin D! Before you enroll for a six-month membership at Hollywood Tans, I suggest purchasing a UVB lamp for home use. Tanning beds emit UVA light, a different type of ray that affects pigment but doesn't produce vitamin D. UVB lamps are especially fantastic for individuals with intestinal issues who may not be able to absorb vitamin D supplements due to ailments such as diverticulitis, Crohn's disease, or leaky gut.
Another life hack for surviving winter morning's is a dawn alarm clock. One of my chief complaints in winter is having to wake before the sun rises - there's something almost inhumane about having to wake in what feels like the middle of the night. Rather than using your phone as your alarm clock, a "wake-up light" is an alarm clock built into a special lamp that gradually increases in brightness over a 30-minute period. The process of gently increasing light stimulates your body to wake up naturally and comfortably, make morning's a whole lot easier.
3. Tune Up Your Thyroid
Our nervous system is what senses our environment while our endocrine system is what responds to it. An often overlooked component of health is that our hormone levels change seasonally. It's natural for thyroid levels to nominally drop in winter; but that also means if you're on thyroid meds, your current regimen may need to be adjusted slightly to accommodate the season. I usually tell patients to get their blood checked a couple of weeks before and after the spring and fall equinoxes so they can work with their doctor to adjust their thyroid meds as needed. I also tell patients to discuss with their M.D. the possibility of switching to Nature-throid or WP Thyroid since these prescriptions are natural forms of desiccated thyroid that contain T3 in addition to T4.
4. Fly South
The homestretch of winter after the holidays in January and February can be particularly difficult for people because it feels like the season just won't end. Give yourself a respite and schedule a long weekend someplace sunny. CheapoAir.com or Kayak.com are two budget travel sites that have great prices on different locations that can warm your bones. The flight time from NYC to the Bahamas is less than 3 hours; so if you haven't put in your request to Santa, it's never too early or too late to ask for a round trip ticket to Nassau for Christmas.
5. Stay Active During Daylight Hours
During winter, you have full permission to indulge in the luxury of an extra hour of sleep - but do it on the front end by going to bed around 9:30pm. Even if you're not a morning person, rise as close to sunrise (or before) as possible, which is surprisingly easy when you go to bed early and the sun doesn't rise until 7:20am. Take advantage of as much daylight as possible so that the day doesn't feel any shorter or darker than it already is.
6. Exercise Like You Kinda Mean It
It's important to keep physically active during winter but not to overstrain. To stay balanced in the winter, conserve your energy but remain animate with such things as swimming, restorative yoga, pilate classes or finding ways to walk in the morning. Winter sports are awesome activities as well - snow shoeing, snow boarding, ice skating, skiing or even sledding are all great ways to seasonally stay in shape. Save the booty bootcamp classes for spring.
7. Limit Alcohol and Caffeine
Bailey's in coffee, though delicious, is like adding rocket fuel to depression. Alcohol and caffeine are psychotropic substances - meaning they cross the blood brain barrier and directly mess with your grey matter. Alcohol is relaxing because it's a depressant and, when combined with the yin movement inward of winter, is liable to bring one from "relaxed" to "black hole depressed" fairly quickly.
Caffeine revs the system up, but at the expense of the adrenal glands - which are responsible for your fight or flight response. When you drink coffee, your brain sends a message to the pituitary gland, which releases a hormone that tells your adrenals to produce the stress hormones adrenaline and cortisol. In other words, you are triggering the same kind of stress response that your body uses when you are in imminent physical danger.
The occasional cup of coffee isn't that bad - your adrenals will generally be able to react capably to this kind of stimulation. Several cups of coffee each day, however, lead to a weakened reaction. Some people might say that their ‘tolerance’ has increased - but the bitter truth is that after long-term and repeated doses of caffeine, your adrenals are weakened and less able to respond adequately stress. That's the last thing you need when your mom drops the F-bomb at the Thanksgiving table.
8. Spice It Up
Slow and steady wins the race - the best foods for winter are warm, slow-cooked stews and soups. Almost all the spices that show up in our holiday meals are medicinals that keep our inner metabolism going, so be sure to add yang spices like garlic, ginger, black pepper, cloves, cinnamon, cardamon and turmeric to any or all dishes. It's important to limit cold drinks and raw vegetables - save those for summer when you need to cool down.
9. Talk It Out
When you're home alone in the dark of winter, quiet contemplation can quickly turn into a rabbit hole of depression. Friends, family and community are great support - but it's important to get an occasional objective reality check and support from a trained professional as well. Traditional, face-to-face psychotherapy has been shown to be helpful in relieving both non-seasonal depression and S.A.D. Cognitive behavior therapy (CBT) is a type of psychotherapy that has been extensively studied and shown to help. In CBT, one is taught to become aware of the negative thought patterns that tend to cycle in the mind and to actively replace those thoughts with more productive, positive patterns. I'm a HUGE advocate of therapy and can personally attest to its benefit.
10. A Little Acupuncture Goes a Long Way
Acupuncture excels at tuning up the endocrine system by harmonizing your hormones. Most acupuncturist will also employ moxibustion or other heat therapies to help you make it out of winter alive. There are plenty of herbal prescriptions that can help with mood as well; however, be sure that you're practitioner is not only licensed, but trained in herbs so that they intimately know how to individualize your prescription.