Medical scientists are learning more and more each day about the biological rhythms of life and how these rhythms play a role in determining health and disease.
Sometimes this biological clock gets out of kilter. Perhaps the best-known example of this occurrence is seasonal affective disorder (SAD)-the medical term for the winter blues. Typically, individuals with SAD feel depressed; they generally slow down, oversleep, overeat, and crave carbohydrates in the winter. In the summer, these same people feel elated, active, and energetic.
The Importance of Light
Although many variables may be responsible for SAD, lack of exposure to full-spectrum natural light appears to be the most logical explanation. The antidepressant effect of light therapy is probably due to restoring proper melatonin synthesis and secretion by the pineal gland, leading to re-establishment of proper circadian rhythm. If you suffer from SAD, try replacing all of the light bulbs in the rooms where you spend the most time with full-spectrum lighting. You may also want to invest in a light box, available at some health food stores and online.
Melatonin-Not That Effective?
Since melatonin secretion in SAD is disturbed, it makes a lot of sense to see if there is any benefit from melatonin supplementation at bedtime. Unfortunately, melatonin alone has produced mixed results in clinical trials. Nonetheless, some people do seem to respond to 2-3 mg of melatonin at bedtime. For further support in resetting your biological clock, I recommend 3 mg (3,000 mcg) of methylcobalamin, a special form of vitamin B12, first thing in the morning.
Do Low Levels of Vitamin D Cause SAD?
One theory about SAD is that it is another disorder linked to low levels of vitamin D. Vitamin D is absolutely essential for proper brain chemistry and neurotransmitter action. To ensure optimal vitamin D status during the winter months, most health experts now advocate daily dosages of 2,000 to 5,000 IU, even in apparently healthy adults.
St. John's Wort Extract in SAD
Studies have shown St. John's wort extract (SJWE) to be very effective in reducing depression scores in patients with SAD. In one study, patients were treated with 900 mg of SJWE daily, combined with either bright (3000 lux) or dim light (<300 lux therapy). There were significant reductions in depression scores in both groups (72 % and 60%, respectively), indicating that SJWE may offer support to patients with SAD-either alone or in combination with light therapy.
SJWE is generally without side effects, but potential drug interactions are a reality. Because SJWE can increase the activity of a drug-detoxifying enzyme in the liver, it has been found to decrease the plasma concentrations of a long list of drugs. If you are taking prescription medication, including birth control pills, do not take St. John's wort without approval from your physician first. A standard dosage is 300 mg three times daily.
Resurrecting St. John's Wort for Depression
Of all of the herbal antidepressant agents, the one with the best data in SAD is St. John's wort extract (SJWE). In the late 1990s, the brightest star in herbal medicine was without question SJWE. In fact, in Germany it was estimated that in 1996 physicians prescribed SJWE eight times more frequently than the antidepressant Prozac for the treatment of depression.
In April 2001, however, a blaring headline on the cover of Time magazine stated, "St. John's What?" The article went on to highlight the results of a study demonstrating that SJWE didn't work any better than a placebo. However, many experts felt that the entire study seemed as if the researchers were stacking the deck against SJWE. For good reason: the study was funded by the maker of Zoloft, the No. 1 antidepressant drug at the time. In fact, the study did not correlate with the other, over 30 double-blind studies (then and current) that researched SJWE use for mild-to-moderate depression. It is important to point out that the subjects selected in the negative study had severe depression for at least two years and were not likely to respond to any treatment. Still, the number reaching remission of illness was significantly higher with SJWE than with placebo, though the overall success rates were very low (14.3% for SJWE; 5% for placebo).
Since this study, there have been several double-blind studies on SJWE comparing it to standard antidepressant drugs, including Zoloft, in mild-to-moderate depression. These studies have shown that SJWE is more effective and has fewer side effects. The take-away message? SJWE may not be strong enough for severe depression; however, it is a great choice for mild-to-moderate depression.
Michael T. Murray, ND, is the author of more than 30 books on natural health, including The Encyclopedia of Natural Medicine, Third Edition. He is regarded as one of the world's top authorities on natural medicine, and is a sought-after lecturer and educator. Visit him online at doctormurray.com.
Paradise Herbs St. John's Wort boasts ideal concentrations of the herb, including the flower, leaf, and stem. One capsule can be taken three times per day.
Rainbow Light Vitamin D Sunny Gummies Sour Lemon Flavor are a tasty way to ensure you are getting enough of this "sunshine" vitamin. Each gummy drop contains 1,000 IU of vitamin D. Great for kids, too.
Natural Factors Methylcobalamin (1,000 mcg) features the most well-absorbed form of vitamin B12. Use up to three tablets in the morning for SAD.