From vitamin supplements to phototherapy, there’s hope for Western North Carolinians suffering from seasonal affective disorder, say several local experts. As temperatures plummet, mountain roads ice over and daylight hours diminish, SAD affects around 5 percent of Americans annually, according to the American Psychiatric Association. It can produce symptoms such as low energy, irritability, oversleeping, weight gain and, in extreme cases, suicidal thoughts.
Severe cases may require medical options, but there are also many effective alternative treatments — and more importantly, means of prevention. Xpress caught up with some local health and wellness practitioners for advice on natural remedies for SAD.
The Vitamin D factor
Brad Rachman, a Black Mountain-based naturopath, specializes in functional medicine. “Over the last 30 years, I’ve treated over 75,000 patients,” says Rachman, “and in my experience with SAD, the entirety of the disorder is driven by two different but simultaneously occurring events.”
The culprits, he says, are a common vitamin D deficiency coupled with the winter time change, which lessens our exposure to vitamin D-producing sunlight and disrupts circadian rhythms. “More than 50 percent of Americans are vitamin D deficient,” notes Rachman, “and it only gets worse when we have less time in the sunlight. There is extraordinary sensitivity in the nervous system to colors and brightness of light, and, unfortunately, the time change occurs when we’re already getting the least amount of sunlight.”
Rachman concludes, “Put all of that together, and it’s no wonder we have a significant percentage of Americans experiencing some degree of SAD symptoms.”
He says that vitamin D is a critical regulator for hormones like serotonin, melatonin, dopamine and norepinephrine — hormones that help keep us happy. Moreover, the only way the body can produce this important vitamin is through direct contact with full-spectrum light, which is best supplied by natural sunlight but can also be imitated with full-spectrum light panels or boxes, Rachman continues. Phototherapy, the treatment produced by these light devices, is usually the first suggestion for treating SAD naturally.
“The way phototherapy works,” says Rachman, “is by triggering the rods and cones in the eyes to create a degree of stimulation. [It’s] best utilized within the first hour of waking.”
These full-spectrum light devices can be found in many clinics but can also be easily purchased for personal use, he notes.
Another critical but easy step to prevent as well as treat vitamin D deficiency in the winter is to take a supplement, Rachman says. “Blood values of vitamin D are not monitored very well in normal check-ups,” he says. Extreme deficiencies often go unnoticed, Rachman continues. “Supplementation is a simple way to fix this, but the tricky part is that we all absorb vitamin D differently and so require different levels of supplementation.”
He recommends that those with SAD team with a primary care doctor to measure blood levels and find their specific optimal range.
Most importantly, Rachman advocates using lifestyle as medicine. With SAD, he says, the best approach is developing personal wellness practices that reduce risk factors like anxiety, stress, poor diet and lack of exercise.
The somatic approach
Somatic psychotherapist and clinical addictions specialist Corey Costanzo, who owns Still Point Wellness with his wife, Robin Fann-Costanzo, says he takes as a first principle that physical and mental well-being are directly related. And a healthy mind-body connection begins with the nervous system. “As a somatic psychotherapist, I try to offer road maps for becoming more mindful of the body’s nervous system response,” says Constanzo, “because oftentimes stress results from resisting the nervous system. With SAD in particular, the nervous system begins to wind down as a response to the change in season and light.”
Costanzo advises mindful attention as a way to work through these changes: “Listen to the body and give it what it wants to reduce stress on the nervous system. As the sun goes down earlier, lights in the house should go down earlier and screens should be shut off earlier. This way you can work with the rhythms that the body is craving and receive a more positive energetic response.”
Costanzo also notes the importance of prevention. “Really, exercise, relaxation practice and general self-care are the first steps to sustainable well-being,” he says.
In this spirit, Costanzo and his wife lead a donation-based restorative yoga and didgeridoo meditation class every Friday at Asheville Community Yoga.
Ayurveda, nutrition and digestion
Offering an ayurvedic perspective on SAD, Greta Kent-Stoll of Asheville Ayurveda emphasizes nutrition. “Digestion is the physical root of disease,” says Kent-Stoll, “so pay close attention to your digestion and eating routines during physically and emotionally trying times.”
Involvement of the “doshas” is the key to diagnosis and prevention of disease, says Kent-Stoll. “Ayurveda teaches that everyone is made up of a unique balance of three doshas: vata, pitta, and kapha,” she explains. “The doshas are vital energies or humors, and when they become imbalanced or excessive in a person, the result is disease. Since winter is the season ruled by Kapha, it is not shocking that people should develop Kapha-type disorders in the winter. These often manifest as lethargy, oversleeping, sluggishness, brain fog and slowed digestion — cornerstones of SAD.”
The antidotes she recommends: warmth, movement and light. “Eat foods that are warm, cooked and well-spiced,” she says. But warmth and lightness are brought about in more ways than just through diet, Kent-Stoll explains. “Get as much sunlight as possible,” she advises. “Take a walk during daytime hours, open the curtains, trim back hanging tree branches and have your living and work spaces be well and pleasantly lit. Find rituals that are nourishing and joyful. Take time to cook and get together with friends and family in person.”
Outdoors with friends
While medication, supplementation, phototherapy, somatic therapy and nutrition are all options for effective treatment of SAD, professionals agree that exercise and community involvement should be priorities for anyone struggling with depressive symptoms. One easily accessible way to engage in the community while getting exercise and crucial sunlight is to join one of the many hiking groups in the area.
Since 1923, the Carolina Mountain Club has been essential in developing hiking trails and fostering a community of outdoor enthusiasts in the Asheville area and beyond. Hike leader and council member Kathy Kyle speaks from experience on the positive effects on mood that the group has provided: “If I don’t get outside and hike, my mood suffers, especially in the winter. The broad unobstructed views along with the physical exertion of climbing up mountains and down steep trails, breathing in the cold air, can’t be replicated at the gym.”
As for energy levels, Kyle remarks, “We have a man in the club who is 86, and he regularly hikes and leads the most difficult hikes the club offers. He is an example of the power that hiking has to increase your energy levels.”
CMC’s members are no less committed to each other than they are to the trails. “The club is family for my husband and me,” Kyle explains. “We have shared birthdays, countless dinners, deaths of loved ones and everyday life experiences with people in the club. I have shared and learned more from the club members than any other group I have been involved with.”
All the practitioners Xpress spoke with stressed that taking advantage of the many resources our area has to offer can really help when in need of a winter pick-me-up. As Kent-Stoll advises, “Keep up with your wellness practices. Don’t postpone wellness! Winter is the perfect time to start, or recommit, to a yoga practice; try a new physical activity; and seek out extra wellness care via ayurvedic consultations, acupuncture, massage and energy work. This is a great time for reflection and inner healing, and passes for wellness services or yoga classes can be great holiday gifts for others and yourself.”