As the winter season takes grip of us here in the northern hemisphere with cold gray skies, darkness and diminished sunlight, many of us develop the “winter blues”. If you do, you're not alone. About 15% of the population may struggle with winter blues, a mild version of Seasonal Affective Disorder (SAD). Studies have shown that nearly 10% of people in New Hampshire have been diagnosed with SAD, but it affects only about 1% in Florida, the Sunshine State.

SAD is a form of depression that comes and goes depending on the time of year. There are 2 main types of the disorder. Fall-onset SAD – This type of SAD starts in late fall and goes away in the spring and summer. Some people call it "winter depression." It is the most common form of SAD. Spring-onset SAD – This type of SAD starts in the spring and goes away in the fall and winter. Spring-onset SAD is much less common than fall-onset SAD.

SAD tends to be more common in women, young adults and those who work night shifts. It also has been found to run in families. Common symptoms include:

• Feeling sad, down, hopeless or cranky most of the day, almost every day
• Sleeping more, but not sleeping well
• Feeling unmotivated with low-energy
• Craving junk or comfort food; gaining weight
• No longer enjoying or caring about doing the things one used to like doing
• Not being able to focus
• Avoiding social activities

There are a number of theories as to what causes SAD and winter blues. The reduced level of sunlight in fall and winter may affect circadian rhythms (our biological internal clock) leading to feelings of depression. The change in season ensuing effect on circadian rhythms may disrupt the balance of the body's level of melatonin, which plays a role in regulating sleep patterns and mood. Reduced sunlight can also cause a drop in serotonin, a brain chemical that affects mood, and might play a role in triggering depression. As sunshine decreases so does the body’s ability to make vitamin D. Drops in Vitamin D have also been linked to SAD.

Knowing these possible causes, there are some things you can do try to lift your mood during these cold dark months:

• Open your shades to let in the sunlight.
• Head outdoors on sunny days.
• Include physical activity in your daily routine.
• Adjust your diet to include foods that provide energy.
• Make plans to stay connected on a regular basis with friends, family and other social supports.
• Try light therapy.

Having patients consume key vitamins and supplements have shown to be quite helpful in my practice. I often recommend checking vitamin D3 levels and supplementing to get levels up to 55-75 ng/mL. Most people need 2,000 IU to 5,000 IU daily. Be sure to take vitamin K2 with your vitamin D3 as this helps prevent toxicity from taking too much vitamin D3, but also is needed to push the calcium into your bones and prevent calcification of your soft tissue, like joints (arthritis) and heart (coronary artery disease). Melatonin at 3-6 mg before bed helps restore normal circadian rhythms. Supplementing with the amino acid 5-htp also helps raise serotonin levels and can be quite helpful with depression. Herbs like St. Johns Wort and Rhodiola are my favorites for lifting mood. Don’t forget taking fish oil – most people need 2000 mg or more of omega-3 fatty acids EPA and DHA. Fish oil is essential for lifting depression.

It's normal to have some days when you feel down, but if it continues for multiple days at a time and you can't get motivated to do activities you normally enjoy it is important to see your health care provider. This is especially important if your sleep patterns and appetite have changed, you turn to alcohol for comfort or relaxation, or you feel hopeless or think about suicide.

Dr. Toby

A person’s ability to generate a fever is an eloquent demonstration of his/her body's innate self-healing potential. The immune system's response to infection is an amazing and intricate process.

Additional white blood cells are manufactured.  These cells destroy bacteria and viruses and also remove damaged tissue and irritating materials from the body. The activity of the white blood cells increases, and they move rapidly to the site of infection. Antibody production increases by as much as 20-fold. You get sleepy and lose your appetite. This conserves energy for natural defense and repair. The elevated body temperature kills certain bacteria and viruses. Iron is being removed from the blood and stored in the liver. Many bacteria need iron for survival.

An elevated body temperature is integral to this process.  Hippocrates knew this when he said, “give me a fever and I can cure any disease.” Suppressing the fever may interfere with healing and prolong the infection.

Naturopathic doctors like to recommend “Wet Sock” Hydrotherapy, often referred to as “naturopathic Tylenol”, to help stimulate the immune system and healing response during acute infections while gently decrease a fever to more comfortable levels.

Fever is part of the body's normal response to infection. Fever is a symptom not a disease. One may be lethargic or flushed, may have a rapid and strong heart beat, and may even hallucinate during a fever. Fevers generated in the course of an illness are not in and of themselves dangerous. 

The underlying cause of a fever and how sick a child (and adult) looks are more important than the height of the fever. Fevers of 107 and 108 degrees can cause brain damage and usually result from heat stroke or accidental poisoning. Routine infections are not likely to produce fevers of this degree. It is normal for one out of twenty healthy children under the age of five to have a fever convulsion. These febrile seizures usually last only a few minutes and produce no lasting or harmful effects.

Routine fevers are not usually dangerous. The underlying cause of the fever or dehydration from inadequate fluid consumption is the source of most potential problems. You cannot judge the severity of the condition by the height of the fever. Above all else, how someone looks and acts determines the likelihood of a serious problem. A child with a temperature of 101 who is abnormally quiet with a vacant stare is much sicker than a child with a fever of 104 who is playing and fully engaged in his environment. Normal fever convulsions, or febrile seizures, are unlikely to cause brain damage. High body temperatures are not more likely to result in febrile seizures compared to lower temperatures.

It can be difficult to determine the seriousness of an acute illness and therefore a pediatrician or other healthcare practitioner should be involved in care.

          Toby K. Toby K. Hallowitz, ND, MSOM, LAc