For most people, the holidays are a cherished time when family and friends gather to reconnect, share gratitude, experiment with culinary delights, reflect on accomplishments, or complain about how much weight they’ve gained during the year!  We celebrate our health and happiness with acts of love, gift-giving, and religious or spiritual observation.  There is, however, a growing number of Americans that experience deep psychological problems during the winter months and holidays.  The reasons are varied, but most people struggle with days that are shorter and darker, and inclement winter weather that creates stressful traveling conditions.  Also, many people have experienced difficulty or trauma within their own families, or have had personal medical challenges.  Whatever the reasons, many adults, adolescents, and children experience some form of mood disorder that is intensified during the winter months and holidays.

According to current estimates, 30 million people in the U.S. suffer from feelings of depression and anxiety.  Many of these individuals don’t seek treatment even though every day is a personal nightmare that doesn’t end.  I like to think of mood disorders as manifestations that result from imbalances in physiology and psychology.  There is no single etiology that can explain why some people experience depression or anxiety.  If you suffer from a low mood during the winter months (Seasonal Effective Disorder) or struggle with depression throughout the year it’s important to have an evaluation with a health care provider that practices functional or nutritional medicine, and who can understand the many factors that cause disordered psychology.  Just treating the symptoms of depression and anxiety with medication may not address the root cause of a brain chemistry abnormality.  An integrative physician will order labs that can identify underlying physiological abnormalities.

Standard tests should include:

1. Blood sugar assessments may identify hypoglycemia which is common in patients with depression and anxiety-glucose, insulin, and A1c.
2. Iron status. Low levels can produce symptoms that mimic depression.
3. Vitamin D status. Low levels are associated with an increased risk of depression.  This is especially important in the winter months when sun exposure is limited.
4. Vitamin B12. Low levels have been identified in various psychiatric disorders.
5. Inflammatory markers-C-reactive protein, interleukin-6, and homocysteine. A high level of inflammation is associated with mood disorders
6. Energy imbalances (mitochondrial function)-heavy metal testing and CoQ10 status.
7. Adrenal function tests. Long periods of psychological stress can cause elevations in cortisol and disruptions in adrenal health, which can cause anxiety and changes in mood.
8. Hormone function tests-thyroid, testosterone, estrogen, and progesterone. Hormones have profound regulating effects on the body, and any disruption can cause various psychological problems.

Any treatment plan should be a collaborative effort between you and your trusted physician.  All medications, diet and lifestyle modifications, and nutritional supplements should be taken into consideration and evaluated to create a personalized protocol that meets individual needs.  Physiology and psychology are not independent of one another, they are intricately linked and influence each other to maintain a healthy body and mind.

In my years of experience working with clients and customers, these are the most effective recommendations I can give anyone who is besieged with a mood disorder:

1. Spend time in nature and get some sunshine. Being in nature has a calming and balancing effect on the body and mind, and sunlight increases vitamin D and serotonin levels, which are needed to combat depression.
2. Get enough sleep (seven hours minimum). Without sleep, our bodies can’t complete necessary restorative functions in the brain and central nervous system.
3. Change stressful thought patterns and incorporate relaxations techniques. Working with a counselor trained in Cognitive Behavioral Therapy can be very effective.  I recommend practicing some form of meditation (mindfulness) and yoga.  These are powerful tools that can have a profound effect on the stress response.
4. Moderate level exercise can improve immune system function, mediate the stress response, improve sleep, normalize digestion, and generally make you a happier person.  Be careful not to engage in excessive or intense exercise on a regular basis.  Going too hard can reverse the benefits of moderate exercise and cause endocrine dysfunction and nutrient loss.
5. Consume healthy foods. A diet high in refined carbohydrates and sugars will cause inflammation that can affect mood.  Consume a diet that’s higher in healthy proteins and fats, especially omega-3 fatty acids.  Eat whole, fresh foods and avoid manufactured food-like substances.  What you eat will have a direct effect on brain chemistry.

You can’t have a discussion about natural approaches for mood disorders without including nutritional supplements.  There are a wide variety of dietary supplements that have been clinically studied and shown to exert a significant effect on brain chemistry, endocrine function, and overall physical wellbeing in depressed patients.  It’s important that you work with your health care provider to choose the appropriate supplement protocol.  In my experience, most integrative physicians and naturopathic doctors will recommend the basics for healthy brain chemistry and gut health (gut-brain axis) including a multivitamin/mineral with higher levels of B vitamins, vitamin D, magnesium, and zinc; a good probiotic supplement; and an essential fatty acid supplement high in omega-3 fats.  If it’s determined that depressive feelings are associated with a blood glucose abnormality then your physician may recommend chromium, berberine, and curcumin.  One central diagnostic criterion of low mood and anxiety involves how the body manufactures and utilizes neurotransmitters like serotonin and dopamine.  Supplements that can have a positive effect on neurohormone and neurotransmitter levels include L-tryptophan, 5-hydroxytryptophan, Mucuna pruriens, L-tyrosine, SAMe, GABA, and L-theanine.

One supplemental treatment option that I’m especially excited about is the use of hemp-derived, full-spectrum CBD oil.  The research community is very excited about the potential anti-inflammatory, mood-regulating, and anti-psychotic effects of cannabis oil from the hemp plant.  In the 30 years that I’ve worked with nutritional supplements, I have never used or recommended a product that is as effective as full-spectrum CBD oil for sleeping problems or disorders, which can be a symptom of depression and anxiety. The phytocannabinoids in hemp modulate and activate the body’s endocannabinoid system, which is directly associated with neuroprotection, stress relief, immune response, and regulating the body’s general state of balance, impacting faculties such as appetite, sleep, mood, and pain.

Michael Chase, MS, NTP

Nutrition Science and Dietetics