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Erica Leazenby, MD, IFMCP, Chef Erica Leazenby, MD, IFMCP, Chef

Lifestyle Supports for Seasonal Affective Disorder

Winter is here and many of us are confronting the long gray days that may take a toll on our mood. If you struggle with a low mood every winter, these strategies may make this winter a bit brighter. 

Winter is here and many of us are confronting the long gray days that may take a toll on our mood. If you struggle with a low mood every winter, these strategies may make this winter a bit brighter. 

What is Seasonal Affective Disorder (SAD)?

Seasonal affective disorder (SAD) is a mood disorder with depressive symptoms that occurs at specific times of year and fully resolves at other times of year. Most SAD occurs in the fall and winter. The cause of SAD is not fully understood, but theories implicate a shift in the circadian rhythm and alterations in serotonin in the brain as potential triggers. If you struggle with SAD, know that you are not alone. SAD affects 0.5% to 2.4% of the population at some point during their lifetime. Additionally, ten to 20% of people struggling with major depression will have a seasonal pattern consistent with SAD. 

What are the risk factors for SAD?

Evidence for risk factors is limited, but some data suggests that family history, being female, younger adulthood, and living at a more northern latitude may increase your risk.

What are the symptoms of SAD?

SAD is a subtype of major depressive disorder. Symptoms include fatigue, loss of interest or pleasure in activities, mood swings, sadness, hopelessness, and social withdrawal among others. Recent studies suggest that SAD may have additional symptoms, including excessive sleepiness, increased appetite especially carbohydrate craving, and weight gain.

How can SAD be treated?

I recommend starting with a proper diagnosis. Before starting treatment, I recommend talking with Relish Health or your trusted healthcare provider about your symptoms. Ruling out underlying physical conditions such as anemia, vitamin deficiencies, hormone imbalances or other medical conditions is important for addressing the root cause of your mood. 

Natural ways to improve SAD include:

Light box for seasonal affective disorder

Light box for seasonal affective disorder

  1. Light Therapy, also called phototherapy, is a well-documented way to improve SAD. The therapy involves sitting a few feet from a special “light box” that exposures you to bright light within the first hour of waking each day. The recommended intensity of light is 2,500-10,000 lux. The time in front of the lamp will depend on the manufacture’s specification and your response to the light. Light boxes are about 20 times brighter than ordinary indoor light. They filter out the potentially damaging UV light, making them a safe treatment for most people. However, people with certain eye diseases or people taking certain medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood. Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to a few weeks. 

  2. Psychotherapy, also called talk therapy or cognitive behavior therapy, is another option to treat SAD. A trained metal health professional can help you identify and change negative thoughts and behaviors that may be making you feel worse. Optimizing stress management and learning healthy ways to cope with SAD can do wonders for your mood and long-term mental health. 

  3. Optimize vitamin D. Because many people with SAD often have vitamin D deficiency, nutritional supplements of vitamin D may help improve their symptoms. However, studies testing whether vitamin D is effective in SAD treatment have produced mixed findings, with some results indicating that it is as effective as light therapy but others detecting no effect.

  4. Eat an anti-inflammatory diet. A nourished brain is a resilient brain. We need to consume several vitamins, minerals, fats, and antioxidants to feel our best, and the only way to authentically do that is with real food. Eat a balance of vegetables, well-sourced fish and poultry, starchy tubers (potatoes, sweet potatoes), fermented foods (sauerkraut, yogurt), nuts, seeds, fruits, and plenty of healthy fats such as olive oil, avocado, coconut oil, and fatty fish like salmon or sardines. If you think you are suffering from SAD, then avoid sugar, refined carbs (i.e., bread, crackers, pasta, cookies), and inflammatory oils, such as canola oil and see if this makes any difference in your mood. Research in the field of nutritional psychiatry shows that eating fish at least once or twice a week can decrease your risk of depression and avoiding ultra processed foods(UPFs) (ie. packaged snacks and frozen meals) and artificial sweeteners is important. People eating nine or more servings per day of UPFs had a 50% higher risk of developing depression than those consuming four or fewer servings per day (that bag of chips is likely multiple servings).

  5. Keep moving. Commit to doing something quick, free, easy, convenient, and pleasant for a least a few minutes most days of the week. Exercise is like medicine. Even small amounts can deliver antidepressant benefits. I assure you doing something—no matter how small—is so much better than nothing. A new study published in 2023 found that weekly hot yoga reduced depressive symptoms by at least 50 percent. Approximately 44 percent of depressed participants of the study doing yoga weekly after 8 weeks were considered to be in remission from their depression.

  6. Medicate or supplement wisely. Because SAD, like other types of depression, is associated with disturbances in serotonin activity, antidepressant medications or targeted supplements have their place in treatment regimens. I always recommend starting with good nourishment and self-care but talk to your healthcare provider or Relish Health if additional support is needed.  

Learn more:

LIFESTYLE TIPS TO EASE YOUR ANXIETY
USE YOUR FORK TO IMPROVE YOUR FEELINGS
GOOD MOOD FOOD

References:

  1. Galima SV, Vogel SR, Kowalski AW. Seasonal Affective Disorder: Common Questions and Answers. Am Fam Physician. 2020 Dec 1;102(11):668-672. PMID: 33252911.

  2. Campbell PD, Miller AM, Woesner ME. Bright Light Therapy: Seasonal Affective Disorder and Beyond. Einstein J Biol Med. 2017;32:E13-E25.

  3. MayoClinic.org. Seasonal affective disorder (SAD), Last accessed 11/25/2023.

  4. The National Institute of Mental Health. Seasonal Affective Disorder. NIH Publication No. 20-MH-8138. Last accesses 11/25/2023.

  5. Yang Y, Kim Y, Je Y. Fish consumption and risk of depression: Epidemiological evidence from prospective studies. Asia Pac Psychiatry. 2018 Dec;10(4):e12335. doi: 10.1111/appy.12335. Epub 2018 Sep 20. PMID: 30238628.

  6. Li F, Liu X, Zhang D

    Fish consumption and risk of depression: a meta-analysis

    J Epidemiol Community Health 2016;70:299-304.

  7. Samuthpongtorn C, Nguyen LH, Okereke OI, et al. Consumption of Ultraprocessed Food and Risk of Depression. JAMA Netw Open. 2023;6(9):e2334770. doi:10.1001/jamanetworkopen.2023.34770

  8. Nyer MB, Hopkins LB, Nagaswami M, Norton R, Streeter CC, Hoeppner BB, Sorensen CEC, Uebelacker L, Koontz J, Foster S, Dording C, Giollabhui NM, Yeung A, Fisher LB, Cusin C, Jain FA, Pedrelli P, Ding GA, Mason AE, Cassano P, Mehta DH, Sauder C, Raison CL, Miller KK, Fava M, Mischoulon D. A Randomized Controlled Trial of Community-Delivered Heated Hatha Yoga for Moderate-to-Severe Depression. J Clin Psychiatry. 2023 Oct 23;84(6):22m14621. doi: 10.4088/JCP.22m14621. PMID: 37883245.

(This blog post is not sponsored by any manufacturer. However, at no expense to you, Relish Health may receive a commission on purchases made through an Amazon link.)

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Erica Leazenby, MD, IFMCP, Chef Erica Leazenby, MD, IFMCP, Chef

Lifestyle Support for Seasonal Affective Disorder

While the pandemic has many of us feeling stressed and isolated, many of us are also confronting the long gray days of winter which may also be taking a toll on our mood. If you struggle with a low mood every winter, these strategies may make this winter a bit brighter. 

While the pandemic has many of us feeling stressed and isolated, many of us are also confronting the long gray days of winter which may also be taking a toll on our mood. If you struggle with a low mood every winter, these strategies may make this winter a bit brighter. 

What is Seasonal Affective Disorder (SAD)?

Seasonal affective disorder (SAD) is a mood disorder with depressive symptoms that occurs at specific times of year and fully resolves at other times of year. Most SAD occurs in the fall and winter. The cause of SAD is not fully understood, but theories implicate a shift in the circadian rhythm and alterations in serotonin in the brain as potential triggers. If you struggle with SAD, know that you are not alone. SAD affects 0.5% to 2.4% of the population at some point during their lifetime. Additionally, ten to 20% of people struggling with major depression will have a seasonal pattern consistent with SAD. 

What are the risk factors for SAD?

Evidence for risk factors is limited, but some data suggests that family history, being female, younger adulthood, and living at a more northern latitude may increase your risk.

What are the symptoms of SAD?

SAD is a subtype of major depressive disorder. Symptoms include fatigue, loss of interest or pleasure in activities, mood swings, sadness, hopelessness, and social withdrawal among others. Recent studies suggest that SAD may have additional symptoms, including excessive sleepiness, increased appetite especially carbohydrate craving, and weight gain.

How can SAD be treated?

I recommend starting with a proper diagnosis. Before starting treatment, I recommend talking with Relish Health or your trusted healthcare provider about your symptoms. Ruling out underlying physical conditions such as anemia, vitamin deficiencies, hormone imbalances or other medical conditions is important for addressing the root cause of your mood. 

Natural ways to improve SAD include:

Light box for seasonal affective disorder

Light box for seasonal affective disorder

  1. Light Therapy, also called phototherapy, is a well-documented way to improve SAD. The therapy involves sitting a few feet from a special “light box” that exposures you to bright light within the first hour of waking each day. The recommended intensity of light is 2,500-10,000 lux. The time in front of the lamp will depend on the manufacture’s specification and your response to the light. Light boxes are about 20 times brighter than ordinary indoor light. They filter out the potentially damaging UV light, making them a safe treatment for most people. However, people with certain eye diseases or people taking certain medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood. Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to a few weeks. 

  2. Psychotherapy, also called talk therapy or cognitive behavior therapy, is another option to treat SAD. A trained metal health professional can help you identify and change negative thoughts and behaviors that may be making you feel worse. Optimizing stress management and learning healthy ways to cope with SAD can do wonders for your mood and long-term mental health. 

  3. Optimize vitamin D. Because many people with SAD often have vitamin D deficiency, nutritional supplements of vitamin D may help improve their symptoms. However, studies testing whether vitamin D is effective in SAD treatment have produced mixed findings, with some results indicating that it is as effective as light therapy but others detecting no effect.

  4. Eat an anti-inflammatory diet. A nourished brain is a resilient brain. We need to consume several vitamins, minerals, fats, and antioxidants to feel our best, and the only way to authentically do that is with real food. Eat a balance of vegetables, well-sourced fish and poultry, starchy tubers (potatoes, sweet potatoes), fermented foods (sauerkraut, yogurt), nuts, seeds, fruits, and plenty of healthy fats such as olive oil, avocado, coconut oil, and fatty fish like salmon or sardines. If you think you are suffering from SAD, then avoid sugar, refined carbs (i.e., bread, crackers, pasta, cookies), and inflammatory oils, such as canola oil and see if this makes any difference in your mood.

  5. Keep moving. Commit to doing something quick, free, easy, convenient, and pleasant for a least a few minutes most days of the week. Exercise is like medicine. Even small amounts can deliver antidepressant benefits. I assure you doing something—no matter how small—is so much better than nothing.

  6. Medicate or supplement wisely. Because SAD, like other types of depression, is associated with disturbances in serotonin activity, antidepressant medications or targeted supplements have their place in treatment regimens. I always recommend starting with good nourishment and self-care but talk to your healthcare provider or Relish Health if additional support is needed.  

Learn more:

LIFESTYLE TIPS TO EASE YOUR ANXIETY
USE YOUR FORK TO IMPROVE YOUR FEELINGS
GOOD MOOD FOOD

References:

  1. Galima SV, Vogel SR, Kowalski AW. Seasonal Affective Disorder: Common Questions and Answers. Am Fam Physician. 2020 Dec 1;102(11):668-672. PMID: 33252911.

  2. Campbell PD, Miller AM, Woesner ME. Bright Light Therapy: Seasonal Affective Disorder and Beyond. Einstein J Biol Med. 2017;32:E13-E25.

  3. MayoClinic.org. Seasonal affective disorder (SAD), Last accessed 2/10/2021.

  4. The National Institute of Mental Health. Seasonal Affective Disorder. NIH Publication No. 20-MH-8138. Last accesses 2/10/21.

(This blog post is not sponsored by any manufacturer. However, at no expense to you, Relish Health may receive a commission on purchases made through an Amazon link.)

Read More
Recipe Erica Leazenby, MD, IFMCP, Chef Recipe Erica Leazenby, MD, IFMCP, Chef

Braised cod with fennel, tomatoes and olives

Fennel is one of my favorite veggies. It has a sweet, anise flavor that in my opinion is underutilized and under-appreciated. The anise flavor of this fall veggie mellows as it caramelizes during cooking. The briny olives and bright tomatoes in this recipe make a delicious pan sauce for the humble cod. I like to serve the fish with roasted potatoes or rice.

Fennel is one of my favorite veggies. It has a sweet, anise flavor that in my opinion is underutilized and under-appreciated. The anise flavor of this fall veggie mellows as it caramelizes during cooking. The briny olives and bright tomatoes in this recipe make a delicious pan sauce for the humble cod. I like to serve the fish with roasted potatoes or rice.

Pro tip: Save the tops of your fennel to add to homemade stock. I store them in the freezer until stock-making day. Fennel tops are one of my secret ingredients for an amazing soup base.


Braised cod with fennel, tomatoes and olives

Braised cod with fennel, tomatoes and olives

Braised cod with fennel, onions and olives

Author: Erica Leazenby
Time: 30 minutes
Serves: 4

Ingredients:

2 Tablespoons olive oil
1 medium fennel bulb, sliced thin
1 small onion, sliced thinly (pole to pole)
1 pint cherry tomatoes
1 garlic clove, diced
1 bay leaf
20-25 Castelvetrano olives, pitted
4 wild caught cod fillets
Salt and pepper to taste
Parsley to garnish (optional)

Directions:

  1. Heat a cast iron skillet to medium heat. Add the olive oil, fennel and onions. Sauté the veggies until they are soft and becoming translucent, about 5-6 minutes.

  2. Add the garlic, bay leaf, tomatoes and olives; sauté for an addition 3-4 minutes until the tomatoes start to soften. Add 1/4-1/2 cup water to the skillet if the veggie mixture starts to thicken. 

  3. Season the cod with salt and pepper. Place the cod on top of the simmering veggies. Use a spoon to baste the fish with the pan juices. Cover the skillet and cook the fish until done. The fish will take about 10 minutes per inch thickness to cook. Most cod fillets are about 1/2-3/4 inch thick and take 5-6 minutes to poach.

  4. Garnish the cod with parsley if desired. 


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Recipe Erica Leazenby, MD, IFMCP, Chef Recipe Erica Leazenby, MD, IFMCP, Chef

Seasonal Agrodolce Sauce

I’ve felt inspired by the gorgeous fruit in the market recently. The plums, peaches and pluots have vibrant color and sweetness that I find especially appealing. “Agrodolce” is a traditional sweet and sour sauce in Italian cuisine. I taught this recipe in a recent cooking class. It is easy to prepare yet makes a dramatic and elegant statement. The recipe captures the flavor of the fruit to make a savory accompaniment to a variety of dishes including fish like salmon or halibut, poultry, pork or even roasted veggies like squash or cauliflower.

Halibut with Agrodolce sauce

I’ve felt inspired by the gorgeous fruit in the market recently. The plums, peaches and pluots have vibrant color and sweetness that I find especially appealing. “Agrodolce” is a traditional sweet and sour sauce in Italian cuisine. I taught this recipe in a recent cooking class. It is easy to prepare yet makes a dramatic and elegant statement. The recipe captures the flavor of the fruit to make a savory accompaniment to a variety of dishes including fish like salmon or halibut, poultry, pork or even roasted veggies like squash or cauliflower.

Agrodolce

Author: Erica Leazenby, MD 
Makes: 1 cup (4 servings)
Time: 20 minutes

Ingredients:

1-2 Tablespoons olive oil, divided
½ large red onion, sliced thin (about 1 cup)
½ cup raw almonds
½ cup golden raisins
1 tsp fresh thyme
1 tsp fresh rosemary, minced
1 small orange, zest and juice
1 cup diced ripe fruit like apple, plum or cherries
1.5-2 Tbsp balsamic vinegar (more to taste as needed)
Pinch salt
Pepper to taste
Water to thin if needed

Directions:

  1. Place 1-2 tsp of oil in a skillet over medium-low heat. Toast the almonds until fragrant, about 3-5 minutes. Set aside.

  2. Place the remaining oil in the skillet and add the onion with a pinch of salt. Stir for 3-5 minutes until soft and caramelized. 

  3. Add the raisins, fruit, herbs, orange zest and juice. Stir until the raisins are plump. 

  4. Add the vinegar and simmer 2-3 additional minutes until the fruit is soft and the sauce has slightly thickened. Add in the reserved almonds. Add 1-2 tablespoons of water if the sauce becomes thicker than desired. Season to taste.

  5. Serve warm or cold. 

Consider these additional pescatarian recipes:

ROASTED SALMON WITH LEMON WALNUT RELISH

GRILLED TUNA WITH ARTICHOKES

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