Seasonal affective disorder (SAD) is a form of depression that occurs during the same months of the year, each year. The majority of those with SAD experience this depression during the autumn and winter months, but SAD may also affect persons in spring or summer months.
Seasonal affective disorder (SAD) is a common phenomenon seen all around the world, but a slightly higher risk is seen in higher latitude areas of the world. The prevalence of SAD is approximately 5% in the U.S.,1 but subclinical levels of SAD are much more prevalent. The main hypothesis for the cause of SAD is the decreased sunlight exposure leading to a decrease in serotonin activity, which affects mood. Symptoms of SAD may include a seasonal pattern of:
Too much sunlight may be potentially harmful, but we now know that not getting enough outdoor sunlight decreases our vitamin D levels in our body and can affect our mood, however, there are natural strategies that may help individuals with SAD. Even a poor diet could worsen the depression associated with SAD, as fast-food and commercial baked goods have been linked to depression.2 A Nutritarian eating style is supportive for those with SAD.
ONLINE: All members of DrFuhrman.com can search the Ask the Doctor archives for discussions on this topic. Platinum and Diamond members can connect with Dr. Fuhrman by posting questions in the forum. Not a member? Join now.
IN PERSON: Book a stay at Dr. Fuhrman’s Eat to Live Retreat in San Diego, California. With options ranging from one, two and three months (and sometimes longer) you will be under Dr. Fuhrman’s direct medical supervision as you hit the “reset” button on your health. For more information: (949) 432-6295 or [email protected].
EVENTS: Join Dr. Fuhrman for an online boot camp, detox or other event. During these immersive online events, you’ll attend zoom lectures, follow a special meal plan, and have access to a special, live Q&A session with Dr. Fuhrman. Learn more about events.
Tsuboi H, Shimoi K, Kinae N, et al. Depressive symptoms are independently correlated with lipid peroxidation in a female population: comparison with vitamins and carotenoids. J Psychosom Res 2004, 56:53-58. doi: 10.1016/S0022-3999(03)00567-1S0022399903005671 [pii]
Dias GP, Cavegn N, Nix A, et al. The role of dietary polyphenols on adult hippocampal neurogenesis: molecular mechanisms and behavioural effects on depression and anxiety. Oxid Med Cell Longev 2012, 2012:541971. doi: 10.1155/2012/541971
Nabavi SM, Daglia M, Braidy N, Nabavi SF. Natural products, micronutrients, and nutraceuticals for the treatment of depression: A short review. Nutr Neurosci 2017, 20:180-194. doi: 10.1080/1028415X.2015.1103461
Hritcu L, Ionita R, Postu PA, et al. Antidepressant Flavonoids and Their Relationship with Oxidative Stress. Oxid Med Cell Longev 2017, 2017:5762172. doi: 10.1155/2017/5762172
Spencer JP. Flavonoids and brain health: multiple effects underpinned by common mechanisms. Genes Nutr 2009, 4:243-250. doi: 10.1007/s12263-009-0136-3
Lai JS, Hiles S, Bisquera A, et al. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. Am J Clin Nutr 2014, 99:181-197. doi: 10.3945/ajcn.113.069880
Beezhold BL, Johnston CS, Daigle DR. Vegetarian diets are associated with healthy mood states: a cross-sectional study in Seventh Day Adventist adults. Nutrition Journal 2010, 9:26. doi: 10.1186/1475-2891-9-26
Blanchflower DG, Oswald AJ, Stewart-Brown S. Is Psychological Well-Being Linked to the Consumption of Fruit and Vegetables? Social Indicators Research 2012. doi:
Beezhold BL, Johnston CS. Restriction of meat, fish, and poultry in omnivores improves mood: A pilot randomized controlled trial. Nutr J 2012, 11:9. doi: 10.1186/1475-2891-11-9
Francis HM, Stevenson RJ, Chambers JR, et al. A brief diet intervention can reduce symptoms of depression in young adults - A randomised controlled trial. PLoS One 2019, 14:e0222768. doi: 10.1371/journal.pone.0222768
Molendijk M, Molero P, Ortuno Sanchez-Pedreno F, et al. Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies. J Affect Disord 2018, 226:346-354. doi: 10.1016/j.jad.2017.09.022
Sanchez-Villegas A, Toledo E, de Irala J, et al. Fast-food and commercial baked goods consumption and the risk of depression. Public Health Nutr 2012, 15:424-432. doi: 10.1017/S1368980011001856
Mocking RJ, Harmsen I, Assies J, et al. Meta-analysis and meta-regression of omega-3 polyunsaturated fatty acid supplementation for major depressive disorder. Transl Psychiatry 2016, 6:e756. doi: 10.1038/tp.2016.29
Martins JG. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. J Am Coll Nutr 2009, 28:525-542. doi: 28/5/525 [pii]
Sublette ME, Ellis SP, Geant AL, Mann JJ. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J Clin Psychiatry 2011, 72:1577-1584. doi: 10.4088/JCP.10m06634
Grosso G, Pajak A, Marventano S, et al. Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PLoS One 2014, 9:e96905. doi: 10.1371/journal.pone.0096905
Shafiee M, Arekhi S, Omranzadeh A, Sahebkar A. Saffron in the treatment of depression, anxiety and other mental disorders: Current evidence and potential mechanisms of action. J Affect Disord 2018, 227:330-337. doi: 10.1016/j.jad.2017.11.020
Lopresti AL, Drummond PD. Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Hum Psychopharmacol 2014, 29:517-527. doi: 10.1002/hup.2434
Hausenblas HA, Saha D, Dubyak PJ, Anton SD. Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials. J Integr Med 2013, 11:377-383. doi: 10.3736/jintegrmed2013056
Khazdair MR, Boskabady MH, Hosseini M, et al. The effects of Crocus sativus (saffron) and its constituents on nervous system: A review. Avicenna J Phytomed 2015, 5:376-391. doi:
Shaw K, Turner J, Del Mar C. Tryptophan and 5-hydroxytryptophan for depression. Cochrane Database Syst Rev 2002:CD003198. doi: 10.1002/14651858.CD003198
Galizia I, Oldani L, Macritchie K, et al. S-adenosyl methionine (SAMe) for depression in adults. Cochrane Database Syst Rev 2016, 10:CD011286. doi: 10.1002/14651858.CD011286.pub2
Mischoulon D, Fava M. Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence. Am J Clin Nutr 2002, 76:1158S-1161S. doi:
Williams AL, Girard C, Jui D, et al. S-adenosylmethionine (SAMe) as treatment for depression: a systematic review. Clin Invest Med 2005, 28:132-139. doi:
Nahas R, Sheikh O. Complementary and alternative medicine for the treatment of major depressive disorder. Canadian Family Physician 2011, 57:659-663. doi:
Schuch FB, Vancampfort D, Richards J, et al. Exercise as a treatment for depression: A meta-analysis adjusting for publication bias. J Psychiatr Res 2016, 77:42-51. doi: 10.1016/j.jpsychires.2016.02.023
Cooney GM, Dwan K, Greig CA, et al. Exercise for depression. Cochrane Database Syst Rev 2013:CD004366. doi: 10.1002/14651858.CD004366.pub6
Kurlansik SL, Ibay AD. Seasonal affective disorder. Am Fam Physician 2012, 86:1037-1041. doi:
Miller AL. Epidemiology, etiology, and natural treatment of seasonal affective disorder. Altern Med Rev 2005, 10:5-13. doi:
Maruani J, Geoffroy PA. Bright Light as a Personalized Precision Treatment of Mood Disorders. Front Psychiatry 2019, 10:85. doi: 10.3389/fpsyt.2019.00085
Golden RN, Gaynes BN, Ekstrom RD, et al. The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. American Journal of Psychiatry 2005, 162:656-662. doi: 10.1176/appi.ajp.162.4.656
The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)
I suffer from Seasonal Affective Disorder, which seems to be at its worst during the winter months. I know not to ingest stimulating foods, such as coffee and tea, as they do play a part in my melancholia, but what other foods should I avoid? And, do you have any other tips for overcoming SAD during particularly hard times of the year?
As far as foods to avoid, it comes down to eating a high nutrient diet and avoiding the processed, refined foods, including sugar and caffeine, and minimizing animal products to less than 10 percent of total calories. Take the supplements I recommend to avoid deficiencies in B12, Vitamin D, and DHA, and get plenty of sunshine. It is important that the exposure to sunshine occur at the same time each day, first thing in the morning. When this is not an option, I recommend light therapy with a therapeutic light designed for this purpose.