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SEASONAL AFFECTIVE DISORDER (3)
Nita Bishop, Clinical Herbalist
Kava extract ( Piper methysticum) has been approved in Germany, the UK, Switzerland, and Austria for the treatment of depression, anxiety and insomnia. Kava binds to receptor domains in the limbic system, exerting a comparable action to benzodiazepines with no side effects. Studies using standardized preparations containing 15% kavalactones have demonstrated that Kava not only improves anxiety states, but, unlike standard anxiolytics, it actually improves mental func-tion and does not promote sedation.
Valerian
The primary clinical application for Valerian is as a sedative in the treatment of insomnia. The active constituents in Valerian are valepo-triates (iridoid molecules) and valeric acid. It can also be used in the treatment of stress and anxiety. A good SAD insomnia protocol consists of melatonin, valerian and 5-HTP taken 30 minutes before retiring.
Aromatherapy is effective
Certain aromatherapeutic oils, notably the flower and fruit scents, such as frankincense, bergamot and geranium, can be helpful for stimulating the hypothalamus and lifting spirits.
Lavandula officinalis (lavender) first appeared in the London Pharmacopoeia in the 17th century and was used for depression and faintness. It has a sedative/calming action, used for insomnia, nervous tension, and depression. Lavender oil has been used for years to enhance a "sense of well-being." Rosemary is a strong brain and memory stimulant and is an effective nervine for stress, tension and depression. Rosemary tea with a pinch of valerian can help reduce the symptoms of depression. Skullcap, passionflower, and wild oats all show benefit in treating depressive symptoms.
5-HTP (hydroxytryptophan)
Increased levels of serotonin have been correlated with a decrease in depression. Brain serotonergic neurons are involved in mood, sleep, appetite and perception of pain. Serotonin is synthesized from trypto-phan by the enzyme tryptophan hydroxylase. Since tryptophan is also a precursor to serotonin, treatment with this amino acid is another approach to SAD. Placebo-controlled studies of tryptophan depletion support the hypothesis of disturbed serotonergic activity in SAD.
5-HTP is a well-researched, direct precursor to serotonin. In the last few years several open studies supported the hypothesis that 5-HTP may be an effective antidepressant. A double blind trial comparing 5-HTP in combination with benzerazide to imipramine in 30 patients showed there was no significant difference in efficacy of 5-HTP and imipramine. Within the human body the amino acid L-tryptophan is converted into 5-HTP. Subsequently, 5-HTP is converted into serotonin which plays a crucial role in healthy nerve and brain function. The amino acid, tryptophan, derived from normal dietary sources, does not directly influence or contribute to 5-HTP levels. Griffonia simplicifolia, an herb historically used in West Africa, provides the best source of 5-HTP. 5-HTP may be the best alternative to tryptophan supplements, currently banned by the FDA.
Using the Ginsengs
SAD is a perfect application for the clinical benefits of adaptogens. Adaptogens assist the adrenals in counteracting the stress that the whole body is going through in depression. Ginseng is perhaps the most famous adaptogenic medicinal plant of China. It has been used in Asia for over 2,000 years to promote overall health, alertness and longevity. Specifically, Panax spp. ginseng extracts can be used short-term to increase mental and physical performance or may be used long-term as a revitalizing tonic. Ginseng improves mental functioning, loss of memory, and slow cognition within one week and the effect continues for months after administration. The anti-stress action of Panax ginseng provides support for SAD sufferers. However, it can overstimulate the CNS and cause anxiety, agitation, insomnia, palpitations, hypertension, tremor, headaches, euphoria, decreased sexual function, diarrhea and skin eruptions. So most of the therapeutic effects of ginseng are reversed when taken in doses that are too high.
Siberian ginseng ( Eleutherococcus senticosis) is also an adrenal adaptogen and has been shown to increase monoamine levels in the brains of rats. It is best to dose Eleutherococcus in the morning and around noon to match the diurnal rhythms of the adrenal gland.
Macro and Micro Nutrients
Nutritional components that affect SAD can be split into macro and micro nutrients. The use of macronutrients and micronutrients provide natural ways to offset the effects of SAD.
Macronutrients
Certain foods help boost serotonin levels in the brain. SAD sufferers crave carbohydrates, which stimulate the production of serotonin and its anti-depressant effects. They may gain 20-30 pounds per winter, and sleep up to four more hours a night. Research conducted at MIT has shown that consumption of carbohydrates stimulates the production of serotonin, which results in deeper, more restful sleep, feelings of well-being, and greater mental focus. Richard J. Wurtman, writing in the Scientific American, points out that the feedback mechanism is disturbed in people with SAD...and the brain of a SAD sufferer fails to respond when carbohydrates are eaten, so the desire for them persists longer than it should.
Simple carbohydrates have been refined to contain simple sugar molecules and are burned up by the body faster. However, complex carbohydrates have numerous physiological benefits. People experiencing SAD symptoms are encouraged to include more complex carbohydrates and other healthful foods in their diets, including eating plenty of fresh fruits and vegetables, whole grains, seeds, and small amounts of fish, poultry, and dairy. Fiber is emphasized along with a reduction in the consumption of saturated fats, refined sugar and white flour.
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