Don’t Settle For Just “Getting By”

understanding and addressing depression

Now that spring is well on its way, is your mood picking up? If you’re still feeling the “blahs” – low energy, persistent sadness, changes in appetite or sleep patterns, and a loss of interest in activities you once enjoyed – this might be more than the winter blues.

While Seasonal Affective Disorder (SAD) is a well-known culprit for winter blues, it’s crucial not to overlook other underlying issues that may contribute to depressive symptoms. Booking an appointment with your ND can provide valuable insights into your mental and physical well-being. During your visit, we can explore various factors contributing to depression, including hormonal imbalances, nutritional deficiencies, lifestyle habits, and environmental stressors.

By taking a comprehensive approach, we can tailor a treatment plan to address your unique needs. This may include a combination of dietary adjustments, supplementation, herbal remedies, lifestyle modifications, and acupuncture. Additionally, we will work collaboratively with you to uncover any potential root causes and develop strategies for long-term wellness.

Here a few tips to consider as we hop into spring…

Protein

Foods that are rich in protein contain amino acids that help produce neurotransmitters like dopamine and serotonin. If your protein intake is low, you may experience low mood. Most adults require 1g of protein per kilogram of body weight. Fortunately, it is easy to increase your protein intake – here are some easy ideas to snack on:

• A handful of unsalted almonds, walnuts, and/or pecans

• A hard-boiled egg

• No-bake energy balls

• An apple with 2 tbsp nut butter of your choice

• Sausage sticks or jerky (aim for ones with no fillers)

• Edamame

Mediterranean Diet

The Mediterranean Diet is a diet high in fish, legumes, whole grains, vegetables, fruits, seeds, and olive oil. It is low in high fat meats and dairy products. Following the Mediterranean Diet has been shown to be protective against depression at all ages throughout a person’s lifespan. For more information, check out our past blog post.

Exercise

Adults (including seniors) should get at least 150 minutes of moderate to vigorous physical activity per week[i]. Think that’s a stretch? Here are some ways to incorporate more movement into your day:

• Do squats or lunges while you brush your teeth

• Park farther away from stores or work

• Take the stairs

• Spontaneous dancing (at home OR in public 😊)

• Deep clean something

• Get up and move your body during commercial breaks – marching in place, jumping jacks, walking lunges across the room…be creative!

Sunshine

Exposure to sunlight increases serotonin levels in the brain. While you may be taking a Vitamin D supplement to keep your levels up, being in the sunshine is the best source of natural Vitamin D[ii]. In order to optimize your exposure, we recommend spending anywhere between 5-30 minutes each day outside[iii] – and while you’re out there, why don’t you get in that little extra bit of exercise and take a walk around the block?

Did you know that Vitamin D is not typically tested when you have bloodwork completed by your physician? Many people may be deficient in this important vitamin and not even know it. If this is something you are concerned about or would like to know more, bring it up with your naturopathic doctor - it may be worth investigating!

Don’t forget…

You don’t have to navigate depression alone. Your mental health matters every day and every season of the year.

[i] https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-adults-18-64-years.html

[ii] Raymond-Lezman JR, Riskin SI. Benefits and Risks of Sun Exposure to Maintain Adequate Vitamin D Levels. Cureus. 2023 May 5;15(5):e38578. doi: 10.7759/cureus.38578. PMID: 37284402; PMCID: PMC10239563.

[iii] Srivastava SB. Vitamin D: Do We Need More Than Sunshine? Am J Lifestyle Med. 2021 Apr 3;15(4):397-401. doi: 10.1177/15598276211005689. PMID: 34366736; PMCID: PMC8299926.

Make Every Day Self-Care Day!

Our busy, modern lives can sometimes make it hard for us to tune into our body’s needs. Here are some of our favorite tips on how to keep balanced while keeping busy!

At home…

Get Outside

Being in nature has numerous mental and physical benefits. Nature therapy has gained popularity as a means to reduce stress and promote healing. Research has come to the same conclusion as nature therapy practices have been shown to reduce heart rate, blood pressure, and the stress hormone, cortisol, when compared to measurements in other environments. (1)

Connect With Loved Ones

It likely does not come as a surprise that social isolation is associated with increased risk for mental health problems–in particular, depression, anxiety, stress-related disorders, and anger. Try to make an active effort to spend time with people you love whether you are able to do so in person or via a virtual connection. (2)

Screen Time Breaks

While technology has improved our lives in an abundance of ways, there can be too much of a good thing. Studies show that increased screen time is associated with negative outcomes such as lowered self-esteem, increased incidence and severity of mental health issues and addictions, slowed learning and acquisition, and an increased risk of premature cognitive decline. Use your screen time wisely–in moderation and with intention. Consider setting time limits on your devices and cleaning up your follow lists on social media to make your social feeds more of a positive space to engage with. (3)

Balanced Nutrition

Enjoying a balanced variety of nutrient-rich, whole foods to fuel your body optimally helps to reduce inflammation and keep your blood sugar (and moods) stable. In general, you should aim for half of your plate to be vegetables, 1/4 complex carbs (whole grains, starchy vegetables), and 1/4 protein. Healthy fats should be incorporated into each meal (avocado, nuts, olive oil, etc), and fruit makes for excellent snacks or dessert. Water intake is imperative for the maintenance of good health and most healthy adults should aim for 2-3L of water daily.

Sleep

It’s not just for beauty! As neuroscientist Matthew Walker says, “There does not seem to be one major organ within the body, or process within the brain, that isn’t optimally enhanced by sleep (and detrimentally impaired when we don’t get enough).” Adequate, quality sleep (7-9 hours per night) is vital for tissue regeneration, and slacking on your sleep can increase your propensity for weight gain, chronic disease, and even cancer. If you are struggling to get a good night’s sleep, our naturopathic doctors would love to help!

At Saskatoon Naturopathic Medicine…

Acupuncture

An effective traditional therapy for many conditions including stress, anxiety, sleep, pain, digestion, and hormonal concerns.

Massage

Our knowledgeable massage therapists offer relaxing and therapeutic massage as well as myofascial release and patient self-care education such as stretching, strengthening and postural awareness.

Somatic Experiencing™

Somatic Experiencing™ is a body-based approach to treating the effects of trauma. Specifically, the symptoms that arise when trauma is held in the body, including chronic or severe pain that does not respond well to medication, headaches, digestive issues, fear, difficulty sleeping, anxiety and depression. Somatic Experiencing™ works with the nervous system and the body’s innate ability to heal and recover from the symptoms of physiological stress. Treatment is gentle, supportive and enhances the effectiveness of the traditional exercise-based physiotherapy and counselling approaches.

Nutritional IV Therapy

IV nutrient therapy is a method of administering water-soluble nutrients (vitamins, minerals, antioxidants, and amino acids) directly into the blood stream. When you infuse nutrients intravenously, you bypass the digestive system, and this achieves a higher blood concentration beyond what is orally possible, especially if digestive function is compromised. Great for many conditions as well as health optimization and energy support. (See our website or call the clinic for more details).

Targeted Therapeutics

If you are looking for a comprehensive approach to your self-care, book a consultation with one of our naturopathic doctors who will conduct a thorough assessment of your health and come up with a customized plan just for you! With a variety of treatment modalities and testing options available, a targeted treatment plan can eliminate some of the guess-work and help you reach your self-care goals more quickly.

Written by Jacalyn Sieben ND

Sources:

1. Hansen, M. M., Jones, R., & Tocchini, K. (2017). Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review. International Journal of Environmental Research and Public Health, 14(8), 851. https://doi.org/10.3390/ijerph14080851

2. Henssler, J., Stock, F., van Bohemen, J. et al. (2021). Mental health effects of infection containment strategies: quarantine and isolation—a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 271, 223–234. https://doi.org/10.1007/s00406-020-01196-x

3. Neophytou, E., Manwell, L.A. & Eikelboom, R. (2021). Effects of Excessive Screen Time on Neurodevelopment, Learning, Memory, Mental Health, and Neurodegeneration: a Scoping Review. Int J Ment Health Addiction 19, 724–744. DOI: 10.1007/s11469-019-00182-2

Seasonal affective disorder & vitamin d

Saskatchewan is known for its long, cold winters. As the temperatures decrease, so do the daylight hours, significantly diminishing the amount of sun we might see each day. To add to that, to avoid the cold, we spend more time indoors and the time we do spend outside has us wrapped from head-to-toe to keep warm. This means less sun exposure and therefore reduced opportunity for us to synthesize vitamin D from its light. For some people, the change in seasons also brings on the “winter blues” also known as Seasonal Affective Disorder (S.A.D.). It is currently thought that a combination of physiologic, psychologic, genetic, and environmental factors play a role in S.A.D., one of them being vitamin D deficiency.

What is seasonal affective disorder?

Also termed “S.A.D.”, Seasonal Affective Disorder is a form of depression that typically occurs in the winter months when our exposure to sunlight is limited. Approximately 2-3% of Canadians will experience S.A.D. at some point and 15% more will experience a milder version of the condition.

There is a natural tendency to slow down in winter compared to the high-energy lifestyles we tend to carry on in summer months. However, if you notice you are feeling particularly low or experiencing the signs & symptoms below, it might be time to consider consulting a healthcare professional for an assessment.

Signs & Symptoms

• Feelings of hopelessness & sadness

• Thoughts of suicide

• Oversleeping

• Cravings for sweet or starchy foods

• Weight gain

• Fatigue/low energy

• Decreased physical activity

• Difficulty concentrating

• Irritability

• Increased sensitivity to social rejection

• Avoidance of social situations

In S.A.D., these signs and symptoms appear and disappear at about the same time each year, and the sad, despairing mood:

• is present most days and lasts most of the day

• lasts for more than two weeks

• impairs performance at work, school or in social relationships

Vitamin D - the sunshine vitamin

Vitamin D, which actually functions more like a hormone, acts on receptors in every tissue in the body including the brain and immune system. As it is a fat-soluble vitamin, we get it through diet from sources such as fatty fish (sardines, salmon, tuna), eggs, and liver; and are also able to synthesize it through our skin when we get sufficient exposure to the sun. As such, vitamin D levels have been shown to fluctuate with exposure to sunlight. Levels tend to decline from fall to winter, and are naturally lower the further north you live from the equator.

Vitamin D has many functions within the body. It is needed for calcium absorption (healthy bones, teeth), healthy immune function, and also has a role in the release of dopamine and serotonin - signalling molecules that, in the brain, are associated with drive, pleasure, and happiness.

So, how much vitamin D do you need?

Health Canada recommends a daily dietary intake of 600-800 IU’s of Vitamin D for adults. However, according to their statistics, most Canadians are not achieving this. While we also know sunlight does provide Vitamin D, here in Saskatchewan, the exposure we get at our northern location is often inadequate, especially in the winter months. Vitamin D levels also decrease with age, skin pigmentation, liver and kidney disease, obesity, certain medications, genetic mutations and other conditions.

How do I know if I’m getting enough vitamin D?

Luckily, there is a test for that! A simple blood test can assess whether you are getting sufficient amounts of vitamin D, or if supplementation may be indicated–or, in some cases, contraindicated. There can be too much of a good thing especially when it comes to supplementation. Vitamin D toxicity related to excessive long-term intake of vitamin D can cause hypercalcemia and related symptoms such as confusion, apathy, vomiting, abdominal pain, pathological calcification, increased thirst and increased urination. It is also important to note that everyone metabolizes vitamin D differently, so some people can experience vitamin D toxicity even at lower doses that are considered safe for the general population. It is always recommended to consult a healthcare practitioner before implementing any new health regimen to see if it is right for you, including vitamin D supplementation.

If you are experiencing symptoms of the “winter blues” or are curious about your vitamin D status or other natural approaches to mental health, you are invited to book a consult with myself or one of my colleagues to discuss your healthcare options.

We look forward to working with you!

In health, Jacalyn Sieben, ND

References:

1. CAMH. (2019). Seasonal affective disorder (SAD). Retrieved from: https://www.camh.ca/en/health-info/ mental-illness-and-addiction-index/seasonal-affective-disorder

2. Canadian Mental Health Association, BC Division. (2013). Seasonal affective disorder. Retrieved from: https://cmha.bc.ca/documents/seasonal-affective-disorder-2/

3. Health Canada. (2012). Vitamin d and calcium: Updated dietary reference intakes. Retrieved from: https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/vitamins-minerals/ vitamin-calcium-updated-dietary-reference-intakes-nutrition.html

4. Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P and Jones G (2018) Vitamin D Toxicity–A Clinical Perspective. Front. Endocrinol. 9:550. doi: 10.3389/fendo.2018.00550

5. Melrose S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression research and treatment, 2015, 178564. https://doi.org/10.1155/2015/178564

Omega-3s for Inflammation-Associated Depression

Essential Fatty Acids (EFAs)

Omega-3 and omega-6 fatty acids are essential fatty acids, meaning the body cannot make them on its own so they must be obtained through diet. They are both polyunsaturated fatty acids, however, they are found in different foods and have different roles in the body. Omega-3s are found in fish, nuts, seeds, and plant oils, while omega-6s are found in meats, vegetable oils, nuts, seeds, and processed foods.

The body requires a balance of omega-3 and omega-6 fatty acids for good health. However, the western diet is abundant in omega-6-rich foods, shifting this balance in some cases by 20:1 or higher. While both beneficial and necessary for the maintenance of good health, omega-3 and omega-6s have opposite effects on inflammatory modulation – the omega-6 pathway being more pro-inflammatory, the omega-3 being more anti-inflammatory.

Inflammation & Depression

Neuroinflammation is an inflammatory response within the brain and is a known component of many brain disorders. Rapaport et al., conducted a study exploring whether inflammatory biomarkers might act as measures of clinical response to omega-3 fatty acids – specifically eicosapentaenoic acid and docosahexaenoic acid – in subjects with Major Depressive Disorder (MDD).

The subjects were assessed for their baseline biomarkers of inflammation, as well as the presence and severity of their depressive symptoms using the Hamilton Depression rating scale. They were then randomized to 8 weeks of double-blind treatment with eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), or placebo. Those given EPA who had high inflammation consistently reported a significant decrease of depressive symptoms by treatment week 8. While also critical to brain function, DHA did not produce the same effect. This difference is possibly explained by the fact that EPA has the ability to dampen the inflammatory response, while DHA does not.

This study highlights the importance of individualized assessment and treatment in mental health, and the value of EPA as part of a comprehensive treatment plan for depression.

Written by Dr. Jacalyn Sieben ND

References:

Kalkman H. O. (2020). The Association Between Vascular Inflammation and Depressive Disorder. Causality, Biomarkers and Targeted Treatment. Pharmaceuticals (Basel, Switzerland), 13(5), 92. https://doi.org/10.3390/ph13050092

Rapaport, M. H., Nierenberg, A. A., Schettler, P. J., Kinkead, B., Cardoos, A., Walker, R., & Mischoulon, D. (2016). Inflammation as a predictive biomarker for response to omega-3 fatty acids in major depressive disorder: a proof-of-concept study. Molecular psychiatry, 21(1), 71–79. https://doi.org/10.1038/mp.2015.22