Three hours ago I got an email from a Huffington Post producer asking if I wanted to participate in a roundtable interview about summer SAD. I nearly didn’t do it, but I’m glad I did. I do wish that it was more informative as it seemed to focus mostly on the emotional aspects of it. If you want to watch, here it is:
I haven’t been blogging for awhile, and this website really needs to be updated. But for anyone who saw me on the Huffpost Live program and wants more information here is an easy summary sheet created by my doctor. Also read below for information about the low dose melatonin treatment I’ve been using to manage my SAD.
Dr. Deborah Gleisner, ND, LM
Seasonal Affective Disorder – Summer Type
WHAT IS SEASONAL AFFECTIVE DISORDER (SAD)?
Seasonal Affective Disorder is depression with a seasonal recurring quality that affects up to 10% of the
population. SAD typically manifests in the fall/winter months, but 5-10% of sufferers experience symptoms
during summer. The DSM-IV recognizes SAD as a subtype under major depression and bipolar disorder.
WHAT CAUSES SAD? There are multiple causes of SAD. Much research has focused on the pineal gland and how light affects the
melatonin pathway. This pathway, which involves tryptophan, 5-HTP, serotonin, and melatonin, is responsible for
mood and sleep patterns. Improper light levels are believed to disrupt this cycle in susceptible individuals.
WHAT CAUSES SUMMER SAD? Not much research is focused on summer SAD, but it appears to have both genetic and environmental
components. Too little light has been implicated in winter SAD; it is theorized that too much light (or a
sensitivity to light) may be a cause of summer SAD. Additionally, some patients feel that increased temperatures
can trigger or exacerbate symptoms.
WHAT ARE THE SYMPTOMS OF SUMMER SAD? Winter SAD has symptoms of “atypical depression” which is medically defined to include weight gain, fatigue,
increased appetite and interpersonal difficulties. Summer SAD has symptoms of “typical depression” which is
medically defined to include weight loss, decreased need for sleep (and insomnia), anxiety, agitation, increased
libido and poor appetite. Both types of depression have feelings of irritability and loss of interest in everyday
WHAT DOES IT FEEL LIKE TO HAVE SUMMER SAD? Some sufferers of summer SAD describe headaches, light sensitivity, and a feeling of oppression when facing
sunlight. Others are very uncomfortable with the higher temperatures of summer months. However, summer
SAD is not just about physical symptoms. Patients feel isolated when they have to decline invitations to outdoor
activities that put them in bright, hot locations for a large part of the day. This isolation is increased when others
find it difficult to understand their need to stay indoors. Many doctors are unfamiliar with this condition and
don’t know the best treatment options to offer.
WHY SEE A DOCTOR? Depression can be a symptom of other medical conditions. It is very important to have a full check-up with a
doctor. He/She can do a full physical exam and blood work. It is important to rule out conditions like anemia,
thyroid disease and vitamin D deficiency, among others. Treatment of the underlying cause will often eliminate
WHAT HOME TREATMENTS ARE AVAILABLE? The first step is to minimize the light and heat of the summer months. Select a place to live that does not have
direct sunlight and incorporate shades, fans, plants, and decor in cool colors. Minimize the amount of time spent
in direct heat/sun; always wear a hat or sunglasses. Cool drinks can be made with “cooling” herbs like
peppermint and licorice. Foods like cucumber and watermelon also have a cooling affect on the body.
WHAT CLINICAL TREATMENTS ARE AVAILABLE? Pharmaceutical drugs to reduce the breakdown of serotonin (ie antidepressants called SSRIs) may be effective,
but only treat one piece of the problem. Supplementing other substances on the melatonin pathway (tryptophan, 5-
HTP, melatonin) may provide a broader scope of treatment. Multivitamins and B complex supplements provide
the building blocks to keep the melatonin pathway running smoothly.
Deborah Gleisner is a Naturopathic Doctor practicing in West Los Angeles. Her practice emphasizes the
importance of stress reduction, good nutrition, sleep, and exercise to address many health concerns.Summer SAD Info sheet
I thought this was quite funny, with the water loving ducks appreciating the rain in the UK!
Unfortunately, where I live–Los Angeles–there has been a historic drought for the past three years. I believe it’s something astounding like the worst drought in 500 years. While it’s pretty much always sunny and generally warm, this past January was just terrible, and combined with the increasing levels of light, I felt my summer SAD already starting to kick in! Despite a few rain days, February has not been much better in terms of sun and high heat.
I can only pray the rest of this year will improve but I don’t hold out much hope!
I know it has been crazy on the East Coast with all the freezing temperatures and snow, and I hope all my summer SAD friends are soaking it up! Send some of it our way out west….!
Here is another tool for your summer SAD arsenal! Tart cherry juice contains high levels of melatonin, and a trial study demonstrated that levels were in fact markedly higher in subjects who drank it vs. a placebo after only one week. This particular abstract does not detail the amount drunk or time of day. My assumption would be 4-8 oz. before bed. I’ll try and dig around to find out more specifics.
I personally like the tart and tangy flavor and drink it straight up, although it would also be nice with ice cubes and/or sparkling water.
I stumbled upon this because it was recommended for fertility regulation, and now that I’m pregnant again I’ve discovered it also helps with my nausea.
Here is the study:
Tart Montmorency cherries have been reported to contain high levels of phytochemicals including melatonin, a molecule critical in regulating the sleep-wake cycle in humans.
The aim of our investigation was to ascertain whether ingestion of a tart cherry juice concentrate would increase the urinary melatonin levels in healthy adults and improve sleep quality.
In a randomised, double-blind, placebo-controlled, crossover design, 20 volunteers consumed either a placebo or tart cherry juice concentrate for 7 days. Measures of sleep quality recorded by actigraphy and subjective sleep questionnaires were completed. Sequential urine samples over 48 h were collected and urinary 6-sulfatoxymelatonin (major metabolite of melatonin) determined; cosinor analysis was used to determine melatonin circadian rhythm (mesor, acrophase and amplitude). In addition, total urinary melatonin content was determined over the sampled period. Trial differences were determined using a repeated measures ANOVA.
Total melatonin content was significantly elevated (P < 0.05) in the cherry juice group, whilst no differences were shown between baseline and placebo trials. There were significant increases in time in bed, total sleep time and sleep efficiency total (P < 0.05) with cherry juice supplementation. Although there was no difference in timing of the melatonin circardian rhythm, there was a trend to a higher mesor and amplitude.
These data suggest that consumption of a tart cherry juice concentrate provides an increase in exogenous melatonin that is beneficial in improving sleep duration and quality in healthy men and women and might be of benefit in managing disturbed sleep.
I love this poem and discovered it on my Baby Poetry DVD as read by the poet with an adorable video:
April Rain Song
Let the rain kiss you
Let the rain beat upon your head with silver liquid drops
Let the rain sing you a lullaby
The rain makes still pools on the sidewalk
The rain makes running pools in the gutter
The rain plays a little sleep song on our roof at night
And I love the rain.
The delightful music is “Echo of Spring” by Willie The Lion Smith
Found at this following excellent website: http://www.heat-sensitive-travel.info/?p=333
Here are the links to the melatonin research by Dr. Lewy.
These documents are the results from Dr. Lewy’s study including melatonin therapy on a summer SAD patient. This is my interpretation: The dose is 300mcg (micrograms) per day starting in Spring (or shortly before you know your symptoms start; for me personally in Los Angeles it is about one month after the Winter Solstice so in late January) . The patient took the dose at 5pm PST (living in Oregon), and later in Fall tapered off and ended the dose as symptoms were no longer present. If symptoms are bad you can also try an additional dose at around 7/8pm.
You can have your doctor contact Dr. Lewy to work out a protocol for you to follow if you should so wish. I did this with my doctor and we not only measured things like my vitamin D and iron levels but also my thyroid and cortisol (I had to spit into a vial every hour for several hours in the evening).
Here is the melatonin I use–there are a few others available and I’m sure they are great I just found it hard to locate such a low dose so I’ll start you off here. Dosages this low are usually not found in stores:
Here is an even lower dose at 200mcg if you wish to use that or if you wish to use slightly more (i.e. 400mcg):
My experience was that it made me pretty tired in the beginning. After about two weeks it leveled off and I only felt mildly sleepy for a period afterwards and then felt fine. In fact–and this is NOT part of the study–I ended up taking it year round and was able to get off my thyroid meds and it often gives me energy instead of making me sleepy!
I want to emphasize that everyone is different you might not have the same results as I or the study subject. Very little is known about summer SAD right now and some people might have it and others might not, or there might be different types. So some of you might react positively to the treatment and for others it might not work or be negative. I’ve had one or two people contact me and say it did not work out for them, or that they were just too sleepy to push through. Personally I thought it was a worthwhile thing to try–inexpensive–and if you find that it’s not practical to take it at 5pm because you are still at work then I’d say still give it a try at a later more realistic hour (but not too much later)–again, that’s off the record and not part of the study.
The concept is to basically anchor your circadian rhythm so that when the days are longer, and your body is suddenly exposed to daylight at later hours, your rhythm is not thrown out of whack and you maintain your levels of melatonin. Remember, light suppresses the melatonin hormone in your body; melatonin hormone signals your body to sleep. It was mentioned to me that it’s possible summer SAD patients rhythms cue from the evening time rather than from the sun rising in the morning (I will have to dig up for info on this for everyone).
Anyway–you can take the below info sheet to your doctor if you want it was written up by my own doctor as a basic information handout.
As with everything please pass this by your doctor. Remember melatonin is a hormone and you should read up on it before taking to make sure it isn’t in conflict with any of your conditions or meds. For me it helped my body process my thyroid hormone better but if you are on thyroid meds you need to be really careful about this and check with your doc/be monitored to make sure your levels are OK. Again, I found I could slowly taper off my dosage and finally stop taking it but that’s just me (I was secondary hypothyroid).
I’ll say this: the melatonin protocol saved my life! I thought I had Chronic Fatigue Syndrome and I’m pretty sure I was mostly just unable to get off the year round SAD roller coaster in sunny Southern California. I lost 5 years of my life to this thing! I still can’t stand living here but at least I’m not ill ALL the time. Now on the few overcast days we have I find that I do not need to take the melatonin–so I do take some breaks from it now and then!
Good luck! If you have questions you can post a comment, email me, or ask questions in the forum (link at the top of the page).