Gopesh Patel, RPh
Gopesh Patel, RPh, is co-owner of New Drug Loft in Manhattan, and VLS and Lane Drugs in Brooklyn. He focuses on providing high-quality prescriptions and compounded medications, as well as personalized care for the 3 stores' many customers. Patel is a member of the International Academy of Compounding Pharmacists, Professional Compounding Centers of America, A4M, and he is a Wiley Protocol Premiere Pharmacist. He is a Preceptor for pharmacy students from the Long Island University College of Pharmacy and the Massachusetts College of Pharmacy and Health Sciences University in Boston.
As a result of these beastly winters, many of my staff and patients do not feel like themselves, which could be attributed to seasonal affective disorder (SAD). SAD is preventable and treatable, but many don’t even realize they are suffering from this insidious condition.
How to recognize SAD
SAD is a type of depression that affects an individual during the same season each year. Winter is the most common season for SAD because of the bleak conditions. Symptoms tend to appear around Halloween and most often alleviate around Easter.
A quick look at the medical literature reveals that it is still unclear what causes SAD, but most experts believe it might be caused by a drop in serotonin, a brain chemical affecting mood.1 Reduced sun exposure can cause a drop in serotonin that might trigger depression. The change in seasons can also disrupt the balance of the natural hormone, melatonin, which hormone plays a role in sleep patterns and mood.
Symptoms of SAD can include:
- Feeling sad, grumpy, moody, or anxious
- Loss of interest in your usual activities
- Eating more and craving carbohydrates like bread and pasta
- Weight gain
- Sleeping more and feeling drowsy during the day
If your patients mention feeling depressed this time of year or are more tired than usual, take into consideration that it might be SAD.
Solutions for SAD
In my pharmacies, we embrace many holistic treatment methods, and how we tackle SAD is no different. I recommend dietary supplements to offset, and in some cases, prevent SAD symptoms. Here are 5 supplements I commonly recommend to my patients that should be able to help yours:
1. 5-HTP: 5-hydroxytryptophan (5-HTP) is an inexpensive nutrient supplement from an African bean that helps increase brain serotonin levels. When these levels get too low, they are believed to trigger depression. The body can make 5-HTP to convert into serotonin, but it must have enough tryptophan on hand to do so, which typically comes from food. By supplementing with 5-HTP, the body can quickly yet naturally replenish serotonin levels. Increased serotonin equals mood improvement - sometimes within minutes. “As an antidepressant, 5-HTP is so effective that it has repeatedly matched or outperformed many of the most established antidepressant drugs, including Prozac, without negative side effects so often associated with these drugs,” wrote Julia Ross, MA, author of The Mood Cure.2
2. Tyrosine: Tyrosine, a natural antidepressant, is the fuel our brain uses to make another natural antidepressant, catecholamines. Tyrosine is so effective in reversing physical and mental consequences of stress that it’s used by the US military. Tyrosine attributes to an overall sense of well-being by promoting powerful pleasure-inducing chemicals called “enkephalines” (cousins to endorphins).
3. Melatonin: Melatonin is a hormone that helps to balance sleep/wake cycles and mood. Melatonin is synthesized from the amino acid tryptophan by the pineal gland in the back of the brain. The perception of daylight in the eyes is a signal for the pineal gland to inhibit melatonin synthesis and release. At night or in the dark, the body’s melatonin production rises, and this increase in plasma melatonin is thought to be responsible for bringing on sleep. The change of seasons can disrupt the balance of melatonin levels, which can result in trouble sleeping and bad moods due to being tired. A melatonin supplement supports a balance, so sleep/wake cycles stay normal year-round.
4. SAM-e: S-adenosyl-methionine (SAM-e) is a methyl donor and participates in a wide variety of biochemical reactions, 1 of which is to provide support for healthy functioning of neurological processes. As a major source of methyl groups in the brain, SAM-e in conjunction with other methyl donor metabolites like betaine, choline, or folate might optimize serotonin and dopamine, as well as the brain’s sensitivity to them. A drop in serotonin negatively affects mood and causes depression, which is a key indicator of SAD.
5. St. John’s Wort: Although St. John’s Wort has a variety of traditional uses, extracts of this flowering perennial are best known for their mood balancing properties and widely recognized for their positive, supportive effects on mental and emotional function. Like many botanicals, St. John’s Wort has been used for thousands of years, but is now gaining immense popularity in the United States and abroad.
Instead of dreading winter, these 5 supplements might actually help your patients look forward to the season and embrace all that it brings.
1. Denoon, D. "The Truth About Vitamin D: Why You Need Vitamin D." WebMD. WebMD, 1 Jan. 2009. Web. 24 Oct 2014.
2. Romito K, Lewy A. "What Is Seasonal Affective Disorder (SAD)?" MyHealth.Alberta.ca. Healthwise, 5 Sept 2012. Web. 24 Oct 2014.
3. Ross J. “The Mood Cure.” Chapter 4. Page 61. Penguin Press. New York. 2002.