Is it the Winter Blues… or is it Your Thyroid?


While it would be so wonderful if it was, the reality is that winter isn’t merry and bright for everyone – so many women have told me that this is a SAD time of year for them. SAD actually standing for Seasonal Affective Disorder. However, many women have asked me how to know if it’s SAD or the Winter Blues. It’s such a huge question that I even got interviewed by Oprah magazine on this very topic! If you’re wondering why you’re not feeling jolly and bright this season, I hope this article might shed light on SAD and thyroid issues that could be an underlying cause, and help you on the road to feeling like yourself again!

“The Winter Blues”

As the days get shorter and darker, this change in light naturally makes a lot of us want to hibernate a bit more – especially if you live in a cold climate! But as. the dark months set in, for some people, even on sunny winter days, you might find yourself feeling down, or even depressed.

It’s estimated that 5 percent of Americans experience SAD and it can strike anyone: In one study of people with SAD, 60 percent of the participants had never been treated for depression before.

The “winter blues” can feel as dark and heavy as a storm. And while it’s seasonal and you might know it’s going to end with the spring, it’s no fun to experience. If it’s the first time you’re having it, it can feel scary.

How do you know it’s probably SAD and not another health problem or related to the depression and anxiety some people feel due to holiday (and with if often family) stress?

Seasonal affective disorder is typically time based – that is, it’s onset occurs when daylight starts to diminish, and is believed to be a result of less light disrupting circadian rhythm in for susceptible individuals. The primary symptom is depression, though of course, depression can be accompanied by typical companions of poor sleep, desire to sleep all the time, sugar and carb cravings, irritability, and weight gain (especially if you’re eating more comfort foods and exercising less). If it’s SAD, it resolves as the light returns or with the SAD treatment approaches discussed below.

But sometimes SAD isn’t just SAD – and sometimes – especially for women – it’s an undiagnosed thyroid condition.

How Do I Know If It’s Probably My Thyroid?

Low mood is a common hallmark symptom of low thyroid function, and low thyroid function is estimated to affect 1 in 8 women in her lifetime. It’s also thought that millions of women are walking around with low thyroid function and don’t know it, causing symptoms of depression, and more. As many as 15% of women on an antidepressant for depression might actually have a thyroid problem that has been misdiagnosed and mistreated as depression – and need thyroid treatment, not an antidepressant!

Okay, so how can I tell if it’s my thyroid…or if it’s Seasonal Affective Disorder?

SAD vs. Low Thyroid Function

Hashimoto’s (and hypothyroidism in general), is not specific to seasons, doesn’t have a time-based start and stop time (it’s continuous) and low mood/depression are almost always accompanied by additional symptoms. These can include several or many of the following: 

  • Fatigue and exhaustion
  • Constipation
  • Weight gain
  • Brain fog (poor focus, fuzzy brain, memory issues)
  • Trouble regulating body temperature (your hands and feet are always cold)
  • Losing more hair than usual, lackluster hair
  • Lackluster skin
  • Anxiety
  • Trouble with hormones or fertility
  • Possibly high cholesterol

Additional ‘symptoms’ that can help you differentiate between SAD and a thyroid problem are:

  • Your fatigue and lack of motivation feel staggering. Not feeling especially motivated to go to work one day? Resist getting out of bed when the temp drops and the down comforter suddenly, inexplicably, seems 1,000-times cozier? That’s a perfectly normal reaction to winter. Pay attention, however, if your lack of motivation and fatigue start to feet outsized and omnipresent, or you’re dragging through every day, it’s worth getting your thyroid checked.
  • Light doesn’t help. If exposure to sunlight (moving your workstation to an area with a bright window, getting outside for 15 minutes in the middle of the day everyday for a couple weeks, or sitting in a front of a light box once-a-day for at least two weeks doesn’t help, it might be a sign of a thyroid disorder.
  • Your low mood and fatigue persist past winter. Consider the possibility of a thyroid disorder – or more general, non-season-specific depression – if you’re still feeling crummy when the days get longer and brighter in Spring. (Interestingly, SAD hits a small percentage of people when spring turns to summer – a phenomenon called Summertime SAD or Reverse Seasonal Affective Disorder. So if you feel fine all winter and then you start to feel blue in the spring, you might be affected by the seasons, only in reverse!)

If you have these symptoms, or suspect you have a thyroid condition, the most important thing to do is see your primary care provider and ask her to run thyroid labs. The first step is to get an accurate diagnosis, but the lab tests that are often used – and the way those tests are often interpreted – can lead to misdiagnosis or under diagnosis and lack of appropriate treatment. At the same time, overtreatment can be its own problem in the functional and integrative world – and you don’t want to go on thyroid medication without a clear diagnosis. (I write more about the different types of thyroid disorders and how to test for them here.)

A proper diagnosis and the right treatment can be life-changing. One of my patients told me she felt someone had finally turned her light back on! For a big picture look at the modern-day thyroid epidemic, check out my blog post Women & Thyroid Health — What We All Need to Know,

If you do have a thyroid problem, the next step is to explore the Root Causes and understand the best path for treatment – including whether and which medication might be best.  My book The Adrenal Thyroid Revolution walks you through everything you need to know about addressing the Root Causes and how to sort through the best medical treatment options for you.

 

 

What Can I Do If It’s SAD?

If it is the winter blues, these interventions can help:

  1. Let there be light! Getting outside at least once a day when the sun is high in the sky (or as high as it goes in the winter) can really make a difference in mood. If getting outside is tricky because of ice or snow or work demands, simply sitting with your face toward a sunny window has been shown to help. If you don’t feel enough energizing effect from the sun, consider a light box. A typical dose of light is 10,000 lx for 30 to 60 minutes a day.
  2. Mind your circadian rhythm. One hypothesis is that SAD is triggered by changes in the circadian rhythm (the sleep-wake cycle) due to changes in the amount of daylight during winter, so getting enough high-quality sleep is important. Help yourself out in the quest for more and better sleep by sticking to a set bedtime and wake time (a daily difference of 15 to 20 minutes in sleep and wake times is okay, but, when possible, avoid going to bed at 9:30pm one night and 12:30am the next. Same with wake-up times); avoid electronics for at least an hour before going to bed (or if you must be on a computer, tablet, or phone before bed, install free software, like flux, that changes the color of your screens at night to make them more circadian rhythm-friendly); and not overcaffeinating, especially late in the day).
  3. Emphasize healthy fats and high-quality proteins. Healthy fats and high-quality proteins are great for brain health and they also help keep blood sugar steady. Balanced blood sugar is especially important for mood. Riding the blood sugar roller coaster (when you eat a high-sugar or high-carb snack and blood sugar soars way up and then comes crashing back down) too often for too long can trigger an inflammatory cascade in the body. The chemicals produced during that inflammatory response can contribute to a depressed mood.
  4. Get Physical. Exercise may be the last thing you want to do when you’re feeling low, but a wealth of research suggests that a little aerobic movement goes a long way in boosting mood. Even a short brisk walk can help. Yoga done several times each week in a class or even at home, has also been shown to lift the mood. Or get silly – for example, I have both a jump rope and hula hoop that I use indoors in the winter!
  5. Stay social. Winter weather makes it far too easy to hibernate. The days are short, the nights are cold, and you just want to sit on the couch under a wool blanket and read a good book. But social isolation further depresses mood. Don’t succumb to the siren song of the sofa! Make sure to stay connected to friends, or stay accountable to getting out of the house by paying for a class or joining a group, where your advanced commitment makes you feel compelled to show up.
  6. Spend time in nature. Getting outside boosts mood and the immune system, a win-win! Getting outside for a short time can also be a triple-benefit when it comes to wrestling back the symptoms of SAD: you get moving, you get sunshine, and you get the benefits of the natural world. Just can’t get outside? Ok, I get it. Check this out – house plants can also boost mood! So bring some green friends into your living and work space for a mood reset!
  7. Supplement for SAD. Several key supplements can help ease the winter blues (please note that I have no financial relationship with any of the companies/products mentioned and share these only for your convenience in finding appropriate products).
  • Research suggests that omega 3 fatty acids can have a powerful and positive impact on depression. I recommend a dose of up to 2 gm of combined DHA/EPA daily from Nordic Naturals vegetarians can use a product such as Omega Twin by Barleans.
  • Curcumin, an active ingredient extract from turmeric, has been shown to have adaptogenic, antidepressant, and anti-anxiety effects and is one of my go-to supplements in my practice. While turmeric itself is fabulous for gut inflammation, for the mind and mood benefits, it’s really the curcumin that works its magic at a dose of 330-500 mg/day of a product prepared with black pepper or specially formulated for absorption (for example, Meriva, Curcum-Evail, or Curcumasorb).
  • The natural supplement Sam-E is a natural substance important for methylation, a process involved in making chemicals called neurotransmitters, which control mood, It should not be used with bipolar depression. A typical dose is 400 mg/day, but up to 800 mg (400 twice daily) may be needed for an optimal therapeutic effect. Rarely, it has been reported to cause mild gastrointestinal symptoms, sweating, dizziness, and anxiety.
  • The herb John’s Wort has been proven to help with moderate to even severe depression in thousands of individuals in studies. A typical dose is 300 mg, 2 to 3 times/day of a product standardized to 0.3% hypericin, or 2-4 mL of tincture, twice daily.
  • Adaptogens are a powerful group of herbs that have been shown to help protect the body from the impact of Circadian Rhythm disruption by supporting the axis in the brain and adrenals (HPA-Axis) that is regulated by circadian cycles- and also controls stress, mood, and inflammation. To learn more about how to reset your Circadian Rhythm head over here. To learn more about adaptogens and pick the one(s) that might me right for you, read here.
  • Last but definitely not least, consider taking a high-quality probiotic with at least 15 billion CFU of Lactobacillus and Bifidobacterium combined species. Increasing evidence suggests that disrupted flora can contribute to a disrupted mood, including depression and anxiety. Studies have shown that eating live active cultures such as found in yogurt can improve women’s moods! I extend this to fermented foods in general, such as sauerkraut, kimchee, and miso.

 

 

Happiness, is, I believe, the natural human state of being. While life offers us all a fair share of challenges, if you’re SAD or depressed for a persistent amount of time, for no explainable reason, or if accompanied by other health symptoms, there is almost always an internal cause that can be identified and treated so you can once again find your happiness.

When to see your healthcare practitioner: If your symptoms persist, you have thoughts of self-harm, or you are experiencing any symptoms that are worrisome to you or your family, it’s really important to consult your primary licensed healthcare practitioner.

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Modell JG,  and Rosenthal NE, et al. Seasonal affective disorder and its prevention by anticipatory treatment with bupropion. Biol Psychiatry. 2005;58(8):658.

Pinchasov BB, Shurgaja AM, Grischin OV, Putilov AA. Mood and energy regulation in seasonal and non-seasonal depression before and after midday treatment with physical exercise or bright light. Psychiatry Res. 2000 Apr;94(1):29-42.

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