WRITTEN BY MELANIE FLORES AND DR. SWATHI
What are the winter blues?
As the days get shorter, many people find themselves feeling seasonal sadness or winter blues. If that’s you, you’re not alone.
Episodes typically begin in late fall and end during spring months when the weather starts to get sunnier. These feelings can be detrimental to one’s well-being and are associated with large psychological and social impairments. Symptoms of seasonal sadness include classic signs of depressed mood: low energy, mood swings, losing interest in activities you once enjoyed, sleeping too much or not enough, difficulty concentration, feeling hopeless or guilty, and overeating.
What causes the winter blues?
Proposed causes of the winter blues include disruptions in circadian rhythms due to shorter days and longer nights that lead to overproduction of melatonin, and a drop in serotonin (a brain chemical that affects mood) and a drop in Vitamin D due to reduced sunlight. These feelings are also more often to affect women, younger people, and those living far from the equator.
What can you do to avoid the winter blues?
Several lifestyle interventions can be made to reduce symptoms of seasonal sadness. Lifestyle changes such as sleep hygiene, daily walks in nature, psychotherapy, stress relief techniques, enhanced indoor lighting, and aerobic exercise.
Vitamins + Minerals
Supplements are also recommended as possible therapies for those experiencing the winter blues. Vitamin D is known as the “sunshine vitamin” because your body produces this fat-soluble vitamin when your skin is exposed to sunlight. Vitamin D can reduce inflammation, keep bones healthy, promote cell growth, and promote immune function. Studies have also found a link between low vitamin D levels and depression. If you live somewhere with low sunlight exposure in winter months, it may be worth talking to your doctor about vitamin D supplementation. Omega-3 fatty acids (EPA and DHA) can be obtained through your diet and fish oil supplements. Omega-3 fatty acids are thought to be of benefit in one’s cardiovascular, eye, brain, and possibly mood health. Omega-3 fatty acids are being studied for their mood-lifting benefits and have shown clinical benefit in some overweight patients with inflammation.
Herbal therapies have been used in Traditional Chinese Medicine for years to remedy low mood, which is a hallmark symptom of seasonal sadness. The winter season is associated with the yin element in Chinese Medicine and the negative attributes associated with this element are common symptoms of low mood such as self-isolation, grief, regret, hopelessness, and guilt. An infamous herbal supplement that has shown clinically meaningful results for aiding in depressive symptoms is St. John’s Wort (Hypericum perforatum). Multiple systematic reviews and meta-analyses studies have shown that St. John’s Wort helps ease low mood. A particular 2016 systematic review of thirty-five studies examining a total of 6,993 patients revealed that St. John’s Wort monotherapy for the treatment of mild and moderate depression was superior to placebo in improving depressive symptoms and not significantly different from the results of antidepressant prescription medication. Adverse effects of St. John’s Wort were also comparable to placebo and were shown to be fewer than when compared to prescription antidepressants. It should be noted that St. John’s Wort has very significant interactions with many prescription medications, including oral birth control pills, and a physician should always be consulted before you decide to incorporate St. John’s Wort into your supplementation regimen.
Peripheral CBD injections have been shown to activate the Serotonin 5HT1A receptors in the human brain and produce mood-lifting effects. Serotonin is a naturally produced chemical in the human body that functions in modulating mood, cognition, reward, learning, and memory. Lowered levels of serotonin are associated with low mood. A 2019 study in rodents evaluated the effect of CBD, as it tested whether CBD could induce rapid and sustained anti-depressants effects after a single administration. The study yielded positive results and showed that a single dose of CBD induced antidepressant-like effects in mice in that it decreased learned helplessness. Learned helplessness is the behavior of which depression is measured in rodent studies, it is the behavior exhibited by rodents after enduring repeated aversive stimuli where the subject accepts powerlessness and stops trying to overcome the aversive stimulus. A 2021 retrospective, observational study observed depressive symptoms in 279 patients that were prescribed CBD treatment. Data was collected at baseline, month three and month 6 of treatment. The patients were separated based on their symptom severity ( mild vs. moderate/severe). Patients with moderate/severe depressive symptoms were shown to be decreased with statistical significance between baseline and month three of treatment, but those with mild symptoms had no observed change.
Further research is needed to test the mood-lifting effect of CBD, but CBD has been shown to interact with serotonin receptors and has been suggested to potentially induce effects beneficial to low mood. While current research is promising, more human research is needed to confirm these results. As the self-treatment of such symptoms with CBD increases, research will continue to be published in the upcoming year that tests the link between CBD and low mood.
The bottom line
If you believe you are experiencing the winter blues or seasonal sadness, it is important to consult with a healthcare provider to come up with the best individual treatment plan for you. CBD can interact with some prescription and herbal remedies, so it is worth discussion with your doctor.
Miller AL. Epidemiology, etiology, and natural treatment of seasonal affective disorder. Altern Med Rev. 2005;10(1):5-13. PMID: 15771558.
Mischoulon D, Dunlop BW, Kinkead B, et al. Omega-3 Fatty Acids for Major Depressive Disorder With High Inflammation: A Randomized Dose-Finding Clinical Trial. J Clin Psychiatry. 2022;83(5):21m14074. doi: 10.4088/JCP.21m14074. PMID: 36005883
Apaydin EA, Maher AE, Shanman R. et al. A systematic review of St. John’s wort for major depressive disorder. Syst Rev 2016;5:148. https://doi.org/10.1186/s13643-016-0325-2
Sales AJ, Fogaça MV, Sartim AG. et al. Cannabidiol Induces Rapid and Sustained Antidepressant-Like Effects Through Increased BDNF Signaling and Synaptogenesis in the Prefrontal Cortex. Mol Neurobiol 2019; 56:1070–1081. https://doi.org/10.1007/s12035-018-1143-4
Rapin, L., Gamaoun, R., El Hage, C. et al. Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic. J Cannabis Res 3, 19 (2021). https://doi.org/10.1186/s42238-021-00078-w
This article was edited by Dr. Swathi and was written by Element Apothec Scientific Communications Intern, Melanie Flores. She is a Doctor of Pharmacy (PharmD) student at Oregon State University and Oregon Health & Science University College of Pharmacy in Portland, Oregon.