Seasonal Affective Disorder (SAD) and TCM
By Fay Meling (Mey) von Moltke-Pao
Fay Meling (Mey) von Moltke-Pao
is a fourth year student in the Acupuncture Program at Michener.
In the Yellow Emperor's Classic of Medicine it is said, "People
and nature are inseparable. In nature, cyclical movement produces
atmospheric influences that exert control over the rhythms of
the seasons and is responsible for change to the myriad living
and nonliving things
warmth of the spring gives rise to birth,
the fire of the summer fuels rapid growth and development, the
coolness of autumn matures all and provides harvest, and the coldness
of winter forces inactivity and storing."
As fall turns into winter, many people are prone to a mild form
of depression that seems to lift in the warmer months of spring.
Along with a depressed mood, one can experience irritability,
headaches, extreme fatigue and lethargy, increased appetite, carbohydrate
cravings, an inability to concentrate, and decreased libido. These
set of symptoms form a condition commonly referred to as seasonal
affective disorder (SAD). Seasonal affective disorder affects
over ten million people in the United States each year, two-thirds
of which are female. While the true cause is not known according
to western medicine, it is thought that decreased melatonin levels
arising from the limited exposure to sunlight in the winter are
involved. Other factors that may contribute to SAD include genetics,
hormones, and stress.
Conventional Western Treatment
Current methods of treating seasonal affective disorder in conventional
western medicine involve light therapy. Light therapy is based
on the theory that increasing exposure to bright lights will increase
the levels of melatonin. For some cases, antidepressants are also
prescribed. Most of these drugs work by increasing the actions
and effects of the chemical stimulants noradrenaline and serotonin
in the body. While all these treatments can control depression,
they do not address the underlying causes associated with it.
Furthermore, antidepressants can produce side effects such as
anxiety, palpitations, insomnia, high blood pressure, reduced
libido, excessive sweating and rash.
Traditional Chinese Medicine (TCM)
According to Traditional Chinese Medicine, everything has a yin
and yang aspect: opposing forces that also complement one another
and form part of a greater whole. Yang is positive in sign and
relates to masculinity, activity, warmth, and brightness. It also
refers to qualities such as increasing, lifting and dispersing.
Yin on the other hand, is negative in sign and relates to femininity,
nourishment, passiveness, cold, and darkness. Yin also refers
to the decreasing, descending and contracting aspects of nature.
In terms of the seasons, the start of the yin cycle begins in
autumn when the amount of daylight gradually decreases, and continues
until the spring equinox when the days and nights are of the same
duration. Since the autumn months mark the beginning of the yin
cycle, there is a tendency towards isolation, sadness, and grieving.
For those people whose constitution (due to gender, genetics,
environment, and lifestyle) is more yin in nature, these feelings
may be even more pronounced. Hormonal changes in both men and
women can influence mood. Based on TCM, the winter months are
associated with the Kidney system, the root of our vital Qi (energy).
It is natural to crave those foods that provide a quick source
of energy and that are high in calories since extra energy can
be stored as fat in the body to help keep the body warm.
Since our body must already use a lot of energy in the winter
to fend off the wind and cold, it is also natural to feel more
lethargic and emotionally and physically sensitive to our surroundings
at this time. Undue physical, mental, or emotional stress, a lack
of sleep, and poor nutrition will only deplete the body's energy
further and increase the chances of experiencing not only depressed
mood, but depressed immunity.
Traditional Chinese Medicine is an ancient art and science based
on over three thousand years of clinical experience that incorporates
several modalities such as acupuncture, herbal medicine, tuina
(Chinese massage therapy), exercise (tai chi and qigong), and
diet therapy to restore balance in the body. In TCM, imbalances
are closely associated with chemical, mental, emotional, and physical
disturbances within the body. The properties of acupuncture points
and meridians have been substantiated in several experiments.
While research in TCM continues to grow exponentially, acupuncture
itself, has been accepted by the World Health Organization as
a useful therapy for many conditions. Although it is already well
known for its effects on pain control, acupuncture is also helpful
in treating several neurological, immunological, and hormonal
disorders and preliminary studies have given promising results
for its treatment of depression.
From a western medical perspective, these studies have shown
that acupuncture releases serotonin and noradrenaline-norepinephrine
in animals, common stimulants used in the treatment of depressive
disorders. As well, recent studies suggest that electro-acupuncture
maybe a viable alternative to the use of tricyclic antidepressants.
The benefit of this is that acupuncture carries no extra side
From a TCM perspective, the body must be viewed as a whole that
is part of a greater whole. Each person is unique and therefore,
specific signs and symptoms relating to a person's physical, mental
and emotional state as well as their lifestyle, diet, and environment
must be taken into account. Since the diagnosis and treatment
are holistic in nature, it is possible to discover the underlying
cause as well as any contributing factors of the condition.
For a condition such as seasonal affective disorder, Traditional
Chinese medicine considers it essential to look at the whole body
and its surrounding environment and treat according to the particular
pattern (excess/deficient, hot/cold, wet/dry, etc.) associated
with the disorder. An imbalance of either yin or yang qualities
eventually leads to illness and must therefore be treated accordingly
so that the body's innate ability to heal itself on all levels
What to do about SAD
Acupuncture and other modalities of TCM, can indeed be helpful
for those who suffer from seasonal depression as they can bring
the body to a more balanced state. In certain conditions, medication
and psychotherapy may be necessary, and the advice of a physician
should be heeded. The following are ways in which you can achieve
a more harmonious state of existence by following the wisdom of
the changing seasons:
During the fall and winter months, it is important to keep physically
active but not to overstrain oneself. Outdoor activities such
as skating, skiing or snowshoeing or even indoor stretches and
exercises such as swimming, yoga, or tai qi, are excellent ways
to keep a healthy mind and body. Special care should be taken
to ensure that one has proper nourishment, rest and a comfortable
living environment. At this time, there is a tendency to reflect
inwardly and conserve energy, in order to prepare for the spring
when energy is once again full and abundant. Allow yourself to
rest more and spend time in solitude to consider the past, present,
and future. Although the tendency to become more inactive and
isolated is reflective of the retracting nature of winter, it
is also important to communicate openly with those close to you
so that you can nourish your personal relationships and maintain
a healthy and positive outlook on life. By addressing your physical
and mental needs in the winter, you can prevent other ailments
from occurring in the future. And by appreciating the natural
changes in the seasons and within ourselves, you naturally adopt
a more healthy and balanced lifestyle in mind, body, and spirit.
For more information regarding seasonal affective disorder or
other health concerns, please contact the Toronto Centre for Acupuncture
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