I am happy to announce that Rebecca Rainwater, Occupational Therapist, is now available for appointments in our office on Main Street in Bothell. Rebecca has been an Occupational Therapist since 2000 and specializes in all manner of upper extremity dysfunction, with particular emphasis on lymphedema, repetitive stress injuries and restoration of hand function. You may benefit from Rebecca’s expertise if you are dealing with any condition that causes decreased function and/or chronic pain in your shoulder, elbow, wrist, hand, or fingers. Examples of these conditions include: arthritis, tendonitis, impingements, burns, lacerations, surgical intervention, or swelling of the limbs. She currently accepts all of these insurance plans: Cigna, Coventry, First Choice Health, Health Net, Labor and Industries, Lifewise, Medicare, Premera Blue Cross, Regence Blue Shield and Uniform Medical. Call Rainwater Rehabilitation at (425) 273-3848 to book your appointment with her today!

What Is SAD? Seasonal Affective Disorder (SAD), winter depression or the winter blues is an affective, or mood, disorder. Most SAD sufferers experience normal mental health throughout most of the year, but experience depressive symptoms in the winter or summer. The condition in the summer is often referred to as Reverse Seasonal Affective Disorder. Many people who have SAD may also have manic periods in the summer.

Signs/Symptoms of SAD: The symptoms of SAD mimic those of clinical depression. Depressed mood (may be irritable), too much or too little sleep, too much or too little eating, weight change, fatigue, restless/agitated, or slowed down, feelings of worthlessness or guilt, brain fog, thoughts of death. Symptoms may range from very mild to severe.

What causes SAD?

Decreased Light - SAD is more prevalent in northern latitudes where the amount of sunlight is diminished. Seasonal mood variations are believed to be related to light. Cloud cover and pollution may further decrease the exposure to sunlight.

• Vitamin D deficiency - skin exposed to sunlight begins the reaction that leads to formation of the active form of Vitamin D. Vitamin D deficiency can lead to depressed mood, poor calcium absorption or even osteoporosis (see bottom of page for Vit. D test info.)

Decreased Melatonin - Another theory is that melatonin produced in the pineal gland is the primary cause because there are direct connections between the retina and the pineal gland.

Decreased Serotonin - Melatonin synthesis is dependent on Serotonin synthesis. The largest pool of Serotonin is in the intestines. Healthy intestines may equal healthy mood.

Treatments for SAD

Light Therapy - goal of 2,500-10,000 LUX for at least 30 minutes per day

• Light Boxes - sit 30-60 centimeters away from light source. Best in the morning.
• Full Spectrum Bulbs - an easier way to get needed light exposure. For home or office.
• Dawn Simulation - this form of light box slowly gets brighter, simulating the rising of the sun.

Diet and Lifestyle

• Exercise: The blue feeling can usually be dampened or extinguished by exercise and increased outdoor activity, (particularly on sunny days), resulting in increased exposure to the sun. We feel better when we exercise.
• Sleep: go to bed and rise at or around the same time each day. Not only does this help to normalize Melatonin production, it also allows your body sufficient time to rest, relax and rejuvenate. Do not sleep with lights or the TV on.
• Diet: eat lots of fish, organic fruit and vegetables, drink enough water, eliminate all refined and processed foods, and eat less saturated fat and fried foods.

Supplements/Nutrients (Please consult with a physician before taking any of these supplements alone or in combination with any other medications) Also, restoring complete digestive health would be a perfect adjunct to any treatment listed below.

• Omega 3 Fatty Acids: one of the main essential fatty acids in fish oil is DHA. DHA is present in high quantities in the brain and is necessary to help promote normal function of neurotransmitters.
• St. John’s Wort (Hypericum perforatum): works well for improving symptoms of SAD. Although it is effective alone, it is more effective when combined with light therapy.
• 5-HTP: 5-HTP is a precursor to Serotonin. It may be helpful to improving Serotonin secretion when taken during the day. Serotonin is a precursor to Melatonin.
• Melatonin: Melatonin supplementation may improve SAD. It will increase brain melatonin and suppress cortisol secretion. Melatonin is best taken at night when levels are naturally elevated.
• Vitamin D: if your Vitamin D is low, supplementation with Vitamin D may help improve mood.