Winter Depression: Can Homeopathy Help?

"In the beginning God created the heaven and the earth. And the earth was waste and void; and darkness was upon the face of the deep: and the spirit of God moved upon the face of the waters. And God said, Let there be light: and there was light. And God saw the light, that it was good: and God divided the light from the darkness. And God called the light Day, and the darkness he called Night. And there was evening and there was morning, one day".

God. Ps 33:6,9 148:5 Mt 8:3 Joh 11:43

Since the beginning of Creation, Light has always been regarded as essential for birth and maintenance of Life. After life was created, it was this warmth which helped in the sustenance of life. In the ancient civilizations too, people recognized the importance of this warmth and aptly worshipped the Sun as a source of these characters.

Life is not always sunny and Alas the cycle of seasons has to turn and the mortals have to face the chilly breezes of winter season. Ah! For the little animals can hibernate but we humans have to strive and work through the winters.

This winter brings with itself laziness and indolence, one wants to cuddle up and let life pass-on. Throughout the centuries, poets have described a sense of sadness, loss and lethargy which can accompany the shortening days of fall and winter. Many of us notice tiredness, a bit of weight gain, difficulty getting out of bed and bouts of "the blues" as fall turns to winter.
However some people feel an exaggerated form of these symptoms. Their depression and lack of energy become debilitating. Work and relationships suffer. This condition, known as Seasonal Affective Disorder (SAD) may affect over 10 million Americans while the milder, "Winter Blues" may affect a larger number of individuals. 'Winter Depression' as the word goes is a form of depression or a low spiritedness that takes over people during the winter season.

What is Seasonal Affective Disorder?
 Seasonal affective disorder (SAD), also known as winter depression or winter blues, is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or, less frequently, in the summer, repeatedly, year after year. The US National Library of Medicine notes that "some people experience a serious mood change when the seasons change. They may sleep too much, have little energy, and crave sweets and starchy foods. They may also feel depressed. Though symptoms can be severe, they usually clear up."

Who are more at risk?
About 70-80% of those with SAD are women. The most common age of onset is in one's thirties, but cases of childhood SAD have been reported and successfully treated. For every individual with full blown SAD, there are many more with milder "Winter Blues." The incidence of SAD increases with increasing latitude up to a point, but does not continue increasing all the way to the poles. There seems to be interplay between an individual's innate vulnerability and her degree of light exposure.

What is its cause?
The exact cause of SAD has not been confirmed and various theories about lack of serotonin, and serotonin polymorphisms, or release of melatonin which is produced in dim light and darkness by the pineal gland have been hypothesized. It is possibly related to the reduction in natural light and the lower temperatures in the winter months but this is uncertain and there is no good evidence for it being more common in very northern countries where the winter hours of daylight are much shorter.

What are the signs and symptoms of SAD?
The symptoms of SAD begin in the fall, peak in the winter and usually resolve in the spring. The classic major depression involves decreased appetite, decreased sleep, and often, poor appetite and weight loss. It also includes:

• low mood starting in autumn or winter.
• lack of energy and lethargy.
• irritability.
• overeating and weight gain (there is often a craving for carbohydrate food).
• lack of interest in socialising.
• increased sleep and daytime sleepiness.

Another apparent symptom of this depression in affected people is the stress and difficulties that they undergo during winter. It resembles that of any other depression that is an outcome of a stressful event. Some people with winter depression also have mild or occasionally severe manic mood swings in the spring and summer. If these episodes are severe, the individual might be diagnosed with Bipolar Disorder.

Complications: The Depressive state of patient can in some cases amount to Suicidal Disposition. Often the patient can present with a picture of Bipolar Disorder which would make it hard to specify the case.

How can SAD be Diagnosed?

According to the American Psychiatric Association, for a diagnosis to qualify as SAD, it must meet four criteria:
- Depressive episodes at a particular time of the year;
- Remissions or mania/hypomania also at a characteristic time of year;
- These patterns must have lasted two years with no nonseasonal major depressive episodes during that same period; and
- These seasonal depressive episodes outnumber other depressive episodes throughout the patient's lifetime.

How it can be treated?

If the symptoms are mild, no treatment may be necessary. The following activities or lifestyle changes may help prevent seasonal affective disorder or improve the symptoms:

• Spend at least 30 minutes outside every day, preferably take a one-hour daily walk outside.
• Exercise or start gyming. But if you can force yourself to start, 15 to 20 minutes of dancing to the radio or fast walking can reduce a sweet tooth and improve mood.
• Set a timer on a light to go on early in the morning in the bedroom.
• Use a dawn simulator for a more naturalistic artificial dawn.
• Increase indoor lighting with regular lamps and fixtures.
• Eating habits: For those who tend to crave sweets during the winter, eating a balanced diet may help one's mood. Reduce caffeine or coffee intake as it suppresses serotonin. Just don't add extra carbohydrates to your daily diet. Include lots of vegetables, fruits and proteins in your diet. If you are into quick snacks include these: Popcorn,Oatmeal (original, not dessert), Nuts, Egg whites for omelets, Peanut butter, Whole grain crackers and bread, Cottage cheese
• Above all say a no-no to candle light dinners. Its Christmas and New year time buddy switch to bright lights.

Treatment of SAD includes:

Light therapy: In it the sufferer is exposed daily to bright light for a definite period of time.
Medicinal treatment: SSRIs (Selective Serotonin Reuptake Inhibitors) have been prescribed to deal with the depression.
Cognitive behavioural therapy

HOMEOPATHIC TREATMENT

The Homeopathic System has an individualistic approach, we treat the patient as the whole and not the disease. For us every patient is a fresh case in which we have to choose the characteristic and prescribe accordingly. Also we have a Holistic approach, we don't just medicate for psychiatric or dermatological complaints. We prescribe for the patient and by the similimum we cure the symptoms told or untold by the patient.

Irrespective of its severity, for a homeopath Winter Depression is a True Chronic Disease (Aph. 78). Its symptoms are due to individual's sensitivity or increased susceptibility to cold as such in winters he suffers from the above said complaints.  Once he is comforted from the harshness of climate he feels safe and better. So a Homeopath must treat the patient as a whole to make the individual resistant to cold. His selection of medicine should always be considering improving the patient's ability to react with cold or to rectify his state of increased susceptibility.

Thus the patient needs a remedy along with changes in life style to get relieved keeping in mind that for complete cure the underlying miasm has also to be dealt.

Miasmatic Assessment:

Sensitiveness to Cold: Psora.

Depression, moroseness: Syphilis.

Irritability: Psora

Laziness: Syphilis

Indifference: Syphilis

Thus we see that the predominant miasm in the cases of Winter Depression is Psora-Syphilis, or TUBERCULAR. So, if your case is relapsing again and again after little improvement you can go for an antimiasmatic treatment depending upon the predominant miasm in the case.

Dr.Samuel Hahnemann in his Organon has advocated about the "Genus Epidemicus". By qualitatively conglomerating the symptoms with which the disease commonly presents itself and we get the medicines which can give us a breakthrough in the case.

Repertorial Analysis
The Rubrics which can be used are:
1. Winter-agg. (taken as Eliminative Symptom)

2. Mind- irritability.

3. Mind- sadness.

4. Mind- laziness.

5. Mind- indifference.

6. Generals- Food and Drinks- Sweets-desire.

7. Generals- Cold air- agg.

8. Stomach- Appetite- increased.

9. Sleep- sleepiness

The Medicines most commonly indicated by the Repertorial Analysis are:

Lycopodium    24/9

Pulsatilla        24/9

Sulphur         24/9

Phosphorus    23/9

Sepia            23/9

Ars-alb          22/9

Calc-carb       22/9

Graphites       22/9

Nix-vomica     22/9

Carbo-veg      20/9

Causticum      20/9

Kali-carb        20/9

Natrum-mur    20/9

Psorinum        20/9

Hepar-sulph    19/9

Medicine is a science of Experience, its object is to eradicate diseases by means of remedies

Dr. Samuel Hahnemann (Medicine of Experience)

Therefore a Homeopath does not have to chafe over the Nosological Diagnosis of the case, he has to use all his knowledge and expertise in identifying the remedy picture and prescribing Similimum. As we see from the above table, that the top grade medicines are Lycopodium, Pulsatilla, Sulphur and Sepia obtaining the highest rank and having symptom similarity with SAD. However in my personal practice I have found Psorinum to be a highly efficacious remedy in such complaints. It covers both the Depressive state and hypersensitiveness to cold providing relief to patient.

Thus by proper case taking and auxiliary methods a homeopath can deal successfully with the cases of Winter Depression.

There is a similar variety of Winter Depression commonly called as the White Coat Depression of Winters which most of the Doctors face in this Healthy Season seeing the regularly receding number of patients in their clinics. Off Course, most of us will accept that "One man's Meat is another's Poison" so, one cannot help wishing for his own betterment. Alas! It's a Cruel World!!!!!!!

Enjoy the winter with a glowing skin. I wish you a Happy winter.