Don’t Settle For Just “Getting By”

understanding and addressing depression

Now that spring is well on its way, is your mood picking up? If you’re still feeling the “blahs” – low energy, persistent sadness, changes in appetite or sleep patterns, and a loss of interest in activities you once enjoyed – this might be more than the winter blues.

While Seasonal Affective Disorder (SAD) is a well-known culprit for winter blues, it’s crucial not to overlook other underlying issues that may contribute to depressive symptoms. Booking an appointment with your ND can provide valuable insights into your mental and physical well-being. During your visit, we can explore various factors contributing to depression, including hormonal imbalances, nutritional deficiencies, lifestyle habits, and environmental stressors.

By taking a comprehensive approach, we can tailor a treatment plan to address your unique needs. This may include a combination of dietary adjustments, supplementation, herbal remedies, lifestyle modifications, and acupuncture. Additionally, we will work collaboratively with you to uncover any potential root causes and develop strategies for long-term wellness.

Here a few tips to consider as we hop into spring…

Protein

Foods that are rich in protein contain amino acids that help produce neurotransmitters like dopamine and serotonin. If your protein intake is low, you may experience low mood. Most adults require 1g of protein per kilogram of body weight. Fortunately, it is easy to increase your protein intake – here are some easy ideas to snack on:

• A handful of unsalted almonds, walnuts, and/or pecans

• A hard-boiled egg

• No-bake energy balls

• An apple with 2 tbsp nut butter of your choice

• Sausage sticks or jerky (aim for ones with no fillers)

• Edamame

Mediterranean Diet

The Mediterranean Diet is a diet high in fish, legumes, whole grains, vegetables, fruits, seeds, and olive oil. It is low in high fat meats and dairy products. Following the Mediterranean Diet has been shown to be protective against depression at all ages throughout a person’s lifespan. For more information, check out our past blog post.

Exercise

Adults (including seniors) should get at least 150 minutes of moderate to vigorous physical activity per week[i]. Think that’s a stretch? Here are some ways to incorporate more movement into your day:

• Do squats or lunges while you brush your teeth

• Park farther away from stores or work

• Take the stairs

• Spontaneous dancing (at home OR in public 😊)

• Deep clean something

• Get up and move your body during commercial breaks – marching in place, jumping jacks, walking lunges across the room…be creative!

Sunshine

Exposure to sunlight increases serotonin levels in the brain. While you may be taking a Vitamin D supplement to keep your levels up, being in the sunshine is the best source of natural Vitamin D[ii]. In order to optimize your exposure, we recommend spending anywhere between 5-30 minutes each day outside[iii] – and while you’re out there, why don’t you get in that little extra bit of exercise and take a walk around the block?

Did you know that Vitamin D is not typically tested when you have bloodwork completed by your physician? Many people may be deficient in this important vitamin and not even know it. If this is something you are concerned about or would like to know more, bring it up with your naturopathic doctor - it may be worth investigating!

Don’t forget…

You don’t have to navigate depression alone. Your mental health matters every day and every season of the year.

[i] https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-adults-18-64-years.html

[ii] Raymond-Lezman JR, Riskin SI. Benefits and Risks of Sun Exposure to Maintain Adequate Vitamin D Levels. Cureus. 2023 May 5;15(5):e38578. doi: 10.7759/cureus.38578. PMID: 37284402; PMCID: PMC10239563.

[iii] Srivastava SB. Vitamin D: Do We Need More Than Sunshine? Am J Lifestyle Med. 2021 Apr 3;15(4):397-401. doi: 10.1177/15598276211005689. PMID: 34366736; PMCID: PMC8299926.

Make Every Day Self-Care Day!

Our busy, modern lives can sometimes make it hard for us to tune into our body’s needs. Here are some of our favorite tips on how to keep balanced while keeping busy!

At home…

Get Outside

Being in nature has numerous mental and physical benefits. Nature therapy has gained popularity as a means to reduce stress and promote healing. Research has come to the same conclusion as nature therapy practices have been shown to reduce heart rate, blood pressure, and the stress hormone, cortisol, when compared to measurements in other environments. (1)

Connect With Loved Ones

It likely does not come as a surprise that social isolation is associated with increased risk for mental health problems–in particular, depression, anxiety, stress-related disorders, and anger. Try to make an active effort to spend time with people you love whether you are able to do so in person or via a virtual connection. (2)

Screen Time Breaks

While technology has improved our lives in an abundance of ways, there can be too much of a good thing. Studies show that increased screen time is associated with negative outcomes such as lowered self-esteem, increased incidence and severity of mental health issues and addictions, slowed learning and acquisition, and an increased risk of premature cognitive decline. Use your screen time wisely–in moderation and with intention. Consider setting time limits on your devices and cleaning up your follow lists on social media to make your social feeds more of a positive space to engage with. (3)

Balanced Nutrition

Enjoying a balanced variety of nutrient-rich, whole foods to fuel your body optimally helps to reduce inflammation and keep your blood sugar (and moods) stable. In general, you should aim for half of your plate to be vegetables, 1/4 complex carbs (whole grains, starchy vegetables), and 1/4 protein. Healthy fats should be incorporated into each meal (avocado, nuts, olive oil, etc), and fruit makes for excellent snacks or dessert. Water intake is imperative for the maintenance of good health and most healthy adults should aim for 2-3L of water daily.

Sleep

It’s not just for beauty! As neuroscientist Matthew Walker says, “There does not seem to be one major organ within the body, or process within the brain, that isn’t optimally enhanced by sleep (and detrimentally impaired when we don’t get enough).” Adequate, quality sleep (7-9 hours per night) is vital for tissue regeneration, and slacking on your sleep can increase your propensity for weight gain, chronic disease, and even cancer. If you are struggling to get a good night’s sleep, our naturopathic doctors would love to help!

At Saskatoon Naturopathic Medicine…

Acupuncture

An effective traditional therapy for many conditions including stress, anxiety, sleep, pain, digestion, and hormonal concerns.

Massage

Our knowledgeable massage therapists offer relaxing and therapeutic massage as well as myofascial release and patient self-care education such as stretching, strengthening and postural awareness.

Somatic Experiencing™

Somatic Experiencing™ is a body-based approach to treating the effects of trauma. Specifically, the symptoms that arise when trauma is held in the body, including chronic or severe pain that does not respond well to medication, headaches, digestive issues, fear, difficulty sleeping, anxiety and depression. Somatic Experiencing™ works with the nervous system and the body’s innate ability to heal and recover from the symptoms of physiological stress. Treatment is gentle, supportive and enhances the effectiveness of the traditional exercise-based physiotherapy and counselling approaches.

Nutritional IV Therapy

IV nutrient therapy is a method of administering water-soluble nutrients (vitamins, minerals, antioxidants, and amino acids) directly into the blood stream. When you infuse nutrients intravenously, you bypass the digestive system, and this achieves a higher blood concentration beyond what is orally possible, especially if digestive function is compromised. Great for many conditions as well as health optimization and energy support. (See our website or call the clinic for more details).

Targeted Therapeutics

If you are looking for a comprehensive approach to your self-care, book a consultation with one of our naturopathic doctors who will conduct a thorough assessment of your health and come up with a customized plan just for you! With a variety of treatment modalities and testing options available, a targeted treatment plan can eliminate some of the guess-work and help you reach your self-care goals more quickly.

Written by Jacalyn Sieben ND

Sources:

1. Hansen, M. M., Jones, R., & Tocchini, K. (2017). Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review. International Journal of Environmental Research and Public Health, 14(8), 851. https://doi.org/10.3390/ijerph14080851

2. Henssler, J., Stock, F., van Bohemen, J. et al. (2021). Mental health effects of infection containment strategies: quarantine and isolation—a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 271, 223–234. https://doi.org/10.1007/s00406-020-01196-x

3. Neophytou, E., Manwell, L.A. & Eikelboom, R. (2021). Effects of Excessive Screen Time on Neurodevelopment, Learning, Memory, Mental Health, and Neurodegeneration: a Scoping Review. Int J Ment Health Addiction 19, 724–744. DOI: 10.1007/s11469-019-00182-2

Seasonal affective disorder & vitamin d

Saskatchewan is known for its long, cold winters. As the temperatures decrease, so do the daylight hours, significantly diminishing the amount of sun we might see each day. To add to that, to avoid the cold, we spend more time indoors and the time we do spend outside has us wrapped from head-to-toe to keep warm. This means less sun exposure and therefore reduced opportunity for us to synthesize vitamin D from its light. For some people, the change in seasons also brings on the “winter blues” also known as Seasonal Affective Disorder (S.A.D.). It is currently thought that a combination of physiologic, psychologic, genetic, and environmental factors play a role in S.A.D., one of them being vitamin D deficiency.

What is seasonal affective disorder?

Also termed “S.A.D.”, Seasonal Affective Disorder is a form of depression that typically occurs in the winter months when our exposure to sunlight is limited. Approximately 2-3% of Canadians will experience S.A.D. at some point and 15% more will experience a milder version of the condition.

There is a natural tendency to slow down in winter compared to the high-energy lifestyles we tend to carry on in summer months. However, if you notice you are feeling particularly low or experiencing the signs & symptoms below, it might be time to consider consulting a healthcare professional for an assessment.

Signs & Symptoms

• Feelings of hopelessness & sadness

• Thoughts of suicide

• Oversleeping

• Cravings for sweet or starchy foods

• Weight gain

• Fatigue/low energy

• Decreased physical activity

• Difficulty concentrating

• Irritability

• Increased sensitivity to social rejection

• Avoidance of social situations

In S.A.D., these signs and symptoms appear and disappear at about the same time each year, and the sad, despairing mood:

• is present most days and lasts most of the day

• lasts for more than two weeks

• impairs performance at work, school or in social relationships

Vitamin D - the sunshine vitamin

Vitamin D, which actually functions more like a hormone, acts on receptors in every tissue in the body including the brain and immune system. As it is a fat-soluble vitamin, we get it through diet from sources such as fatty fish (sardines, salmon, tuna), eggs, and liver; and are also able to synthesize it through our skin when we get sufficient exposure to the sun. As such, vitamin D levels have been shown to fluctuate with exposure to sunlight. Levels tend to decline from fall to winter, and are naturally lower the further north you live from the equator.

Vitamin D has many functions within the body. It is needed for calcium absorption (healthy bones, teeth), healthy immune function, and also has a role in the release of dopamine and serotonin - signalling molecules that, in the brain, are associated with drive, pleasure, and happiness.

So, how much vitamin D do you need?

Health Canada recommends a daily dietary intake of 600-800 IU’s of Vitamin D for adults. However, according to their statistics, most Canadians are not achieving this. While we also know sunlight does provide Vitamin D, here in Saskatchewan, the exposure we get at our northern location is often inadequate, especially in the winter months. Vitamin D levels also decrease with age, skin pigmentation, liver and kidney disease, obesity, certain medications, genetic mutations and other conditions.

How do I know if I’m getting enough vitamin D?

Luckily, there is a test for that! A simple blood test can assess whether you are getting sufficient amounts of vitamin D, or if supplementation may be indicated–or, in some cases, contraindicated. There can be too much of a good thing especially when it comes to supplementation. Vitamin D toxicity related to excessive long-term intake of vitamin D can cause hypercalcemia and related symptoms such as confusion, apathy, vomiting, abdominal pain, pathological calcification, increased thirst and increased urination. It is also important to note that everyone metabolizes vitamin D differently, so some people can experience vitamin D toxicity even at lower doses that are considered safe for the general population. It is always recommended to consult a healthcare practitioner before implementing any new health regimen to see if it is right for you, including vitamin D supplementation.

If you are experiencing symptoms of the “winter blues” or are curious about your vitamin D status or other natural approaches to mental health, you are invited to book a consult with myself or one of my colleagues to discuss your healthcare options.

We look forward to working with you!

In health, Jacalyn Sieben, ND

References:

1. CAMH. (2019). Seasonal affective disorder (SAD). Retrieved from: https://www.camh.ca/en/health-info/ mental-illness-and-addiction-index/seasonal-affective-disorder

2. Canadian Mental Health Association, BC Division. (2013). Seasonal affective disorder. Retrieved from: https://cmha.bc.ca/documents/seasonal-affective-disorder-2/

3. Health Canada. (2012). Vitamin d and calcium: Updated dietary reference intakes. Retrieved from: https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/vitamins-minerals/ vitamin-calcium-updated-dietary-reference-intakes-nutrition.html

4. Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P and Jones G (2018) Vitamin D Toxicity–A Clinical Perspective. Front. Endocrinol. 9:550. doi: 10.3389/fendo.2018.00550

5. Melrose S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression research and treatment, 2015, 178564. https://doi.org/10.1155/2015/178564

Physical Activity for Prostate Cancer - HIIT it up!

Physical activity is one of the many ways in which we can optimize our health before, during and after cancer treatment. Prostate cancer patients undergoing active surveillance can benefit from optimizing their physical activity levels (missed our post on active surveillance? Check it out here)

The Canadian research study Exercise During Active Surveillance for Prostate Cancer (ERASE) trial looked at how exercise during active surveillance in men with prostate cancer influenced their cardiorespiratory fitness [1]. Prostate cancer patients on active surveillance who did a supervised high intensity interval training (HIIT) three times per week for 12 weeks had improved cardiorespiratory fitness levels and reduced PSA levels compared to the control group (prostate cancer patients on active surveillance who did not do the HIIT training) [1]. Although we don’t know the long-term effects of this training, other studies have suggested that improving fitness levels can provide benefits in heart health and weight management and may reduce side effects associated with prostate cancer treatment [2-5].

Quick ways to incorporate more physical activity into your day:

• Take the stairs instead of the elevator/escalator

• Add daily walks on your own or with family/friends

• Get up from your work desk every 20 minutes for a quick stretch and stroll, or get a standing desk

• Do household chores such as snow shovelling, raking the leaves, mowing the lawn, gardening, vacuuming and others

• Dance!

• Enroll in leisurely sporting teams or engage in sports such as golf, tennis or others with friends or family

Talk to your doctor to make sure any high intensity types of exercises are safe for you. 

References:

[1] Kang, D.-W., Fairey, A. S., Boulé, N. G., Field, C. J., Wharton, S. A., & Courneya, K. S. (2021). Effects of Exercise on Cardiorespiratory Fitness and Biochemical Progression in Men With Localized Prostate Cancer Under Active Surveillance: The ERASE Randomized Clinical Trial. JAMA Oncology, 7(10), 1487. https://doi.org/10.1001/jamaoncol.2021.3067

[2] Kim, S. H., Seong, D. H., Yoon, S. M., Choi, Y. D., Choi, E., Song, Y., & Song, H. (2018). The Effect on Bone Outcomes of Home-based Exercise Intervention for Prostate Cancer Survivors Receiving Androgen Deprivation Therapy: A Pilot Randomized Controlled Trial. Cancer Nursing, 41(5), 379–388. https://doi.org/10.1097/NCC.0000000000000530

[3] Galvão, D. A., Taaffe, D. R., Spry, N., Cormie, P., Joseph, D., Chambers, S. K., Chee, R., Peddle-McIntyre, C. J., Hart, N. H., Baumann, F. T., Denham, J., Baker, M., & Newton, R. U. (2018). Exercise Preserves Physical Function in Prostate Cancer Patients with Bone Metastases. Medicine and Science in Sports and Exercise, 50(3), 393–399. https://doi.org/10.1249/MSS.0000000000001454

[4] Bourke, L., Smith, D., Steed, L., Hooper, R., Carter, A., Catto, J., Albertsen, P. C., Tombal, B., Payne, H. A., & Rosario, D. J. (2016). Exercise for Men with Prostate Cancer: A Systematic Review and Meta-analysis. European Urology, 69(4), 693–703. https://doi.org/10.1016/j.eururo.2015.10.047

[5] Keilani, M., Hasenoehrl, T., Baumann, L., Ristl, R., Schwarz, M., Marhold, M., Sedghi Komandj, T., & Crevenna, R. (2017). Effects of resistance exercise in prostate cancer patients: A meta-analysis. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 25(9), 2953–2968. https://doi.org/10.1007/s00520-017-3771-z

Movement is Medicine - It's never too late to start if you have (or had) Breast Cancer!

The Importance of Physical Activity in Breast Cancer Patients

The World Health Organization (WHO) recommends 150 minutes (about 2.5 hours) of moderate to vigorous-intensity physical activity per week for adults, which has been shown to reduce the risk of developing cardiovascular disease, diabetes and depression, can improve bone health, and reduce all-cause mortality [1, 2]. Additionally, regular physical activity has also been demonstrated to support breast cancer patients before diagnosis, during treatment and in survivorship.

IMPACT OF PHYSICAL ACTIVITY BEFORE DIAGNOSIS

Research has shown that women who were physical activity before being diagnosed with breast cancer had decreased mortality from breast cancer and all-causes compared to women who were not physically active before diagnosis [4, 6]. One of these studies also found that women who were sedentary (not physically active) before diagnosis but started exercising after diagnosis had a 45% lower risk of death from breast cancer compared to women who were not physically-active before or after diagnosis [6]. This impact was achieved just by engaging in brisk walking 2-3 hours per week!

EXERCISE DURING CANCER TREATMENT IS SAFE AND EFFECTIVE

One study looked at how exercise impacts the health of patients with stage II+ breast cancer. They found that engaging in exercise was safe for these patients, and was associated with improvements in quality of life, fitness level, fatigue, strength, mental health, and weight [3]. Another study conducted on breast cancer patients undergoing chemotherapy found that more intense exercise regimens (50-60 minutes 3 times per week) were slightly better than moderate-intensity exercise regimens (25-30 minutes 3 times per week) in improving pain, hot flashes, and strength, however both regimens were effective in managing side effects from chemotherapy [5].

PHYSICAL ACTIVITY AFTER TREATMENT IS STILL BENEFICIAL

Research on breast cancer survivors has also shown benefit. One study found that breast cancer survivors who practiced 150 minutes of moderate-intensity exercise per week had a 27% decrease in all-cause mortality (ie. dying from any cause) and a 25% decrease in breast cancer mortality, compared to women who had lower levels of physical activity [2].

MOVEMENT IS MEDICINE

So, what does this mean? It’s never too late to increase your levels of physical activity! No matter where you are on your health journey, physical activity appears to benefit health by reducing risk of dying from cancer and other causes and improving side effects during treatments. As always, talk to your doctor to make sure you are engaging in physical activity that is safe for you!

WHAT CAN I DO TO INCREASE MY PHYSICAL ACTIVITY LEVELS?

There are a number of ways to increase physical activity and movement in your daily schedule! An easy way to remember the difference between moderate-intensity and vigorous intensity exercising is talking and singing - at a moderate level of intensity, you can talk but would find it difficult to sing; at vigorous-intensity, it would be difficult to talk. Here’s a few ideas:

• Take the stairs instead of the elevator

• Walk or bicycle to work, or walk the kids to school

• Go for walks before or after work, or during the day

• Take up a sport or hobby that involves movement, like dancing, tennis, swimming

• Raking the leaves, shovelling snow, gardening

• Yoga, tai chi and Qigong

• Household chores like vacuuming, mopping

• Our favourite at Saskatoon Naturopathic Medicine: 15 minute at-home dance session - just turn on your favourite song and dance!

References:

[1] https://www.who.int/dietphysicalactivity/physical-activity-recommendations-18-64years.pdf

[2] Beasley, J. M., Kwan, M. L., Chen, W. Y., Weltzien, E. K., Kroenke, C. H., Lu, W., Nechuta, S. J., Cadmus-Bertram, L., Patterson, R. E., Sternfeld, B., Shu, X.-O., Pierce, J. P., & Caan, B. J. (2012). Meeting the physical activity guidelines and survival after breast cancer: Findings from the after breast cancer pooling project. Breast Cancer Research and Treatment, 131(2), 637–643. https://doi.org/10.1007/s10549-011-1770-1

[3] Singh, B., Spence, R. R., Steele, M. L., Sandler, C. X., Peake, J. M., & Hayes, S. C. (2018). A Systematic Review and Meta-Analysis of the Safety, Feasibility, and Effect of Exercise in Women With Stage II+ Breast Cancer. Archives of Physical Medicine and Rehabilitation, 99(12), 2621–2636. https://doi.org/10.1016/j.apmr.2018.03.026

[4] Lahart, I. M., Metsios, G. S., Nevill, A. M., & Carmichael, A. R. (2015). Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncologica (Stockholm, Sweden), 54(5), 635–654. https://doi.org/10.3109/0284186X.2014.998275

[5] Courneya, K. S., McKenzie, D. C., Mackey, J. R., Gelmon, K., Friedenreich, C. M., Yasui, Y., Reid, R. D., Cook, D., Jespersen, D., Proulx, C., Dolan, L. B., Forbes, C. C., Wooding, E., Trinh, L., & Segal, R. J. (2013). Effects of exercise dose and type during breast cancer chemotherapy: Multicenter randomized trial. Journal of the National Cancer Institute, 105(23), 1821–1832. https://doi.org/10.1093/jnci/djt297

[6] ​​Irwin, M. L., Smith, A. W., McTiernan, A., Ballard-Barbash, R., Cronin, K., Gilliland, F. D., Baumgartner, R. N., Baumgartner, K. B., & Bernstein, L. (2008). Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: The health, eating, activity, and lifestyle study. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 26(24), 3958–3964. https://doi.org/10.1200/JCO.2007.15.9822