Disease Proof

Counteract the winter blues naturally

The connection between a healthy lifestyle and a healthy mood state is often overlooked; however it is well known that exercise and other natural methods are effective at alleviating depression symptoms.  My natural protocol for depression has helped many sufferers of depression and seasonal affective disorder (SAD) improve their symptoms without the risks and side effects associated with antidepressant medications. Even for those of us who do not suffer a mood disorder, it is common to experience some decline in mood during the winter. Fortunately, there are natural methods that help to alleviate the winter blues.


Exercise is known to be as effective as antidepressant drugs or cognitive behavioral therapy for improving the symptoms of depression.  Exercise works by increasing the production of serotonin, a mood-elevating neurotransmitter, which is often low in those with depression. The combination of aerobic exercise plus strength training is better than aerobic exercise alone, and yoga has also been shown to improve symptoms.1-4

Sunrise. Flickr: SashaW

Light exposure

In the winter, we tend to spend most the day’s sunlit hours indoors, at work or just staying warm at home. Exposure of the retina to morning light helps the brain to properly regulate its production of melatonin and therefore our sleep-wake cycle; inadequate light exposure during the winter can disrupt this cycle. During the winter, if getting natural sunlight isn’t possible, a therapeutic light is an effective substitute; it corrects the body’s clock, restores normal melatonin production, and stimulates production of serotonin.5  SAD has been successfully treated with light therapy for nearly thirty years, and light therapy is also highly effective for depression, comparable to the effects of anti-depressant drugs, so it is effective even for non-seasonal depression.6 Light therapy is an excellent tool for anyone who experiences sadness, fatigue, or disrupted sleep patterns, and especially if you note this associated with winter.  

Omega-3 fatty acids

Omega-3 fatty acids play an important role in brain health; DHA is primarily associated with cognitive function, and EPA with mood.7 A meta-analysis of 28 trials determined that EPA supplementation is effective for improving depression symptoms.7,8  EPA and DHA are considered long-chain omega-3 fatty acids, in contrast to the shorter ALA found in plant foods, such as flax, hemp, and chia seeds, walnuts and leafy greens. The primary source of EPA is fish, although a small amount ALA from plant foods can be converted to DHA and EPA in the body. Since conversion efficiency is low for many people, in addition to eating ALA-rich foods daily, I recommend a DHA + EPA supplement for everyone, and additional EPA for those with depression.9-11

High-nutrient diet

Two studies compared mood scores in subjects eating vegetarian or omnivorous diets.  In an observational study, vegetarian Seventh Day Adventists reported more positive mood and lower levels of depression and anxiety compared to omnivore Adventists.12  In a second study by the same research team, subjects were assigned to different diets for two weeks. The subjects in the vegetarian group increased their mood scores after the two weeks, but those on the omnivorous diet did not.13  These results suggest that plant foods contain substances that positively affect mood. One possibility is the high antioxidant content of plant foods; the brain is highly susceptible to oxidative stress, and markers of oxidative stress are indeed associated with a higher incidence of depression.14

In October 2012, another study found a connection between fruit and vegetable consumption and healthy mood.  The authors collected data on the diets of 80,000 people, and analyzed scores on a life satisfaction questionnaire relative to the amount of fruit and vegetables consumed daily. Even after adjusting for many other parameters such as employment status, marital status, income, illness, education, and other dietary variables, greater fruit and vegetable consumption was strongly correlated with greater life satisfaction scores.15

In addition to antioxidants, vitamins and minerals may factor into the positive effects of fruits and vegetables on mood. Several B vitamins contribute to the production of mood-enhancing neurotransmitters, folate for example.16,17 Folate deficiency is known to increase the risk of depression; about one-third of people with depression are folate-deficient.17-20 Also, a low-sodium, high-potassium diet has been shown to have a positive effect on mood.21 Green vegetables and legumes are rich in folate, and all whole plant foods are naturally rich in potassium and low in sodium.

Vitamin D

Reduced exposure to sunlight during the winter means less natural vitamin D production by the skin. Scientists don’t know exactly how vitamin D works in the brain, but it is thought to affect the production of neurotransmitters, including serotonin.22  Low blood vitamin D levels are associated with SAD and depression, and there is evidence that supplementing with vitamin D helps to maintain a healthy mood state.23, 24 For example, a 4000 IU/day dose of vitamin D for six months starting in the summer improved wellbeing scores in February compared to a lower (600 IU) dose.25 Vitamin D is active in essentially every cell and tissue in the human body, and contributes to many facets of health.  It is crucial for everyone to maintain adequate blood vitamin D levels (a 25(OH)D of 35-50 ng/ml) with supplements.

The natural brain-healthy properties of a high-nutrient diet, regular exercise, adequate vitamin D and omega-3 stores, and light exposure combine to promote a positive mood, even in the cold, gray days of winter.


Image credit: Flickr - SashaW 


1. Gill A, Womack R, Safranek S. Clinical Inquiries: Does exercise alleviate symptoms of depression? J Fam Pract 2010;59:530-531.
2. Uebelacker LA, Epstein-Lubow G, Gaudiano BA, et al. Hatha yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract 2010;16:22-33.
3. Saeed SA, Antonacci DJ, Bloch RM. Exercise, yoga, and meditation for depressive and anxiety disorders. Am Fam Physician 2010;81:981-986.
4. Ma Q. Beneficial effects of moderate voluntary physical exercise and its biological mechanisms on brain health. Neurosci Bull 2008;24:265-270.
5. Miller AL. Epidemiology, etiology, and natural treatment of seasonal affective disorder. Altern Med Rev 2005;10:5-13.
6. Golden RN, Gaynes BN, Ekstrom RD, et al. The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. Am J Psychiatry 2005;162:656-662.
7. Kidd PM. Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Altern Med Rev 2007;12:207-227.
8. Martins JG. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. J Am Coll Nutr 2009;28:525-542.
9. Harnack K, Andersen G, Somoza V. Quantitation of alpha-linolenic acid elongation to eicosapentaenoic and docosahexaenoic acid as affected by the ratio of n6/n3 fatty acids. Nutr Metab 2009;6:8.
10. Davis BC, Kris-Etherton PM. Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications. Am J Clin Nutr 2003;78:640S-646S.
11. Arterburn LM, Hall EB, Oken H. Distribution, interconversion, and dose response of n-3 fatty acids in humans. Am J Clin Nutr 2006;83:1467S-1476S.
12. Beezhold BL, Johnston CS, Daigle DR. Vegetarian diets are associated with healthy mood states: a cross-sectional study in Seventh Day Adventist adults. Nutrition Journal 2010;9:26.
13. Beezhold BL, Johnston CS. Restriction of meat, fish, and poultry in omnivores improves mood: A pilot randomized controlled trial. Nutr J 2012;11:9.
14. Tsuboi H, Shimoi K, Kinae N, et al. Depressive symptoms are independently correlated with lipid peroxidation in a female population: comparison with vitamins and carotenoids. J Psychosom Res 2004;56:53-58.
15. Blanchflower DG, Oswald AJ, Stewart-Brown S. Is Psychological Well-Being Linked to the Consumption of Fruit and Vegetables? Social Indicators Research 2012.
16. Coppen A, Bolander-Gouaille C. Treatment of depression: time to consider folic acid and vitamin B12. J Psychopharmacol 2005;19:59-65.
17. Miller AL. The methylation, neurotransmitter, and antioxidant connections between folate and depression. Altern Med Rev 2008;13:216-226.
18. Ng TP, Feng L, Niti M, et al. Folate, vitamin B12, homocysteine, and depressive symptoms in a population sample of older Chinese adults. J Am Geriatr Soc 2009;57:871-876.
19. Sachdev PS, Parslow RA, Lux O, et al. Relationship of homocysteine, folic acid and vitamin B12 with depression in a middle-aged community sample. Psychol Med 2005;35:529-538.
20. Watanabe H, Ishida S, Konno Y, et al. Impact of dietary folate intake on depressive symptoms in young women of reproductive age. J Midwifery Womens Health 2012;57:43-48.
21. Torres SJ, Nowson CA, Worsley A. Dietary electrolytes are related to mood. Br J Nutr 2008;100:1038-1045.
22. Bertone-Johnson ER. Vitamin D and the occurrence of depression: causal association or circumstantial evidence? Nutr Rev 2009;67:481-492.
23. Murphy PK, Wagner CL. Vitamin D and mood disorders among women: an integrative review. J Midwifery Womens Health 2008;53:440-446.
24. Lee DM, Tajar A, O'Neill TW, et al. Lower vitamin D levels are associated with depression among community-dwelling European men. J Psychopharmacol 2011;25:1320-1328.
25. Vieth R, Kimball S, Hu A, et al. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J 2004;3:8.



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Comments (5) Read through and enter the discussion with the form at the end
Helyn - January 29, 2013 9:34 PM

What wonderful advice and, as usual, rock solid documentation. Thank you, Dr. Fuhrman!

michael clark - January 30, 2013 4:03 PM

Love it I have a name for this type of self treatment it is called ACT Active Client Treatment as opposed to PCT or passive client treatment (all that is required is for you to supply the water we will supply the pill).

Exercise (not over by the way) Breathing Diet & a healthy Attitude are actually all Natural Biofeedback methods of just simply doing the right things to take care of ourselves.

Enjoyed the article


Michael A Clark I.S.M.A. N.M.Q.A.A

mike rubino - January 30, 2013 9:59 PM

Good article. I think I need a trip to a warm sunny place for 10 days .

Jamie - February 1, 2013 1:40 PM

Great article! I read a study that claims allowing yourself sun exposure until your skin turns a light pink is safe and healthy. That we are under exposing ourselves with suncreens and shading for fear of aging and skin cancer. Anyone else heard this? Wonder if Dr. Furham agrees with it? I love the sun so I hope this study is sound. I have SAD in the Summer. I love the winter. I live in St. Louis and summers here are miserable while our winters are mostly mild. Does the low winter sun index provide enough exposure? I am out in the sun for @ least an hour on my walks each day. Does that provide enough exposure during the winter months?

Dolores Behrens - February 4, 2013 3:06 PM

I am 78 years young. I have been working with Dr. Fuhrman for
upwards of ten years. I follow what he advocates and I stay
healthy. Never a flu shot. Never a cold that lasts more than two days and not very often at that. Thank you Dr Fuhrman

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