Treatment options for depressive symptoms (Part 1) - Winter blues and milder depressive moods.  

Light into the darkness of winter and the soul  

As different as depressive clinical pictures can be in their manifestation, so different are the possibilities of their treatment. A wide spectrum of therapeutic means is available, ranging from treatment with light and herbal agents to various psychotropic drugs and forms of psychotherapy.  

"More light" - these are said to have been Goethe's last words... Fortunately, we have not yet reached that point, but in the case of the so-called winter blues or even seasonal winter depression, light therapy can certainly be helpful.1 It is not for nothing that people have been celebrating festivals of light such as Advent, Christmas or even Hanukkah in the dark season for centuries, trying to bridge the weeks until the next spring in this way. And it is not without reason that there are light cafés, daylight lamps in offices or, in the very north, even at bus stops in Scandinavia, where many days are virtually dark in winter!2 Out of ten patients treated with light therapy, six to nine experience an improvement in their symptoms within two to three weeks. Treatment may or may not help. It should be started and designed only after medical consultation.3 At a dose of 10,000 lux, about half an hour of light therapy a day is usually enough. The portion of artificial light in the morning hours is particularly effective. 

People are different; they react differently to situations of emotional stress. It is impossible to predict whether depression, feelings of anxiety or exhaustion with or without physical complaints will be in the foreground. Blame and reproaches from third parties or appeals to pull oneself together are in any case inappropriate and in no way helpful!

If anxious moods and inner restlessness are in the foreground, high doses of lavender oil can be used. Nervous restlessness can be treated with preparations of passionflower herb. For sleep disorders, proven combinations of valerian, hops and lemon balm can also be recommended.

Mild depressive moods, if they do not subside quickly on their own,can usually be treated well with St. John's wort (Hypericum perforatum). However, the mood-lifting effect only sets in after a few weeks of regular use. To ensure adequate and consistent dosage, do not use tea preparations, pressed juices, or non-pharmacy St. John's wort preparations.⁴
 St. John's wort is the only herbal antidepressant recommended in the National Health Care Guideline "Unipolar Depression".⁵ It has been shown in clinical studies to be as effective as synthetic antidepressants in mild and moderate depression and at the same time better tolerated. An advantage is that St. John's wort does not make people tired, i.e. it does not have a sedative effect and does not affect the ability to react.

However, attention must be paid to possible interactions with other drugs, whose effect can be weakened or intensified by the simultaneous intake of St. John's wort. Here it is recommended to study the respective package insert thoroughly and, if necessary, to seek advice from a doctor or pharmacist. This can reduce the effect of the contraceptive pill, which can lead to intermittent bleeding and even unwanted pregnancies. Users should therefore use additional contraceptive methods when taking St. John's wort.
A typical side effect of St. John's wort is photosensitization, i.e. increased sensitivity to UV light with an increased risk of sunburn. Under no circumstances should one take sunbathing while taking St. John's wort or - especially to be considered in the dark season, when depressive moods occur more frequently - use high-altitude sun or visit a tanning salon. Even in winter and without direct sun exposure, when taking St. John's wort, good UV protection of the skin in light-exposed areas (face and hands) is very important.

The lack of light affects the mood of around 20 percent of people in Germany: they suffer from listlessness, an increased need for sleep and ravenous appetite, and even depression. Light therapy and outdoor exercise can help.1