Q: My PMS always gets worse in the winter and I find it really hard to get up in the mornings. Why is this? What can I do about it?

A: Many women find that their symptoms of PMS get worse when the nights are longer and darker. This lack of warmth and light seems to make things worse because when you are exposed to plenty of bright light your body starts to produce serotonin which wakes you up and makes you feel more energetic and alert. Without enough serotonin you can end up feeling depressed and irritable, with food cravings and problems sleeping. Sounds a lot like PMS, doesn’t it?

It’s clear that too little serotonin and not enough light can play a part in PMS or make symptoms worse. Change in appetite, insomnia, reduced energy, weight gain, problems concentrating and fatigue are symptoms of both PMS and low serotonin levels so if you are suffering from any of these symptoms you need to light up your life. This is crucial if your PMS gets worse in the winter or if you suffer from depression. By boosting your serotonin levels, your mood will be boosted and you will have more energy in the morning to leap out of bed.

To increase your serotonin production make sure you are exposed to either full-spectrum light from the sun or a bright white light for at least 15 minutes during the morning. Light has a direct effect on your brain, helping to set your body clock for sleep and waking. The incandescent lights you may have in your lamps are not good enough and you should try to walk outdoors – even if the sun isn’t out. Don’t wear sunglasses as your eyes need to be exposed to natural light. If you think you need something more you could buy an alarm clock that is also a bedside lamp so when you set it to wake up at 6.30 am it gradually turns up the light intensity starting about 20 minutes before you need to get up – simulating what dawn does. If this doesn’t wake you first the alarm goes off at your wake up time. You may also want to consider getting a special light box that can provide full-spectrum.  The light is measured in units called lux, and a typical light box provides 10,000 lux. Daylight is around 5,000 lux and it takes around 2,500 lux to have a therapeutic effect on your internal clock. You can do light therapy yourself as long as you don’t over do it and follow the instructions on the box to the letter – but it is always best to check with your doctor first for advice.

Few of us can escape the symptoms of mild jet lag twice a year when the clocks go either forward in March or back in October for one hour. Studies suggest that it takes people several days to fully readjust their body clock and sleep schedule after the time change.

Researchers report that adapting to the spring time change is more difficult than facing the end of Daylight Saving Time in October, which lengthens the day rather than shortening it. Every year the movement against daylight saving time gathers momentum claiming that putting the clock forward in March increases the risks of accidents on the roads but at present there are no signs to change the situation.

 

The following tips can help you beat fatigue and sleepless nights when the clocks change:

 

• Begin to re-jig your sleeping routine a few days before the time change by going to bed earlier for a March clock change and later for an October change. You could start by going to bed 15 minutes earlier or later and then the next night 30 minutes and so on.
• Get at least 15 minutes exposure to sunlight, without glasses on, first thing in the morning. The bright sunlight (or any bright light) tells your body’s natural biological clock that its time to wake up, and that same clock will then be set to tell your body its time to go to sleep about 14 to 16 hours later. 
• Reorganise your mealtime schedule by eating dinner earlier or later.
• Be careful when operating machinery or driving on the day of the time change.
• Avoid turning to caffeine to wake you up in the morning and alcohol at night to help you sleep. Eat properly, drink lots of water and remain physically active.
• Don’t nap after 3 pm.

Q: Every few months I feel really low and exhausted for a few weeks. It eventually passes but I want to know what I can do to make it go away or prevent it happening again without resorting to antidepressants.

A:  There are a number of reasons why you may feel low periodically and this can include exhaustion – both physical and mental – lack of sunlight, nutritional deficiencies, blood sugar imbalances, hormone imbalances, an imbalance of bacteria in your bowel and lack of quality sleep. Depression is also a possibility so if none of the measures suggested below work I suggest you visit your doctor to discuss your condition.

 

To get to the bottom of this I suggest you start by evaluating your diet. Are you eating healthily? If you eat a lot of refined and processed food, chocolate, sweets and crisps this will make you feel low because it will make your blood sugar levels swing and you won’t have the nutrients you need to feel healthy and happy. If you drink alcohol I suggest you cut down immediately because alcohol is a well known depressant. It can also use up your B vitamins which are needed for good brain function. In addition to eating a healthy diet I suggest you take a good multivitamin mineral supplement, making sure it contains good levels of the B vitamins including folic acid.

 

It is also incredibly important that you make sure you cut down on saturated and transfats found in most animal products, which can trigger weight gain, poor concentration and fatigue and then increase your intake of foods rich in mood boosting omega 3 essential fats, such as oily fish, nuts and seeds. One component of omega 3, called DHA, is vital for helping to build neural pathways in your brain and for proper brain function so try to eat oily fish such as organic salmon two times a week and if you don’t eat fish use linseeds (flax).  For a while take a supplement of either fish oil or linseed oil at the same time as improving your intake from the diet.  (I use Omega 3 Plus in the clinic, which contains 500mg of DHA in two capsules as well as over 700mg of EPA – see the Resources Page.)

 

If you smoke, quit because smoking prevents healthy blood flow to your brain. A live, natural organic yogurt every day will help to prevent toxicity in your bowel and if you feel heavy and tired because of constipation be sure to eat enough wholegrains, fruit and vegetables to get things moving again. 

 

If the weather has an effect on you try not to stay indoors. Even if the sun isn’t out natural daylight is important for regulating your sleep patterns and for boosting your mood. You may also want to invest in a light box and have daily half hour sessions at home because the special light mimics the sun, encouraging feel good hormones.

 

And finally, aim for at least 30 minutes of exercise every day. Research has shown that exercise is one of the best ways to beat depression and boost mood and wellbeing.  Studies have shown that St John’s Wort can be help for mild to moderate depression and so may be worth trying but this herb must not be taken if you are also taking antidepressants and you would need to check if you are taking other medication as there are a number of contraindications with St John’s Wort.  (see a good strength St John’s Wort on the Resources Page.)