Just recently an individual within the HD community emailed me with a very interesting question. "Dear James, I was wondering if you can give me some advice on this. Does the change of seasons have something to do with depression and changes in someone with Huntington's disease?"
This is a great question. Although I am not a medical professional, I took some time to investigate this, and here is an overview. First, what do we know about Huntington’s disease?
As per the Mayo Clinic, "The most common psychiatric disorder associated with Huntington's disease is depression. This isn't simply a reaction to receiving a diagnosis of Huntington's disease. Instead, depression appears to occur because of injury to the brain and subsequent changes in brain function.”
HOPES (Huntington’s Outreach Project for Education, at Stanford) notes, “Interestingly, serotonin stimulates the expression of BDNF, and BDNF enhances the growth and survival of neurons that release serotonin. Because Huntington’s patients have decreased levels of both BDNF and serotonin, this interaction could play an important role in the pathogenesis of HD.”
Dr. LaVonne Goodman writes, “Why do HD patients get psychiatric symptoms? Of course part of the reason is reactional, we're depressed and anxious because we feel sadness and fear. But the most significant reason for psychiatric symptoms is the disease itself. The HD mutation directly causes disruption of nerve circuits in parts of the brain that control emotions. The serotonin system is one of the most important systems for maintaining emotional and nerve cell health.” [HDDrugWorks.org]
So, do seasonal changes potentially exacerbate depression in a person with Huntington’s disease?
Many of us feel better, happier, and more energetic when the sun is shining and we are more active. On less brighter, more melancholy, weather-ridden days, we tend to feel the opposite. With Daylight Saving Time [fall ahead], this change shortens the time in which our bodies are exposed to sunlight. We rely on sunlight for our bodies to create the nutrient - Vitamin D, which plays a role in depression. Inasmuch, sunlight may have an affect on the level of melatonin, causing us to be lethargic and bringing on the need for sleep. For many individuals (with or without Huntington’s disease), this time of year affects our sleeping and waking time. We have to “reset” our body’s biological clock (circadian rhythm) and allow the change to take place. Concerning individuals with Huntington’s disease, it is known that we battle with serotonin and dopamine levels, so we need to be proactive with our overall health, regardless of the season. I know it is easier said, than done. To help individuals in our community, many medical professional have prescribed Serotonin reuptake inhibitor drugs [SSRIs] treat depression and many other symptoms of Huntington's disease. During these seasonal changes, it is very important to remain steadfast with these prescribed medications, and contact your physician if “seasonal” changes affect you. Always seek medical attention if you become more depressed or show additional signs of depression!
What can you do to fight the blues?
BDNF: (Brain - derived neurotrophic factor) is a protein related to the "Nerve Growth Factor" (NGF) found in the brain. Our amazing Dr. Jan Nolta (Director of the Stem Cell Program at UC Davis School of Medicine, and directs the Institute for Regenerative Cures), introduced many of us in the Huntington's community to BDNF. The BDNF helps to keep existing neurons "alive" and to help the growth of new neurons and synapses. They are found in vital areas of the brain (specifically pertaining to the striatum in Huntington's disease) for learning, memory, and thinking. BDNF is a major factor in the development and progress of Huntington's, because BDNF sustains the striatum of the brain, which is the brain area most affected in HD. Numerous animal studies have shown specifically that raising BDNF levels can protect the brain - particularly the striatum in HD mouse models. The new research suggests that actively increasing BDNF levels is likely to slow the development of Huntington's symptoms, as well as protect the brain. The promising new findings about BDNF can be exploited even today. They are easy, cheap, reasonably safe ways for people to increase BDNF levels in the brain. Exercise, maintaining a reasonably low weight, and enjoying a stimulating, but not overly stressful social and mental life, all raise BDNF levels. During the seasons, enjoy hobbies, communicate more with your family and peers (support groups), and keep yourself occupied! Be sure to take as much time for yourself. Get as much sunshine and remain active. This will ultimately result in a much needed boost to your immune system and help put a smile on your face!
Change is not always easy. Personally, the changes in season [from warmer weather to colder weather] has a great affect on me. Even in Florida, the slightest change is difficult for me to overcome. However, I continue to adhere to the medication regimen prescribed by my doctor, and try to remain as active as possible. I wish to thank you for writing me and for bringing about some very important topics!