Let the Sunshine In

As a clinical social worker, I have observed firsthand the effects that vitamin D levels can have on mood.  The shorter days of Winter are tough on many people. Vitamin D- which our bodies make when exposed to the sun, is crucial for making hundreds of enzymes and protein and interacting with more than 2,000 genes vital for health and fighting disease- is in limited supply.  Vitamin D deficiency has been linked to chronic modern diseases such as heart disease, diabetes, cancer, osteoporosis, and depression. 

Several studies suggests that Vitamin D deficiency and depression are linked, and that increasing Vitamin D levels can help. We do not know whether low levels of vitamin D cause depression, worsen it, or are a symptom of the underlying depression. One study included  adult women with depression, all of whom were taking antidepressants. The women were also being treated for Type 2 Diabetes or an underactive thyroid gland. All were deficient in vitamin D, with levels under 21 ng/mL. Levels below 21 ng/mL are considered vitamin D deficient.  The women received vitamin D therapy for eight to 12 weeks. After treatment, their levels increased to 32 to 38 ng/mL. The women also reported improvements in symptoms of depression following vitamin D therapy. One woman's depression score changed from indicating a major depression to mild depression.  

I believe that many doctors and mental health professionals have had similar experiences with patients. I have had three clients who presented with major depression, tested below 10ng/ml in vitamin D, and after 10 weeks of receiving vitamin D supplements and weekly therapy, experienced a remission in their depression. Of course we can't measure how much improvement was caused by the increase in Vitamin D, and how much was caused by therapy.  My stance regarding treatment is to  use every helpful, healthy tool available to combat depression.

In addition to the clients who have suffered from major depression and had their Vitamin D levels tested, I have had many clients who have described and exhibited increased symptoms of depression in the late Fall and Winter. Seasonal Affective Disorder (SAD) is real, can be debilitating, and is prevalent when vitamin D stores are low.  In one study, eight subjects with SAD received 100,000 I.U. of vitamin D daily and all experienced a significant lessening of their depression as measured by the Hamilton Depression Inventory. Vitamin D blood levels improved by 74% in all eight subjects.  Vitamin D may be an important treatment for SAD. More, larger studies will be necessary to confirm these findings.

Vitamin D is called the sunshine vitamin because our bodies produce it when exposed to sunlight. Sunlight is an excellent source of vitamin D.  A person sitting outside in a bathing suit in New York City gets more vitamin D in 20 minutes than from drinking 200 glasses of milk.  Many experts suggest getting 10 to 15 minutes of sunshine sans sunscreen three times weekly.  Talk to your doctor about the pros and cons of sun exposure for you. 

Vitamin D is also added to milk and other foods, and is available in small amounts in fatty fish like tuna, salmon, and mackerel; beef liver, cheese, and egg yolks. It can be hard to get as much as we need from our diets, which is why supplements are often needed. Many, but not all, doctors include Vitamin D levels in their standard battery of blood tests when patients come in for a physical. Make sure you check with your doc if you are depressed, and request a blood test for Vitamin D levels. Your health depends on it.

Surviving Snow-Fatigue, or Snow Derangement Syndrome

With the huge amounts of snow, cold and grey skies we have had this Winter, many of us are feeling desperate for warmth and sunshine. Unless you have the good fortune to be able to flee to a tropical hideaway, it's a good idea to shake up your routine. 

• Humor is healing. Seek out a funny friend or a favorite comedy.
• If you have children, remember that you are not responsible for entertaining them. Challenge them to come up with new games and to entertain themselves. A great book full of old school, inexpensive activities is "The Orange Mama Laid", by Kirsten Denny. (Available on Amazon)
• Get outside on sunny days. Even better, leave your sunscreen off for 15 minutes to maximize absorption of Vitamin D.
• If you exercise, try a new sport or class to create some novelty for your body and brain.
• Plan your real or imagined spring garden. Consider starting seedlings indoors in March. Visualizing a bountiful garden and planning for fresh food will lift your spirits.
• Do a good deed. Even small acts like offering a smile to a cranky neighbor or letting someone into traffic have been scientifically proven to reduce stress and create a feeling of well-being.
• Check your caffeine intake. We often unconsciously increase our caffeine consumption during the Winter to keep the cold at bay. If this is the case for you, gradually bring it back down to no more than two to three cups a day. More than that can cause irritability and interfere with sleep.
• More hours indoors can lead to more hot Toddys and wine by the fire. If you are prone to the blues, limit your alcohol intake as much as possible- it's a depressant, and it interferes with sleep. 
• Low folic acid levels are associated with depression. A good source of folic acid is found in leafy green veggies. If they aren't your top food choice, chop them and add them to soups and stews for the last five to ten minutes of cooking. This works well with swiss chard and spinach.



Even my snow-loving Golden Retriever, Ginger, is struggling this Winter!

• You've heard it before, but I would be remiss if I did not mention Omega 3 fatty acids, which play a crucial role in overall health. However, Omega 3's are found in greater concentrations in the brain than in other parts of the body, and have been shown to alleviate depression. Omega-3s can be found in fatty fish like wild salmon, sardines, Atlantic mackerel, and in lower quantities in ground flaxseeds, walnuts and omega-3 fortified eggs. Ground flaxseeds can be substituted for small portions of flour or pancake mix without sacrificing taste. Kirkland Signature Natural Fish Oil Concentrate with Omega-3 Fatty Acids - 400 Softgels

Making all these changes would be daunting. Try choosing a few that appeal to you, and monitor your mood, health and overall level of functioning for the next few weeks. Hopefully you will see some positive results. If your low mood persists, you may be suffering from Seasonal Affective Disorder (SAD) or depression, and should consider getting a professional opinion from a licensed therapist.