As part of my illness I have suffered greatly with Seasonal Affective Disorder, known also by its appropriate acronym - SAD. I notice large seasonal variations in my mood, energy levels and other symptoms and also day to day variations depending on the weather. Even a cloudy or rainy day in summer can make me feel depressed and sluggish.
I have recently tried high dose vitamin D treatment after seeing studies that showed very positive results and wanted to tell you about what it has done for me. First though I want to talk a bit about my experience with SAD.
There was a time before I knew about SAD and realised I had it when I felt suicidal each year from October to March. All I felt was total despair and spent most of my time in bed. If I hadn't still been living at home with my parents I wouldn't have been able to cope and who knows what would have happened. As it was I stubbornly fought a mental battle against thoughts of ending my life and managed to pull through.
Thankfully after a few years I saw the pattern and realised what was going on. The first treatment I heard about for SAD was bright light therapy. This is usually one of the first treatments recommended by doctors (along with antidepressant medication) and involves sitting in front of a special 'light box' for a certain period of time each day, usually 30 minutes to 2 hours depending on the light box and severity of the patient's symptoms. Light boxes are designed to provide light bright enough to mimic the effects the sun has on the body; namely suppressing production of the sleep hormone melatonin and stimulating production of the mood enhancing neurotransmitter serotonin (along with a number of others).
» Learn more about SAD light boxes
Unfortunately for me, although studies suggest light boxes are very effective as a treatment for SAD and I heard many sufferers recommending them, they did little to reduce my symptoms. I experienced a moderate energizing effect but my mood was still very low.
The first thing that really made a difference for me was the simple measure of waking up earlier in winter. My sleep pattern had been to go to bed about 2-3am and wake up at 12-1pm (a shift common in ME/CFS, SAD and other environmental illnesses). One year as October approached I began going to bed between 11pm and midnight and waking up at 9am. The difference this made to my mood was astonishing. Although during that winter there was still a noticeable difference to how I felt in summer I no longer felt the heavy weight of despair and didn't have a single suicidal thought. Further to this getting outside during daylight hours in winter and letting the suns rays directly enter the eye also made a positive difference.
So if you suffer from SAD and spend your days in bed asleep or with the curtains closed try waking up earlier and getting outside as much as possible. Like me you may be amazed by how much your mood improves.
Now on to vitamin D. The sun not only affects the physiology of our bodies (and our mood) by the action of bright light hitting the retina of the eye but also by triggering the production of vitamin D in the skin as its rays strike uncovered areas. You may be surprised to learn that "vitamin D" is actually not a vitamin at all; its active form is actually a form of steroid hormone. As a result it has powerful effects on the body beyond aiding in the absorption of calcium and prevention of osteoporosis for which it has traditionally been known. The thing that is important to SAD sufferers is that vitamin D is required for the production and activation of the mood elevating neurotransmitters serotonin, dopamine and noradrenaline/norepinephrine.
When exposed to certain wavelengths of UVB rays from the sun the skin produces vitamin D3 (cholecalciferol). This is the most active form and is also found in oily fish and animal products. Plants contain the vitamin D2 (ergocalciferol) form which is less well absorbed and utilised by the body. Vitamin D3 is also widely available in supplement form.
After seeing studies suggesting people low in vitamin D were more likely to develop depression and SAD and that vitamin D supplementation could alleviate the symptoms of SAD I began to suspect it would also benefit me. A few small studies had shown that doses of 800-2000iu per day were enough to help those with SAD so last winter I supplemented 2000iu every day but gained little benefit. However, I then came across research which used much higher doses - 100,000iu in one single dose.
I discussed using higher doses with my nutritionally orientated doctor and she said she had used doses of 25,000-50,000iu D3 per week with her ME/CFS and SAD patients with great success. This works out at roughly 3500-7000iu per day. Vitamin D3 has been shown to be non-toxic at these levels and well tolerated as the body converts it to the active hormone (1,25-dihydroxycholecalciferol) in the liver and kidneys as needed.
I started with a 25,000iu dose and within hours the effects were obvious My mood, even on an overcast day, was noticeably brighter. It was a strange sensation in that I felt as if it was summer even on a cloudy day in the depths of winter. I found this mood elevation lasted for 3-4 days before starting to really tail off. Taking 50,000iu lasted the maintained the improved mood for the whole week so I now intend to take this dose weekly during the winter.
So it seems I have found the missing piece of my SAD puzzle. The combination of getting as much sunlight as possible and taking high dose vitamin D3 is highly effective at relieving my symptoms and making me feel like I do during the summer months when the sun is doing all of the work.
If you suffer from SAD then I highly recommend you try adding vitamin D3 to your treatment regimen. It may be that 800-2000iu per day may be all you need in which case regular capsules of 1000iu from the healthfood store will be fine. These are very inexpensive. If you require higher doses like myself then getting the concentrated form and taking it weekly or every other week may be a better option. There are a few suppliers on the internet (no prescription required) or you may have to get it through your doctor.
SAD is a terrible thing to experience so I hope this information helps those of you who are suffering.
Here's to brighter and happier winters!
Luckily for those who can't get the extra sun their body needs to produce enough vitamin D on its own, it has been found that vitamin D3 (cholecalciferol) supplements can be very effective at treating SAD. Although the number of studies published on the subject is quite low, all have produced favourable results.
An important and widely cited study conducted at The Department of Medicine, Union Memorial Hospital, Baltimore, compared the effects of a single 100,000IU vitamin D injection to 1 months bright light therapy on the condition of 15 SAD patients6.
Eight patients were given vitamin D and seven were given light therapy. Before and after treatment each patient was evaluated using the Hamilton Depression scale, the SIGH-SAD, and the SAD-8 depression scale. The results showed that every patient given vitamin D improved on all 3 depression scales, whereas the patients given bright light therapy failed to significantly improve on any. The study also found that both treatments elevated vitamin D status after 30 days but that the vitamin D injection raised levels twice as much as did bright light therapy. The amount each patients vitamin D levels had risen also correlated strongly with the reduction in symptom severity achieved. So in this study at least, vitamin D was actually a lot more effective than bright light therapy for the treatment of SAD. It should be noted however that 15 participants is a low number to get very accurate results and that bright light therapy has proven effective in many other studies.
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- Seasonal Affective Disorder treatments include vitamin D and bright light – review Dec 2015
- All items in Winter Depression/SAD 35 items Nov 2011
- 36 percent less depression when have high level of vitamin D – July 2011
- Depressed people had less than 10 ng of vitamin D – July 2010
- vitamin D variations and mental health - Aug 2010 nice charts
- Depression in UAE peaks in the summer – probably due to sun avoidance – Feb 2011
- Several abstracts on vitamin D and depression – Y or N July 2010
- Less than 20 ng vitamin D increases depression by 80 percent – Dec 2010
- Depression 40 percent more likely if low vitamin D – Oct 2011
- SAD rate 10X higher in cloudy Seattle than sunny Florida - April 2011