Under The Weather Or Depressed?

For whatever reason, until today, I’ve been feeling really run down with no energy or motivation to do anything. My sleep’s been OK, but I felt more tired than usual. My ability to focus and concentrate was definitely affected, and my wife even called my mood "morose." Ouch. I hope my bad mood didn’t rub off on my three boys.

The reason for bringing this up is that today, I feel great all of a sudden. The only difference that I can think of is that the sun shined in New York City for the first time in days, maybe even over one week. We’ve had either rain or overcast weather most of June. 

I realize now that I was probably suffering from a mild case of seasonal affective disorder (SAD), which affects susceptible people who either don’t get enough sunlight or during the winter season, when there’s much less sunlight. I didn’t think I could have this, but I guess things change as you get older.

For prolonged cases of SAD, bright light therapy is one way to treating this condition. Another way is to spend more time outdoors, even with the overcast skies. 

How many of you were also under the weather this past week?


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5 thoughts on “Under The Weather Or Depressed?

  1. Dr. Park,

    Numerous research studies show the relationship between lack of sunshine and it’s effect on mood. Psychologists have known for quite some time that SAD (Seasonal Affective Disorder) is a real syndrome. I’ve treated many patients in my practice with this condition. Studies also suggest there may be a relationship between low vitamin D level and certain types of diseases. As routine care, many primary care physicians order Vit D lab tests for their patients. In my practice, in addition to helping patients overcome depression through CBT (Cognitive Behavior Therapy), I emphasize a total health program. Advances in scientific nutrition tell us that it’s not just a healthy diet, but the right kind of healthy food that can stabilize and even enhance mood. Similarly, it’s the right kind of exercise that can elevate mood. I’ve seen some remarkable changes in my patients’ overall functioning when they incorporate the proper diet, exercise and sunlight exposure into their lives. –Mitchell S. Levy, Ph.D., P.C.

  2. You’re absolutely right about the interaction between Vitamin D, sun exposure, and well-being. I didn’t want to get into all the scientific details of the benefits of sun exposure, but I do think Dr. Mercola’s take on this issue is something worth considering.

    One major change that I made in my life recently is to join a running club, which runs at 8AM every Saturday. Some of my other runs during the week are also in the mornings. I used to be a night owl, but ever since I started my running schedule, I’m now a morning person! I’m sure that more consistent sun exposure also had something to do with it.

    I agree that in general, we’ve gone overboard with the skin cancer issue. The immunologic benefits of moderate sun exposure probably outweigh any increased risk of skin cancer.

  3. I am concerned that you may be obstructing your airway more than you realize and as a result suffering its consequences. Would a night spent with an APAP machine with a smart card be possible? I don’t mean to sound like your mother telling you what to do, and I am obviously not your physician, but I couldn’t help but speak my mind.

  4. I’ll second the Vitamin D possibility. I grew up in Upstate NY. I used to say in”in NY, you don’t tan, you rust”. Vitamin D deficiency is far more common than people realize and in NYS it is epidemic. It is impossible to make adequate Vit D from sunshine for nearly half the year, even if one tries (and no matter where people live, if they use sunscreen, aren’t exposed to midday sun on a regular, year-round basis, they are likely to be deficient, especially if their skin is highly pigmented).

    Even where I live in “sunny” So Cal, nearly everyone I know who gets their 25 (OH)D level tested is either deficient or really low in the reference range (ref range is 30-100 ng/mL). My SD gynecologist says 80% of her patients are deficient or have very low 25 (OH)D levels. Perhaps in So Cal because there is so much emphasis on youthful appearance, we mistakenly try even harder to avoid the nearly always present sun and the foods that contains some Vit D (natural fats and organs from animals raised outdoors on pasture, yolks from outdoor chickens, etc.).

    Recommendations for Vit D are outdated and were determined to prevent rickets in infants. Now research is showing that Vit D receptors are all over our body and very important throughout life for far more than bone and dental development and maintenance. Optimal Vit D serum levels seem to be at least >50ng/mL, with some evidence that 60-80 ng/mL is even better. I try to make sure my family stays in that range through a combination of sun exposure and supplements.

    We have noticed exceptional resistance to cold viruses, with either no colds or very short mild colds that end within 3 days of doubling our Vit D dose. My husband (he was skeptical) and I had an opportunity to test this theory when he returned from a long weekend trip cross-country with our son. I had worked at home alone those 3-4 days, so I wasn’t exposed to anyone with or without a cold. My husband had a flare-up of diverticulitis during his return trip home and we went to Urgent Care within an hour after his return. Our son went to the neighbor’s house. In Urgent Care we waited among many very sick people. Within two days my husband and I had the symptoms of a cold beginning. I doubled my Vit D dose from 4000iU/day to 8000iU (my 25 (OH)D level on 4000iu is about 50-60 ng/mL). My husband had only been taking 2000iU and he often missed some days. He did not change his Vit D dose. He suffered for 2-3 weeks with that cold that turned into a lingering cough (and spread it around his lab). I had symptoms for 2 days (sore throat, stuffy/runny nose), then by the 3rd-4th day the cold was entirely gone with no lingering effects. Our son was taking 4000iu daily, had a 72 ng/mL Vit D test result, and he didn’t get the cold at all. You bet my husband wanted to raise his D3 dose then. A month later we visited my family in the NE at Christmas and a raging cold started with my BIL the night we arrived, then spread around. Our family doubled our D3 dose again and no one got the cold, but everyone of the NE family members came down with it sometime that week, except for my 73 yo dad, who takes the supplements I send him for his birthday and Father’s Day.

    Not long afterward my NE family members wanted to know more about Vit D, so they all had their 25 (OH)D tested. All of them were severely deficient (under 25 ng/mL, especially the ones who use sunscreen religiously (the teenage girls). The all take Vit D now, though not all of them take enough. They all thought their D-fortified milk and multi-vit or calcium supplement was adequate. It isn’t.

    I have found that the Vitamin D Council’s recommendation for 1000iu oil-based D3 (not D2, or hard tablets) for EACH 25 pounds of body weight is a good and safe guideline for achieving a 25 (OH)D in the mid-range of the reference range (for most people). Of course, the best way to know for sure is to test the 25 (OH)D twice a year – late winter/early spring and again in late summer/early fall and adjust D3 dose accordingly. My family’s HMO doctors don’t have a problem ordering the test *if asked*, but another way to check Vit D status easily and inexpensively is to participate in a University of California research faculty “call to action” study on Vitamin D via http://www.grassrootshealth.net. Grass Roots Health mails out inexpensive mail-in blood drop tests that can be done at home without a doctor’s order (except in NYS) as part of a study on health and Vitamin D status.

    In addition to supplementing with Vitamin D, I also try to get more sun exposure now. I had a basal cell carcinoma removed from my nose 10 years ago and repaired with a skin graft (so I do understand the skin cancer issue) and then I avoided the sun scrupulously for many years. It was like living in a cave without the sun. Now I am prudent and avoid burning, but I try to get 15-20 minutes of midday sun on a regular basis and don’t use sunscreen very often anymore (I use fabric, seek the shade, wear a hat, etc. more often than sunscreens). My mood, sleep, strength, balance, and energy level improved. The basal cell experience *was* a big nuisance (the graft takes up to a year to fully heal), but the effect of sun avoidance was far worse for my overall health in so many ways than the problems from the basal cell cancer. I tried sun exposure without supplementing Vit D but my D level went down to 40 ng/mL, which I consider too low. I feel far better in many ways when it is above 60 ng/mL.

    I also noticed my skin is far less sensitive to the sun now that I have greatly reduced omega 6 PUFA vegetable oils from my diet. I do not avoid naturally saturated fats or cholesterol. When I was in my 20s and consumed a lot of PUFA omega 6 oils and avoided cholesterol, I developed brown spots on the backs of my hands, sunburned easily, and developed the basal cell carcinoma. Those issues seem to have stopped (I’m 47 yo) and the older brown spots have faded considerably. I think the unstable PUFAs in the skin cell membranes are damaged more easily by UV exposure than when the cell membranes include more stable fatty acids from saturated fats.