Seasonal Affective Disorder: Is It Impacting You?

Dr. Mike: Dr. Mike here. So, you just can't shake the winter blues? Well, maybe it's Seasonal Affective Disorder. Stick around to learn more.

Live Foreverish Introduction: You're listening to Live Foreverish, a show dedicated to helping you live just a little longer. Here [are] your hosts, Dr. Mike and Dr. Crystal Gossard.

What Is Seasonal Affective Disorder? 00:00:17

Dr. Mike: All right, Dr. Crystal. We're going to be talking about seasonal depression disorder—or as some people call it, Seasonal Affective Disorder (SAD). Either way, they're interchangeable for us today. I'm glad we are [talking about it], because it’s not just the winter blues.

Dr. Crystal: That's true. It's more than just feeling a little down because the skies are gray.

Dr. Mike: Yeah. And maybe you're stuck inside a little bit.

Dr. Crystal: Right. Well, it's a subtype of Major Depressive Disorder.

Dr. Mike: Right. Yeah. It's a subtype, meaning it has all the same criteria. We're going to get into all this—how you're diagnosed and stuff. So, stick around for today's show.

Plus, we have some really good suggestions for you. We know that when winter hits…there's that song—I know Dana Dye, our writer, wanted me to say—“Summertime Blues.”

Dr. Crystal: Yes.

Dr. Mike: She's like, “That's a good song, but the blues are likelier in the dark winter.” We know [during] winter there's less sun. Even when it's daylight, it's at less of an angle, so it doesn't seem as bright.

Dr. Crystal: Right.

Dr. Mike: It gets darker quicker. We know there's less vitamin D production that happens when it's winter, especially in [places in the] northern hemisphere.

There's all this stuff that goes on [during] winter. That right there can cause some people to be blue [or] down a little bit. But for those where it's more severe and it's happened before…

Dr. Crystal: Right. For at least two years. So experiencing seasonal depression for at least two years and having more seasons of depression than seasons without depression.

Dr. Mike: It's almost like a cycle. It's like wintertime comes; I get hit by it. I get a little bit better in spring and summer. Fall comes, and you're following this cycle. Which is why it's also a subset of bipolar [disorder], we think.

Dr. Mike: We never really cleared that up, but I think that's where it comes from.

Dr. Crystal: According to the DSM, or Diagnostic and Statistical Manual of Mental Disorders, that's how it's classified.

Dr. Mike: Yeah. So, this is a serious diagnosis.

Dr. Crystal: Well, yes. And again, it's more than just a depressed mood.

Dr. Mike: Well, let's go through them. Here we go—here's the list.

Dr. Crystal: It’s a loss of interest in daily activities, feelings of worthlessness, thoughts of death, disturbed sleep, fatigue, difficulty concentrating or making decisions, change in appetite or change in activity—and unfortunately, [this significantly] increases the risk of suicide as well as other health conditions.

Dr. Mike: And again, these are pretty much some of the same criteria you find in major depression—that's why it's a subset of it. I didn't look this up—forgive me. If somebody wants to fact-check me, that's fine.

I think it's four or more of these, or three or more of these symptoms, in that cycle that we talked about. It's not just one; it's not just a depressed mood. You [must] have a couple more, and it needs to be repeated.

That's how you get your diagnosis. Let’s talk about the cause a little bit. Out of all this stuff we've looked at preparing for this and some of the stuff we said at the intro—where do you fall?

Can You Test Your Levels for Seasonal Depression Disorder? 00:03:50

Dr. Crystal: I'm going to go back to your conversation about fall [and] winter [having] less sun. We know there's a connection between the sun, or light, in the production of serotonin.

I'm falling [into] that category. I like that theory where diminished sunlight affects the production of serotonin—that's our feel-good brain chemical.

Dr. Mike: It's your wellness one. It's “things are good.”

Dr. Crystal: Things are good. Things are great.

Dr. Mike: Serotonin says to Dr. Crystal, “You're doing good. It's a good day.”

Dr. Crystal: Right! So, you're unable to produce or even maintain serotonin levels. When you think about Major Depressive Disorder, most of the drugs to treat it [are]…

Dr. Mike: …are focused on serotonin.

Dr. Crystal: …focused on serotonin, improving serotonin’s availability.

Dr. Mike: Yeah. I think that's definitely a part of it. I like this—I think it's spot on.

But if you're going to make the case of sunlight and a certain thing, I can too. It's vitamin D.

How Is Vitamin D Linked to Seasonal Affective Disorder? 00:05:04

Dr. Crystal: No arguments here.

Dr. Mike: We also know that [during] winter, the angle of the sun is different. It's just [not quite] enough to stimulate good vitamin D production in your skin—especially in the United States if you live [north of] the 37th parallel.

Remember, I thought it was the 34th and I got it wrong. It's the 37th parallel.

To help people visualize, think of the United States, look coast to coast [and] draw a straight line through Dallas. It's somewhere around there. If you're north [of] that line, you're not making vitamin D.

Dr. Crystal: We know that vitamin D is connected [to] all sorts of health…

Dr. Mike: What do you even say about it?

Dr. Crystal: Good health, bad health or however you would like to look at [it]. We know there's that association.

Dr. Mike: I always like to say [it] because I just like it—I think it's so cool. There is a receptor on every cell line for vitamin D. I think there [are] maybe 1 or 2 exceptions, but vitamin D is influencing pretty much every tissue.

Dr. Crystal: We know lower levels of vitamin D have been observed in depressed patients compared to controls. So, there's that association. And you know, Dr. Mike, we're not saying cause and effect.

Dr. Mike: No. Because ultimately, we don't know.

Dr. Crystal: Right.

Dr. Mike: This is all theory. It's all very interesting. I think the theories are good and solid, but we still don't know exactly.

Dr. Crystal: But you know, Dr. Mike, maybe my theory or my idea is the real deal.

Dr. Mike: It could be.

Dr. Crystal: The sun impacts the production of vitamin D. Vitamin D levels in the central nervous system (CNS) impact the production of serotonin and dopamine.

Dr. Mike: So, vitamin D drops in the CNS. [Then], serotonin and dopamine drop in the CNS. There's your serotonin connection as well.

It's not just sunlight with serotonin. It could [also be that] D is the issue there. Maybe D is a way to get the serotonin low. [Low] serotonin, just like in regular depression, is really the issue here. Uh oh! But we still don't know.

Dr. Crystal: I mean, these are strategies. And we'll talk about how you can get more light, how can you improve your vitamin D.

Dr. Mike: Right now, there is more research [on] depression in general—on sunlight and D. We already know boosting serotonin can help in all forms of depression. That's why you have the drugs. But we wanted to focus a little bit more on D because that's something so simple.

Dr. Crystal: And so inexpensive.

Dr. Mike: Cheap, yeah. The blood test for it, to know [how much D is] in your blood, [is] so cheap. We’re going to get into all that.

And the reason: There are many studies, but we have one where 235 adolescents with any form of depression received 2,250 units of vitamin D3. [The] control group received just 250 for nine weeks.

I'm not going to go into all the details. At the end of the day, those receiving the higher [dose of] vitamin D did better.

Why Is It Important to Test Your Vitamin D Levels if You Have SAD Symptoms? 00:08:29

Dr. Crystal: Yeah.

Dr. Mike: That’s just one example. There's one here [on] Major Depression Disorder—1600 units versus placebo. Again, [there was an] improvement.

Dr. Crystal: I would note that last study was a seven-month study. So, sometimes you want to make sure you get those levels up and maintain [them]. [Don’t] assume that it's going to happen overnight.

Dr. Mike: You mean getting the vitamin D levels? No, it’s going to take some time.

Dr. Crystal: And improvement in the symptoms, too.

Dr. Mike: The only way to get the D levels up quickly would be [to do] high-dose injections.

Dr. Crystal: Some doctors will do that.

Dr. Mike: Oh, yeah. There's nothing wrong with that. If you really want to get them up there quickly—25,000 or 50,000 units—a big injection, and then [you start taking it orally]. That'll get you up fast.

Dr. Crystal: Right. My dad's doctor did that with him.

Dr. Mike: But in these studies, they didn't do that. They started with the basic pill of 2,200 units and the other one of 1,600 [units].

But here's something we always talk about, though. You should take vitamin D every day.

Dr. Crystal: That was the point I was trying to make—I'm not sure if I was that clear. But [when I read], “Seven months,” it tells me I need to take vitamin D and always make sure that my levels are adequate.

Especially if [I have] mental health issues—specifically depression—a genetic predisposition or something that I deal with, I need to make sure I have adequate vitamin D.

Who Is Most at Risk for SAD? 00:10:10

Dr. Mike: Yeah. I almost didn't want to do this, but I am because even if you have no risk factors for anything, you should know your vitamin D level. That's just my opinion.

I remember doing lectures, and most of the people in these lectures were 45, 55, 60 years old or something like that—you know, you've done it before. I would ask, “How many people here know their cholesterol level?” and everybody [knew].

[Then, I would ask], “How many people know [their] vitamin D level?” Like maybe three [people knew].

Dr. Crystal: No one.

Dr. Mike: You want to throw that one in there, too. It's pretty cheap.

I think everybody [should take it] but if you have some of these risk factors for SAD—women get it the most, [if there’s] family history or you're living more in those northern latitudes [above the 37th parallel].

Dr. Crystal: I think this was good to go over, Dr. Mike.

Dr. Mike: Young adults, 18 to 30, are going to be the biggest ones hit. And of course, this is thrown in there, but isn't it really for everything? Genes are involved.

That's all it says. I don't really know what the conclusion of that was. If you’re there, please check your vitamin D. But—and this is a big but—check it anyway even if you're not. So—it was a moot point, I guess.

Dr. Crystal: True. But even more important, if you find yourself in some of those other categories.

Dr. Mike: Let's talk a little bit more about vitamin D and how much people should be taking. And let's talk a little bit about blood level.

Dr. Crystal: Right. So, RDA is about 600 or 800 IUs. Most people will find that they may need more than 2,000, 5,000 or even up to 8,000 international units of vitamin D to reach optimal levels.

Now we should probably give some clarification on [what’s] optimal because with the RDA amounts—600 or 800—you may be able to get your levels in the normal range on your typical lab work. But what's considered normal, like above 30, 35 or so [in] the 30s—I don't have the exact numbers—may not be enough for optimal health.

Dr. Mike: Of course. Remember, those RDA numbers are about protecting from diseases of deficiency. So if they say 30 or 35 is normal, that's fine. You [won’t] get rickets. But you may not get all the other benefits attributed to [high levels of] vitamin D.

Dr. Crystal: I like that. You're right—that's it. The RDA is designed to prevent diseases caused by a deficiency of that nutrient.

Dr. Mike: Avoiding rickets is great, but I want to do more. That's where we can come up with these optimal numbers.

Dr. Crystal: So, it's pretty personalized. Optimal vitamin D levels [are] 50 to 80 nanograms per milliliter. That's your goal.

More is not always better. We like to think sometimes, “You're vitamin D. You’re so great—I'm going to take as much as I can.” Don't do that. If you're taking a liquid, please measure it.

Dr. Mike: [You have to] be careful with the liquid.

Dr. Crystal: I have taken our liquid. My husband walked in one day, and I had the dropper. I [was] going all in with the dropper. He was like, “What are you doing?” I said, “Okay, you're right. Maybe I shouldn't do that.”

Dr. Mike: You [have to] be careful with that.

Dr. Crystal: Those are some considerations when you're looking at the add-ins and what to look for in your lab work. If you're above 80, you may need to cut back.

Dr. Mike: Yeah, you may just go to every other day dosing, talk to your doctor or just stop for a couple of weeks.

Dr. Crystal: And make sure your doctor is looking at your labs. Let your doctor know, “Hey, doc, I'm taking vitamin D, so can you just add it to a routine lab work?” Insurance typically covers it. Easy breezy. Ask for it.

Dr. Mike: Not a problem. I do 5,000 a day. If I ever miss a day, I take a break on Sunday. I don't know why. I just do sometimes. It's okay, because my blood level is in the upper 70s nanograms per mil. And that's 50 to 80.

Dr. Crystal: Yeah. That’s great. We touched on vitamin D—that was Dr. Mike's theory. Can I go back to light and talk about light therapy?

Light Therapy for SAD 00:15:01

Dr. Mike: But wait—before you do that, one more thing. Not about vitamin D.

Dr. Crystal: Okay. He wants to [talk more about] vitamin D.

Dr. Mike: It's about serotonin. Because we're also saying serotonin is playing a role here as well. We just talked about D. What about serotonin? One of the things I'm not going to get into details: saffron extract.

Dr. Crystal: Oh, yes.

Dr. Mike: Just leave it there. Go to LifeExtension.com and look up saffron. You'll see that it can help with serotonin.

Dr. Crystal: Yep. Then try light therapy if the skies are grey.

Dr. Mike: Yeah. Well, okay. But explain that [it’s] not just going outside when it's a sunny day.

Dr. Crystal: It's not. This includes a light box device that emits bright light to simulate sunlight. You use it when you wake up, [about] 20 to 30 minutes in the morning—some people a little longer.

You want to make sure the light box provides 10,000 lux of light with as little UV light as possible. But light therapy is among the first-line therapies for Seasonal Affective Disorder.

So, I think you do light therapy and [add] vitamin D. Hopefully, you'll see some improvements.

Dr. Mike: Yeah. One of the things about light boxes, too—I have learned [to] look for ones that are certified because they are guaranteed at 10,000 lux and low UV light. I think it's funny because they remind me of my sisters’ makeup mirrors that they had in the bathroom.

Dr. Crystal: I have one! I have one here in the studio. Is it the trifold one?

Dr. Mike: They had these ones that opened up, and they would just be doing [their makeup]. But those weren't light therapy. That's what some of them look like.

I also saw—because I was curious what's happened recently with technology—they're smaller now. You can get ones that almost look like little iPads that are on a stand. But the key thing is [that] it needs to be concentrated on you [at] 10,000 lux.

Dr. Crystal: All right.

Dr. Mike: There [are] different [ones]. Just make sure it's certified.

Dr. Crystal: There you go.

Dr. Mike: Lightbox—I like it. I think it's great. It makes sense.

And ultimately, there [are] a lot of theories there. But at the end of the day, it's down to serotonin because that light's hitting your eyes. When light hits the eyes, melatonin [goes] down [and] serotonin [goes] up.

Dr. Crystal: There you go.

Dr. Mike: I like it.

Dr. Crystal: And that has nothing to do with the UV.

Dr. Mike: Yeah, nothing to do with UV. It’s okay.

Dr. Crystal: It’s specifically the light…

Dr. Mike: Yeah. You're not [going to] get sunburn.

Dr. Crystal: …and the serotonin that's being produced.

Dr. Mike: That's why it's low UV. You don't have to worry about any of that stuff. Then there’s, of course, Dr. Crystal—you have to say the next one.

Physical Activity and Mood 00:17:41

Dr. Crystal: I have to say it: physical activity.

Dr. Mike: Physical activity. That’s just it.

Dr. Crystal: Physical activity in general. We're not talking about Seasonal Affective Disorder, specifically—just physical activity. It also boosts serotonin.

Dr. Mike: It helps any mood disorder or issue, even anxiety and panic disorder—all [of] that is helped with some exercise. I like the way we're moving away from saying the word exercise and we're just talking about activity.

There [are] many ways to get that activity in. When people say [exercise], they automatically think treadmill, gym or jog. It limits what people are thinking. But pickleball…

Dr. Crystal: House [chores].

Dr. Mike: Basketball.

Dr. Crystal: Vacuuming. I think we did a whole blog on that.

Dr. Mike: Gardening. Walk for 10 minutes and then go and pick weeds. Seriously! That’s an activity. All of that counts...across the board.

Dr. Crystal: It does. Movement.

Dr. Mike: Yeah. And of course, if you're doing things like walking, for instance—we know that just walking 10 minutes can have a significant effect on your body and mood. If you can push 20, do 20 minutes.

If you can push 30, do 30. A little bit more will be better. But it's okay—start where you [have to] start.

Dr. Crystal: You can take exercise snacks. Remember, Dr. Mike.

Dr. Mike: I remember when we first talked about that, I was thinking, “Oh, she's snacking between exercises now.” But that's not what it was.

Dr. Crystal: No, the short bursts. Those can be helpful as well.

Diagnosis and Therapy Importance 00:19:23

Dr. Mike: Okay, there you go. Of course, [I have to] throw it in—if you need a therapist, please go see a therapist.

Dr. Crystal: Well, you should be getting a diagnosis from a licensed professional. Let's just say that.

Dr. Mike: Even if you're feeling a little blue. You know my position: I think everybody should have a therapist and see them once a year no matter what. You think things are okay, [but] that therapist will bring out stuff.

Dr. Crystal: I know. It can be so healing. I think that's something that people overlook—the power of mental health and how that even translates to better physical health.

Dr. Mike: If you have to have an antidepressant, take it.

Dr. Crystal: Take it.

Dr. Mike: I'd rather you not be depressed than not take it.

Dr. Crystal: Take it and take your vitamin D.

Dr. Mike: Okay. Excellent. I thought this was fantastic. A lot of good information.

Don't forget, you [can] go to LiveForeverish.com—over 550 other episodes you can download, like, share, and of course, we want you to start giving us ranked-star reviews. [It’s] very helpful. Share, share, share, and subscribe. We've got a lot for you to do over there.

Dr. Crystal: So, you never miss a show. Turn on your notifications for your app—whichever app you're using.

Dr. Mike: We're adding a lot of things they [have] to do now.

Dr. Crystal: Checklist.

Dr. Mike: Check this. Check this—subscribe here. Do that. But you guys know how to do it—they do it all the time.

Dr. Crystal: They do.

Dr. Mike: So do it to [us].

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Dr. Mike: You're going to have to write this in the script again. Remember, you used to do that. Robson, she used to write it on the script for me.

Dr. Crystal: Maybe it's there.

Dr. Mike: It is there!

Dr. Crystal: So, LifeExtension.com. Discount code: “PODCAST” [for] 10 percent off, $50 or more, plus free shipping.

Dr. Mike: I guess I should start looking at the script a little more.

All right. Thank you, guys, so much. I'm Dr. Mike. That is…

Dr. Crystal: Dr. Crystal.

Dr. Mike: Thanks for listening.