Vitamin D for Depression with a Seasonal Pattern: an Effective Treatment Strategy
International Physical Medicine & Rehabilitation Journal
Low level of vitamin D is often associated with major depression with a seasonal pattern, formerly known as seasonal affective disorder under the DSM IV classification. Major depressive disorder is commonly observed during the fall and winter seasons in countries away from the tropical zone and is referred to as depression with a seasonal pattern under the DSM V classification. Here, we conduct a review of literature to address the factors highlighting the association between vitamin D level
... vitamin D level and depression with a seasonal pattern. Objective: 1) Review the epidemiology, etiology and pathogenesis associating vitamin D level and depression. 2) Provide treatment recommendations and practice guidelines for addressing vitamin D deficiency associated with depression with a seasonal pattern. Methods: Literature review on human studies published in English language from 2000-2017 using PubMed, EBSCO, and Google Scholar was performed. Results: Majority of published studies have associated low level of vitamin D to depression with a seasonal pattern. A high prevalence of major depressive disorder is observed in Northern latitude countries with severe, prolonged winter that experience little or no sunshine available within the wavelength that is necessary for cutaneous synthesis of vitamin D. A review of literature indicated that reduced exposure to sunlight is associated with low levels of vitamin D, decreased serotonin activity, an increased production of melatonin, and changes in circadian rhythm. Associated factors include socio-demographic (older age, female, higher BMI>25Kg/m 2 , geographical location), and clinical correlates including chronic pain, comorbid neuropsychiatric conditions, chronic diseases (hypertension, diabetes mellitus, autoimmune disorder), and musculoskeletal disorders. Treatment recommendations include light therapy, antidepressant treatment, psychotherapy, melatonin and vitamin D supplementation. Among all the modalities, vitamin D supplementation is an effective preventative and treatment strategy for the management of depression with a seasonal pattern. Conclusion: Sunlight exposure within the recommended wavelength promotes vitamin D synthesis from cholesterol in the skin. Vitamin D deficiency is observed among adults especially those residing in sunlight deficient geographical locations. Among vitamin D deficient individuals suffering from major depression with a seasonal pattern, early detection and vitamin D supplementation can be a simple, convenient, and cost-effective treatment strategy for improving symptoms and mental health outcomes associated with major depression.