In 2015 I was taking 25µg of vitamin D at about 8:30 and 18:30 then another 12·5µg before I went to bed, usually between 23:00 and midnight. 50µg is required to prevent dementia. The extra 12·5µg kept me out of depression. This is a total of 62·5µg (2500 IU) per day on top of the base level my body is currently producing and is just over four times the recommended daily allowance of 15µg (600 IU) for my age group. My experiences indicate that vitamin D has a fundamental role in normal brain function and is required in much greater amounts than currently supposed. Dismissing this as the placebo effect ignores the facts that:
There is a part of my brain that I consider as 'me' that is aware of my environment. It sees the piles of washing up, the laundry to be ironed, the dust and cobwebs, the rotting floorboards and window frames. It knows that life would be improved relatively quickly if those tasks were done. However I am unable to perform these tasks without authorization by some other part of my brain. With sufficient vitamin D this controller is able to factor in the future and schedule tasks accordingly. Depression occurs when vitamin D levels fall and the higher level decision making processes switch off and leave the brain in a more primitive mode where it can only authorize tasks out of habit or urgency. When I see that there are plates to be washed, with normal brain function I can think “I will do them now and make the place look tidier.” With depression the conditions for action might be “Do I need those plates now” and “Am I expecting visitors soon.” If the conditions are not met, the thought just fades away and the dirty plates become ‘out of sight, out of mind’. In severe depression I got used to running out of plates and finding myself doing the washing up right before cooking a meal. The The brain and dementia - Parts of the brain article on the Alzheimer's Society website describes the frontal lobes as being the ‘management centre’ of the brain. It says ‘They deal with solving problems, setting goals and making decisions, as well as with starting, carrying out and finishing tasks.’ It seems that this is the part of my brain that is being compromised by lack of vitamin D.
We like to think that we are in control of our own lives so we make excuses for the things that we are unable to do. The ironing and washing up do not get done because we are fed up with them. We stay in bed because it is warm and cosy. The doughnut that we know we should not eat is just our little treat. It is only when we begin to realise that we are unable to do the things that we want to that the feelings of hopelessness and suicide surface. We are not in control of our own lives. I prefer to be at work because my tasks are being actioned by someone else and I am able to get on with something useful.
SAD occurs as seasonal fluctuations in light levels move the brain in and out of depression. The periods when my brain is constantly cycling through tasks unable to make a decision occur in the autumn when my brain is on the threshold of going into depression. If I stop taking vitamin D, it takes about twenty-one hours before I start to notice a deterioration in my mental capacity. The effect on the depression is more complicated. I can take a tablet before going to bed and in the morning I am clear of depression. If I decide to browse the internet instead of getting on with jobs that need doing, I feel myself gradually losing the intention of doing those jobs after about an hour. If I realise what is happening in time I take a 12·5µg tablet and then get on with the task in hand. If not, depression takes full hold. The idea of taking another tablet is lost and I end up frittering my life away into the afternoon. If I begin a task while the depression is gone then I will see that task through to completion even if it takes several months, for example, renovating a room. It could be that once a task is begun other chemicals such as dopamine take over and keep the depression at bay or simply that the decision making criteria in the brain change and it becomes a case of “I've started so I'll finish.”
The fact that a dose is still effective after a night's sleep but only lasts about an hour when awake suggests that vitamin D is not consumed while we are asleep. It could be that we sleep to preserve vitamin D while there is no sunlight. Various studies (BBC Panorama - Sleepless Britain, Mobile Phones in the Bedroom: Trajectories of Sleep Habits and Subsequent Adolescent Psychosocial Development) indicate a range of symptoms including depression, reduced cognitive function and obesity linked to lack of sleep. These are the same as those I have experience so I wonder if this is because of a sleep deprivation induced reduction of vitamin D.
The abstract to ‘The Relationship between Excessive Internet Use and Depression - Psychopathology 2010;43’ states “Future research is needed to corroborate the existing evidence and address the nature of the relationship between Internet addiction and depression: there is co‑morbidity between these conditions that needs greater investigation.” The depression resulting from SAD results in an inability to initiate tasks and we resort to habitual activities. Browsing the Internet or playing video games are such activities. Spending long hours on the computer out of sunlight will lead to even lower levels of vitamin D and increase the depression. In 2010 a South Korean couple was arrested for allowing their three-month-old baby to starve to death while they played an online game for twelve hours. Although problems like me being unable to reply to my niece’s wedding invitation pale into insignificance in comparison, it makes me wonder if vitamin D deficiency may have been responsible.
25µg of vitamin D is only effective for one hour yet the amount of vitamin D in 240g of salmon was effective for much longer. I now have reason to believe that the omega‑3 fatty acids present in the salmon may be a cofactor in depression and dementia. I intend to investigate this hypothesis further.
The wallpapering episode indicates that there is also a long term effect related to the average level of vitamin D. When the base levels had fallen too far, a 12·5µg tablet was not enough to lift me out of dementia. The research paper Vitamin D And Dementia states: “In vitro studies suggest that vitamin D is involved in neurotrophic support by inducing nerve growth factors and neurite outgrowth in embryonic rat hippocampal neurons” and “In aged rats, decline in learning and memory was ameliorated by vitamin D3 supplementation via a subcutaneous injection.” It concludes with “Evidence from animal and cellular studies suggests that vitamin D has multiple functions throughout the central nervous system and could be implicated in the prevention and treatment of disorders such as dementia and AD.” I suspect that it will eventually be discovered that dementia is to vitamin D as scurvy is to vitamin C. The two common treatments for SAD are light therapy boxes and selective serotonin reuptake inhibitors (SSRIs). Both act to regulate serotonin levels so it could be that vitamin D performs a similar role.
Some of the more common symptoms include:
Some of these symptoms (such as problems with memory or concentrating, and withdrawal) are similar to those experienced by people with dementia. This is why assessment of someone for possible dementia will usually include ruling out depression first, in case depression alone, rather than dementia, is causing their symptoms.
- a sad, hopeless or irritable mood for much of the time
- a loss of interest or pleasure in activities that were once enjoyed
- feelings of low self-esteem, worthlessness or undue guilt
- feelings of isolation and of being cut off from other people
- sleep disturbance, such as early morning waking
- problems with remembering, concentrating or making simple decisions
- increased agitation and restlessness
- tiredness or loss of energy
- eating too little or too much, with weight loss or gain
- aches and pains that appear to have no physical cause
- thoughts of death and suicide.
My experience demonstrates that depression and dementia are two stages of the same underlying condition. After taking a 12·5µg tablet I have normal brain function for about 45 minutes. It takes only another 15 minutes to enter a state of depression. The rate of this transition suggests that the cause is excessive vitamin D breakdown rather than insufficient production. If I stop taking the tablets, my cognitive function starts to deteriorate after about 21 hours and declines sharply over the next few hours. My mother suffered from SAD but it had become year round by the time her cognitive function was declining significantly. She was initially diagnosed with depression but subsequently found to have Alzheimer's disease.
Sundowning, or sundown syndrome, is a neurological phenomenon associated with increased confusion and restlessness in patients with dementia. A multitude of behavioural problems begin to occur in the evening or while the sun is setting. It seems to occur more frequently during the middle stages of Alzheimer's disease and mixed dementia. This suggests to me that vitamin D levels continue to drop and eventually reach another threshold that is crossed each day as light levels fall causing brain malfunction in a similar way to the stress I experienced as the days got shorter at the end of the summer. The fluctuations superimposed on a much reduced base level could result in increased sensitivity to the change. It seems that there is a progression of vitamin D levels affecting successively higher levels of brain function. There are three main explanations for why humans lack fur. Another possibility is that we lost our body hair in order to maximise vitamin D production and allow our brains to function at the highest level.
Because I was going from full mental capacity to near dementia every day, the differences in my brain function became more apparent over time.
When I first began suffering from SAD I thought it was just after effects of the emotional breakdown. Both result in a state of listlessness. When I began writing the paper for Nature magazine, I hit a wall of procrastination. I had already written this website content but, when it came to summarizing it, my writing seemed naive and I was worried that I was not conveying the information effectively. I was unable to focus on writing and inevitably ended up browsing the internet instead. I began to think that I was still suffering from depression but the fact that I was even making the decision to sit down and write made me realise that it was something different. It seems that the listlessness produced by emotional trauma, SAD and procrastination is because the brain is unable to authorize tasks and we resort to our favourite pastimes as a default. With emotional trauma it becomes so preoccupied with reliving the event(s), continuously contemplating what should have been done and rehearsing what to do in the future, that it is never free to action everyday tasks. This problem can be resolved with the help of a psychologist or a good friend. SAD is caused by vitamin D falling below the level required for proper brain function. Procrastination arises when the brain is simply unable to decide what to do through lack of confidence because of things such as inexperience and fear of humiliation. When depressed we are able do tasks when they become urgent. Likewise with procrastination we are better able to get on with the work as the deadline approaches.
There are noticeable changes of brain state from 'fantasy' to 'real life' mode. With depression, while walking home from work I might be thinking about all the things I need to do and formulating a plan of action in my head. When my house comes into view my brain begins to switch mode and I feel a sense of foreboding, the kind of feeling that may cause spiritual people to seek the help of a medium or a Feng Shui expert. By the time I am inside the door, that plan is forgotten. With procrastination the switch is more acute. I may be sitting at my computer struggling to find the words to express my thoughts clearly and succinctly. I get up to make a cup of tea and right away the perfect words are going through my mind. I sit back down and struggle to remember the elegant phrase I was just thinking about. On one occasion I felt my enthusiasm drain as I crossed the last couple of metres towards my chair. I stepped back and felt my spirit lift. It was as though as though the chair had a force field around it. The same switch occurs any time we imagine a task and then face the reality of putting it into action. We rehearse a theatre production in the company of acquaintances and dream of the perfect performance and good reviews. When it comes to stepping in front of an audience, fear and self-doubt manifest themselves in the form of stage fright.
© Copyright 2020 Andrew Jarvis.