Depression During the Holiday Season

As 2012 winds down to a close, it is the season for celebrating friends and family, festive atmospheres and the holiday spirit. For many, this time of year brings people close together as they bond through work parties, family events and gift exchanges.

But for some, the December season marks a time of sadness and withdrawal, especially for those who experience depression. Regardless as to whether or not the season is too overwhelming or marks an anniversary of something significant, it is important to know there are options for help.  Everyone has felt depressed at some point in their lives. It is normal to feel sad or down for short periods of time for specific reasons. But when the blues start to take over someone’s life, it is time to seek help. 

True depression often interferes with eating, sleeping, interacting with friends and family, and enjoying life.  Symptoms include feeling sad, down, overwhelmed, hopeless, dark and despairing. There may be problems concentrating, problems sleeping (or vice versa -- sleeping all the time), loss of appetite (or stress-eating), withdrawal, low energy, feeling guilty and more.

People may not want to engage with their families, they find shopping overwhelming, they do not want to get out of bed, going to parties seems like a chore. They may find themselves fighting with or avoiding their children and significant others.

Help is available but it is important to recognize the symptoms and realize that it is okay to seek support.  Talk to those around you. Talk with your health care provider, your counselor, your spouse, your church leader, your best friend or your mom.  Seek support groups online and realize that you are not alone. Seek support groups within your area as local community centers and churches often offer classes or sessions in a group setting.

If you are feeling blue because you are alone, the holiday season is a great time for volunteering!
Consider offering your services to play with animals at the shelter, work at the food bank, collect clothes for the homeless, wrap toys for children in need, or serve food for a church.

It is the time of year to call up friends you have not seen in awhile or create new traditions with others in your circle that are alone as well during the holidays.

December is often a dark and cold month for most of the United States, therefore consider getting a light box and use it daily.  Set it on your bathroom counter while you get ready in the morning or have it on your desk at work. The light box, commonly called full spectrum light, affects the pineal gland in the brain to improve mood and circadian rhythm.  If you can afford it, consider a vacation somewhere warm and sunny to break the monotony of snow or rain. Even going outside and enjoying fresh air can improve mood and outlook – consider skiing, snow shoeing, hiking, and sledding.
While antidepressant medications may be indicated, and can work quickly and effectively, natural remedy alternatives to consider include 5-HTP and L-tryptophan. They can both improve serotonin levels (the hormone involved with depression) but it is important not to take these with an antidepressant medication if you are on them already.

There has been a lot of stress and strife this 2012 year and as a result depression can be a natural reaction. If your sadness and blues are lasting longer than seem "normal" to you, seek help because it is there all around you. Do not be left down and out during this time of celebration.

Read more at the women's health website, Empowher.
References:
1. National Institute of Mental Health: Depression. Web. 23 December, 2012.http://www.nimh.nih.gov/health/publications/depression/index.shtml
2. Light Therapy as Effective as Fluoxetine for Seasonal Affective Disorder. Web. 23 December, 2012.http://www.medscape.com/viewarticle/491504
3. University of Maryland Medical Center: 5-Hydroxytryptophan. Web. 23 December, 2012.http://www.umm.edu/altmed/articles/5-hydroxytryptophan-000283.htm

5 Facts About the Hormone Testosterone for Women

When women think of the word testosterone they often think of MEN.  To sum it up, testosterone is what makes a man a man (so-to-speak) while estrogen and progesterone are often more associated with women.  However, testosterone is just as important to women but not in the same high level amounts.  These are five things about testosterone that may have you asking your health care provider for a test.

1)      Testosterone is made from cholesterol (its backbone) and another hormone known as DHEA.  DHEA is made in the adrenal glands and can help with stress, increased energy and low mood.  The more well known DHEA is DHEA-S, which is the one to test for.  Supplementing with DHEA should be done in the morning however; women should use lower doses than men.  The side effects can include increased anger, irritation, acne and inappropriate hair growth often on the face, nipples and chest.

2)      Testosterone helps significantly with energy, motivation, sense of well-being and sex drive in women.  When testing for this hormone, the total and free levels should be evaluated as the ‘free’ is active.  Testosterone has similar side effects to elevated DHEA and should be used with caution only under your health care provider’s direction.

3)      Keep in mind, testosterone is not a ‘magic pill’ for sex drive.  Many women have normal levels of testosterone and still find themselves lacking in desire.  A lot more goes into the libido for women than it does in men.  As women get older, their hormone levels overall change but so do their energy levels, sleep habits and stress which all interfere with their sex drive.

4)      Testosterone is made in both the ovaries and adrenal glands. Women who had their ovaries surgically removed may notice a significant decline in testosterone in the body.

5)      The birth control pill, if used correctly, protects against unwanted pregnancy but can also lower sex drive by lowering testosterone.  The pill increases a hormone known as sex hormone binding globulin that binds up excess free testosterone and gets rid of it from your body.  With less testosterone floating around, the desire for sex is less.

 

Just as a man might need testosterone replacement, so might a women but with significantly lower doses.  Consider asking your health care provider about testosterone and DHEA-S testing if hormone changes, fatigue, mood issues, and lower sex drive are occurring on a regular basis.  Your hormones may truly be out of balance.

References:

1.       Androgen Replacement Therapy in Women.  Web.  2 December, 2012.

http://www.medscape.com/viewarticle/773774_1

2.       Birth Control Pill Could Cause Long-Term Problems With Testosterone, New Research Indicates.  Web.  2 December, 2012.

http://www.medicalnewstoday.com/releases/35663.php

New Vitamin D Guidelines - Update or Bogus?

In the October 2012 issue of the science journal PLOS ONE, researchers determined that the appropriate level of Vitamin D for the average American is above 20 ng/ml which is 10 points lower than the original cut-off of 30ng/ml.  These new lab values have been picked up and supported by the Institute of Medicine and subsequently several insurance companies however other groups, such as the Endocrine Society, maintains 30 ng/ml and above is adequate.

There is a lot of research in general about Vitamin D.  It is touted as a vitamin (actually, it's a hormone) that helps with bone strength and support, muscles, mood (think seasonal depression in the cold winter months), autoimmune conditions (most all of them) and cancer protection/prevention.  The Institute of Medicine reports that the evidence is 'too conflicting' to really support a higher Vitamin D level in the blood yet reputed groups such as The Vitamin D Council and Life Extension coupled with the Endocrine Society think otherwise.

Does it matter?

I think so.  If research can point to higher levels of Vitamin D (as in the 50-100 ng/ml) range as even *possibly* helpful for bones, mood, autoimmune and cancer without side effects (assuming one does not overdose on Vitamin D), then let's support the *possibly* and take Vitamin D.  Anecdotally, patients often report just 'feeling better' at higher levels (as in above 20 ng/ml).

Either way, talk with your health care provider and request Vitamin D testing.  Vitamin D is a fat-soluble vitamin and does require other nutrients such as magnesium, zinc and Vitamin K, to work more effectively.    The Vitamin D3 form known as cholecalciferol, is the more appropriate form to take.

References:
Holly Kramer, Chris Sempos, Guichan Cao, Amy Luke, David Shoham, Richard Cooper, Ramon Durazo-Arvizu. Mortality Rates Across 25-Hydroxyvitamin D (25[OH]D) Levels among Adults with and without Estimated Glomerular Filtration Rate <60 .="." 7="7" font="font" nbsp="nbsp" one.="one." plos="plos">