Can Vitamin D Really Help Ease Depression Symptoms? What About Other Nutrients?
Vitamin supplements can help fill in nutritional gaps in your diet and boost levels in people who have vitamin deficiencies. But the role of supplements in reducing depressive symptoms remains questionable.
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A number of studies in recent years have looked at whether taking vitamin D supplements can reduce the risk of many health concerns, including heart disease, certain metabolic disorders, and even bone fractures. While several studies suggest that vitamin D supplementation may not be the solution to those conditions, recently published research does make a case for this vital nutrient as a means of easing symptoms of depression.
The review of 41 international studies, published in the journal Critical Reviews in Food Science and Nutrition, suggests that vitamin D supplementation may alleviate depressive symptoms in adults with depression. However, the researchers also note that large clinical trials could better answer the question of just how helpful boosting vitamin D levels might be in helping people coping with depression.
David Mischoulon, MD, PhD, director of the Depression Clinical and Research Program at Massachusetts General Hospital, cautions that the role of vitamin D deficiency and its relationship to depression has been the source of many controversies, including some very intense debates.
“Much of the disagreements observed seem to be based on discrepancies between what we see in clinical trials versus in the real world of practice, as well as theories about the underlying mechanisms that might explain the connection between vitamin D and depression,” he explains. “Designing clinical studies can be complicated. Furthermore, individuals who volunteer to participate in clinical trials may differ in various ways from those people who do not, and this can make it difficult to generalize the findings to larger populations. Meta-analyses, which group various studies together, artificially creating a larger sample, represent a step forward in understanding the impact of vitamin D on mood; however, meta-analyses are only as informative as the studies that they examine. Ideally, we need large-scale prospective studies that can give more conclusive evidence.”
Vitamin D and Depression
One mechanism that might explain how vitamin D supplementation could make a difference in people with depression is that vitamin D may positively impact serotonin and melatonin metabolism, which could account for some of its effects on mood regulation and sleep, Dr. Mischoulon says.
Serotonin is a neurotransmitter, or chemical messenger between brain cells. Research suggests that low serotonin levels may play a role in depression; however, that is also a somewhat debatable theory. Melatonin is a hormone involved in the sleep-wake cycle. Poor sleep is both a risk factor for depression and a symptom of the mood disorder that affects more than 5 percent of adults over the age of 60.
Vitamin D also appears to play an important role in regulating inflammation in the body—a risk factor for depression. But even that association may not provide a solid explanation of any vitamin D-depression connection. A study published earlier this year in Natural Translational Psychiatry suggests that depression can exist independently of inflammation in older adults. The study noted that all older adults with depression don’t necessarily have elevated inflammation levels unless they already have an inflammatory condition such as arthritis.
So Why the Interest in Vitamin D?
The reason consumers and researchers may look to vitamin D as a potential game changer for depression and many other health problems may lie in the hope that there are nutritional approaches to managing many psychological and physical conditions.
“Obviously, most people would find it more acceptable if they could treat their depression with vitamin D as opposed to taking a prescription antidepressant,” Dr. Mischoulon says. “For many, the ability to manage themselves with over-the-counter supplements reduces some of the stigmas associated with psychiatric disorders, and gives the individual more independence in terms of self-management. This may explain the popularity of vitamin D and other supplements of that sort.”
But Vitamin D isn’t the only nutrient associated with boosting mood. For example, there is a well-established link between the B vitamins and mood, Dr. Mischoulon says. Folic acid (a form of vitamin B9) deficiencies have been linked with depression, and studies have shown that replenishment of folate can provide a real benefit.
“Even providing supraphysiologic levels (greater than those naturally found in the body) of folate in people who are not deficient per se has also been shown to alleviate depression, usually in conjunction with a standard antidepressant in people who did not fully respond to the antidepressant in the first place,” Dr. Mischoulon says. “Vitamin B12 deficiency also has a link to mood and other neurologic problems, though the link with depression itself is not clearly established. Certainly deficiencies in these vitamins should be corrected as soon as they are discovered, but their overall impact on mood remains to be well characterized.”
While deficiencies in certain vitamins require supplements, many nutrients essential for optimal physical and mental health can and should be consumed in food.
Dealing with Depression
While there is certainly no harm in eating healthier and monitoring your levels of vitamins B and D—which can be done as part of routine blood work—it’s important to understand that a better diet and other lifestyle changes may not be enough to effectively manage depression. There are many examples of super-fit athletes and otherwise healthy individuals who struggle with depression or are in treatment for it.
“As a general recommendation, I advise people who suspect they may be depressed or notice a few or many symptoms associated with depression to obtain a professional evaluation from a qualified clinician,” Dr. Mischoulon says. “Lifestyle interventions such as improving sleep, exercise, and stress management, among other things, have been shown to have beneficial effects on mood and in some cases may be adequate as a sole treatment. However, some forms of depression are more serious and may require antidepressants or other therapies that have been more rigorously tested and demonstrated to be effective, particularly for more severe depression.”
Dr. Mischoulon acknowledges that many individuals may be reluctant to pursue traditional talking therapies or antidepressants, either because of past negative experiences with them such as the side effects, weight gain, etc., or because of stigmas attached to their use.
“However, trying to self-medicate is never a good idea,” he adds, which “may often result in the individual delaying proper treatment and potentially experiencing a worsening of the depression.”
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