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Winter’s Dark Days Bring the Body Blues
by Nancy Schatz Alton

Come fall, female Seattleites face a health-altering lack of bright light. Seattle places second among major American cities, second only to Anchorage, in the quest for northernmost latitude, leaving us with a scant 8.5 hours of daylight on December 21. Match that with a high-percentage of overcast days – there were 24 cloudy days in December 2003 – and it seems the rain is the least of our worries.

But how do short, dreary days affect our physical well being? We’ve all heard about SAD (Seasonal Affective Disorder), but that’s not gender-specific. The Body Blues, a term coined by University of Washington professor Marie-Annette Brown, Ph.D., R.N., is a type of mild mood disorder that is found almost exclusively in women. The main symptoms are eating too much and gaining weight, low energy, irritability or tension, sleep difficulties, difficulty concentrating or fuzzy thinking, daytime drowsiness, decreased interest in sex, mild anxiety, mild depression, and heightened sensitivity to rejection or criticism. Living in a low-light environment can trigger the Body Blues, while soaking in light every day helps reverse its symptoms. Pair daylight with 20 minutes of brisk walking and a handful of vitamins, and you’ve got the cure for the Body Blues.

Although only recently identified, the disorder has actually plagued women for centuries under different guises. In the 19th century, this female problem was thought of as a neurotic or nervous depression. The Victorians attributed its symptoms to fragile female constitutions or even a woman’s “willful deviation from traditional femininity.” Today we call it many things: PMS, the baby blues or mild post-partum depression, winter depression, and perimenopausal and menopausal symptoms.

It wasn’t until the 1990s that scientists linked serotonin activity in a woman’s brain to her production of estrogen. Researchers have found that a dearth of serotonin, called the brain’s primary feel-good chemical, is one of the causes of several conditions, from sleep problems to bulimia. After this finding, scientists discovered that when women have high estrogen levels, they have more serotonin activity in their brains. Unfortunately, falling levels of estrogen happen in women not only on a monthly basis (think PMS), but also after giving birth, while breastfeeding, during perimenopause and during the decades following menopause, the exact times when women are likely to be mildly depressed.

As a nurse practitioner at the University of Washington Women’s Health Care Clinic, Dr. Brown met women who were feeling tired and cranky and struggling with their eating. “I would test their thyroids, their livers, and see if they were getting enough sleep, but there was no explanation for why they were feeling this way,” she says. Her questions lead to a randomized, placebo-controlled study involving 112 moderately depressed women. She partnered with Jo Robinson, a health journalist, who, after years of writing about women’s health issues, wanted to find drug-free therapies to treat women’s most common problems, including overeating, fatigue and low-level depression. Working with Brown’s colleagues at the UW, they based the study on more than 600 scientific papers. Using research on gender differences on depression and alternative therapies that had already been proven to enhance a woman’s mood, they set about to find a program to combat mild vegetative depression in women.

“What women experience is as much physical as mental: The symptoms were lethargy, irritability and eating too much. There was less of an emphasis on feeling sad. It was a bigger experience than that,” says Dr. Brown. “It’s more like their body was depressed. There was mood stuff: irritability, cranky, tiredness. They would have never have said they were depressed. On a depression scale, they were mildly depressed.”

Half of the women in the study, who ranged in age from 19 to 78, undertook three therapies: bright light, brisk walking and a combination of six vitamins and minerals. After two months on the program, the women’s depression scores went from mild depression to normal mood. “We measured mood: all felt less irritable, less stressed and calmer. Their food cravings lessened,” says Dr. Brown. “Twenty-five percent lost weight even though we didn’t ask them to lose weight. It turned out to be much easier than [the participant’s] thought it would be. It truly took 20 minutes a day.”

This regimen is known as the LEVITY program: Light, Exercise and Vitamin Intervention Therapy. The light portion reflects the changing nature of our lifestyles. “For eons, people lived their lives outdoors. Our bodies have been programmed to work in light,” says Dr. Brown. “We’ve all become light deprived. Outdoors there is this intensity of light. Light is measured in lux. On a bright, sunny day, there is 50,000 lux outside; on an overcast rainy day, there’s 2,000; most home environments are about 50 lux. We’ve really moved indoors. Everything we keep designing keeps pulling us back indoors where there’s virtually no light.”

Pair this with a winter day in Seattle: We get up and go to work in the dark, spend our days inside, then commute home in the dark. “If we wake up and there’s so little light, our melatonin production (the sleep hormone) doesn’t get shut down as well and it doesn’t come back so robustly at night, [disrupting our normal sleep cycles],” says Dr. Brown. For the program, women need to get more bright light during the daytime but less at night. Unlike the SAD remedy, this doesn’t have to involve a light box: spending even 20 minutes outdoors on a cloudy day helps relieve the Body Blues. There are some tricks to gaining more light on a drab day:

• Position yourself correctly – Look straight ahead rather than down at the ground, walk away from shadows, or soak in light near a body of water, which doubles your light exposure.

• In the rain – Use an opaque umbrella or wear a hat or hood that doesn’t block the light from your eyes.

• Indoors – To gain more light indoors, move your workspace and furniture closer to a window; open your blinds; and buy energy-efficient brighter bulbs.

• Nighttime – And at nighttime, let there be dark: When reading, use only enough light to see the page and if city light pours into your windows, invest in light-blocking shades or don a sleep mask.

The exercise portion of LEVITY isn’t a pain-inducing two-hour session at the gym. Instead a brisk, 20-minute walk outdoors five or more times a week does the trick. (Stepping outside also satisfies the light portion of the program.) Studies have shown that moderate intensity exercise is the best mood enhancer. Making the exercise goal manageable also seems to make it easier for women to stick with the program: A year and a half after the study was published, 86 percent of its participants were still walking. “For women, [walking] was the one time in the day when no one wanted anything from them,” says Dr. Brown.

Called an “antidepressant cocktail,” the vitamin regimen is based on nutrients women typically lack in their diets: 50 mgs each of vitamins B1, B2, B6; 400 mcg folic acid; 400 IU of vitamin D; and 200 mcg Selenium. Vitamin B1 relives fatigue and improves memory. The body needs B2 to produce mood-boosting chemicals. Vitamin B6 is nicknamed the “women’s vitamin” because it treats several women’s conditions, including pregnancy nausea and PMS; it’s essential for the production of serotonin. Folic acid also enhances women’s moods. Vitamin D, which people naturally gather from the sun, stimulates serotonin production. “When we live this far north, you can’t get enough vitamin D on our skin in the wintertime, even if we went outside naked,” says Dr. Brown. Selenium eases anxiety and depression while increasing energy levels.

Four Forks-area healthcare providers – a physical therapist, two nurse practitioners and a mental health counselor – believe the LEVITY program makes sense physiologically, and were impressed with the research Dr. Brown used to back up her study. They spent several evenings a few summers ago studying Brown and Robinson’s book, When Your Body Gets the Blues: The Clinically Proven Program for Women Who Feel Tired and Stressed and Eat Too Much, chapter by chapter. “We discussed what her implications were and what she had to say, so we all four understood and agreed it wasn’t just a fad,” says Kathy Lawley, P.T., director of physical rehab services at Forks Community Hospital. They all encourage their patients to see if the program makes sense for them. They’ve also created a panel and have presented the tenets of the program to three community gatherings, including a meeting of tribal women in Neah Bay.

Back in Seattle, a patient of Dr. Brown’s who sings LEVITY’s praises is Estelle Klasner, Ph.D., a UW faculty member in rehabilitation medicine. After she completed her dissertation, she was looking for a way to get back into shape. Remarkably, Dr. Klasner found When Your Body Gets the Blues without hearing about it from Dr. Brown. “I brought it to my next appointment and I sort of became the poster child,” she says. “I really thought it was something that talked to real women. It was based on 12 years of sound, peer-reviewed research. You know, Dr. Phil’s great but if you’re not going to tell me what the research is based on, I’m not going for it. I’m in academia.”

She found the program quite easy, taking each piece step-by-step until she was doing all three components. She bought a light box because she doesn’t always have time to go outside during daylight hours. “The biggest change for me was having more energy to be with my kids when I came home from work and to do the things I enjoy,” she says. “I didn’t crave junk food anymore. I wasn’t obese. I thought if I can lose the weight that’s great, but if this is how I’m supposed to be, that’s OK. For me, [the important part] was gaining the energy back; the weight lose was a tremendous asset.”

Besides ridding herself of the Body Blues, Dr. Klasner is also happy that she’s not eating food out of a bunch of little packages. “You actually feel like you’re doing something for yourself. You’re taking care of yourself without a contrived effort. This is a lifestyle change and it’s so easy and natural.”

©2004 Caliope Publishing Company