Mental Health Matters—A Monthly Column

James L Fleming, M.D.
Medical Director, Senior Life Solutions


Those of us who live in parts of the country which experience all four seasons tend to appreciate our summers much more than those who live in tropical or subtropical areas. Summer also provides opportunities for activities which science is increasingly showing are beneficial to our mental health. The first thing that comes to mind is summer sun. Sunlight can help those who suffer from winter depression and if we get morning sunlight (at least 30 minutes) we can help regulate our sleep-wake cycle by “setting the melatonin clock” in the pineal gland deep within the brain. But recent research has also highlighted the role of Vitamin D which is naturally produced in our skin when it is exposed to sunlight.

With the advent of the internet and other forms electronic communication and entertainment, we spend much less time outside than did earlier generations and this may part of the reason why there seems to be an epidemic of Vitamin D deficiency in modern society. When I studied nutrition in college prior to going to medical school, we were taught that the main role of Vitamin D was to help keep our bones healthy and the only deficiency problem associated with the “sunshine vitamin” which was ever discussed was “bow legs” as seen in disease Rickets. Now we know Vitamin D does much , much more: being anti-inflammatory it can help deal with arthritis and other forms of chronic pain, it can prevent or reduce risk of various types of cancer, and, as many psychiatrists have started to discover, deficiency of this nutrient can contribute to mental disorders especially depression. People with darker skin tend to more susceptible to Vitamin D deficiency and routinely using sun screen, while helpful with prolonged sun exposure in the prevention of skin cancer, also reduces the natural conversion of the pre-vitamin in the skin to Vitamin D.

So what can we do to reduce our risk of Vitamin D deficiency? In most cases taking some tablets or capsules of Vitamin D3 (the form which is best absorbed and therefore routinely available in all pharmacies) in a dose of about 1000 IU (international units, not milligrams which most other vitamins are measured in) is usually a good idea. The recommended daily dose is only 800 IU but some Vitamin D researchers (e.g. including those at my alma mater, the University of Wisconsin- Madison) believe our daily intake should be closer to 4000 IU. Others caution against toxicity of this vitamin since, being fat-soluble, levels can build up over time. When in doubt, consult with your health care provider.

On the other hand, its impossible to get Vitamin D toxic from sunlight because of built-in feedback mechanisms. In addition, sunlight-derived Vitamin D is also the most efficient way to delver this vital compound to our bodies. To do this spend about 30-40 minutes outside, getting sun on arms, legs and/or back with minimal or no sunscreen (for longer periods of exposure we should use sunscreen). Sitting near a sunny window inside can help our sleep-wake cycle but won’t make Vitamin D because windows routinely filter out the ultraviolet light necessary for conversion of the compound in the skin. When we do go outside, especially when its hot, remember to hydrate with plenty of water and other fluids to prevent dehydration and overheating.

In future columns i’d like to talk about some of the other wonderful, natural gifts with which we are blessed in summertime. But here is a brief preview of two such gifts which research is increasingly bearing out the benefits of: take advantage of the abundance of fresh fruits and veggies as well as opportunities to connect with friends and family during these sunny, breezy days. And most of all: enjoy and be grateful!