Macular Degeneration, Seasonal Affective Disorder and Vitamin D

Sometimes it is a combination of things that can help or hurt you. Most of the time, if you do not know what these things are you can’t benefit or suffer in the dark. The link between macular degeneration, seasonal affective disorder, and vitamin D offers some out-of-the-box info which may help you in the long run. These are just the combination you might rarely think about correlating with one another but obscure and broad spectrum studies show the evidence. 

Don’t take your vision for granted and see how staying on top of some healthy choices or avoiding certain triggers can increase your quality of life. You just may stay ahead of the curve while others fall prey to the blinding disease of macular degeneration which, according to Bright Focus Foundation, currently afflicts approximately 11 million Americans and 170 million worldwide. These numbers are expected to double by 2050.

Seasonal Affective Disorder

Seasonal affective disorder (SAD), also known as major depressive disorder with seasonal pattern, is the diagnosis given to some people who react with depressive symptoms to the changing light of the fall/winter seasons. 

SAD mostly affects those living in countries further from the equator who experience drastic light change along with a true four season environment. Symptoms often decrease as spring approaches and many suffering with SAD gain back their emotional balance.

According to Medical News Today, SAD tends to include a constant presentation of one or more of these signs and symptoms:

• Suicidal ideas
• Reduced libido 
• Increased appetite 
• Consistent low mood 
• Sleeping for too long 
• Stress and irritability
• Difficulties in making decisions 
• Restless activity, such as pacing
• Feelings of guilt and worthlessness 
• Overeating and possible weight gain 
• Crying, often with no apparent trigger 
• Feelings of fatigue, even after a full night’s sleep 
• Anxious feelings that are out of proportion with their cause or trigger
• Social withdrawal and a reduced interest in activities that once provided pleasure

Some remedies for SAD are: psychotherapy, cognitive behavioral therapy (CBT), the herbal remedy St. John’s Wort, melatonin, bright light therapy and vitamin D. When it comes to macular degeneration, these last two remedies are particularly important. Bright light therapy may be a dangerous choice, especially for those suffering from age-related macular degeneration (AMD) but vitamin D could be highly beneficial. 

SAD Bright Light Therapy May Be Dangerous for AMD Depression

The incidence of depression amongst AMD patients is high. 

An archived JAMA study from 2002 stated, 

“The prevalence and disabling effects of depression in older patients with AMD are substantial. Recognizing that depression is a treatable disorder that exacerbates the effects of AMD will lead to improved outcomes. Innovative interventions to prevent or treat depression in specialty eye clinics are possible.”

17 years later, this silent suffering continues as a similar analysis is determined in the results and conclusion of a study published in the Journal of VitreoRetinal Diseases (6/6/19) which stated, 

“Of the 51,019 patients analyzed in this study, []…the prevalence of depression among AMD patients was 25.0%…the odds of carrying a diagnosis of depression are also 1.3 (95%) times more likely…Patients with AMD have increased odds of suffering from [] depression.”

AMD depression is real. Add in symptoms of SAD and the mental state of a person with AMD can be significantly compromised. Unfortunately, this can lead to a desperation for alleviating symptoms in any way possible. Bright light therapy is sometimes recommended for SAD but research has recently shown this remedy to be a potential danger for those struggling with macular degeneration. 

Medical News describes bright light therapy,

“Also known as phototherapy, this intervention can help restore a person’s circadian rhythms…a person sits in front of a specialized light-box for a set amount of time every day between early fall and spring. The National Institute of Mental Health (NIMH) recommends engaging in light-box exposure as soon as possible after waking up. In general, people should receive light therapy for 20–60 minutes per day, depending on the strength of the light.”

In a 2008 study published in JAMA (Journal of the American Medical Association), English researchers concluded that,

“Animal and laboratory studies have shown that blue light damages the retinal pigment epithelium and choriocapillaris through generation of reactive oxygen species and may be a factor in the pathogenesis of age-related macular degeneration (AMD).”

Specifically regarding bright light therapy and how it affects AMD, researchers from the Department of Ophthalmology, Duke University Medical Center, Durham, NC stated that,

“Intense visible light sources that do not filter short blue visible light used for phototherapy of circadian imbalance (i.e. seasonal affective disorder) increase the risk for age-related light damage to the retina.”

Healio reported that, according to optometrist, Dr. Bergin, it is recommended that a patient considering light therapy obtain a pre-retinal examination. 

She commented, 

“Fluorescein angiography and a retinal evaluation are recommended if there is a threat of age-related macular degeneration,…Follow patients at 3 to12 month intervals.”

Unless SAD symptoms are very severe, it may be best for AMD patients to avoid bright light therapy altogether. However, vitamin D for SAD is recommended and it just may help prevent or slow macular degeneration as well; a win-win.

Benefits of Vitamin D for AMD and SAD

Due to less exposure people have to the sun, many are deficient in vitamin D. Therefore, your doctor may recommend Vitamin D3 to make up for this deficiency. Vitamin D is responsible for many systemic functions including: bone strength, mood, and sleep. Now, researchers have determined that vitamin D may play a key role in preventing AMD as well as reducing symptoms of SAD. 

JAMA published a study of combined vitamin D and AMD research that concluded,

“A 6.7-fold increased odds of AMD (95%) was observed among women with deficient vitamin D status…In this study, the odds of AMD were highest in those with deficient vitamin D status”

Lead author, Amy Millen, associate professor of epidemiology and environmental health in UB’s (University of Buffalo) School of Public Health and Health Professions

“Our study suggests that being deficient for vitamin D may increase one’s risk for AMD…if you’re at high genetic risk for AMD, having a sufficient vitamin D status might help reduce your risk.”

Supplementing with vitamin D3 has shown to reduce depressive symptoms as well, particularly SAD. Researchers have linked many patients struggling with depression to being diagnosed with low D in their blood. 

Alan Stewart of the University of Georgia College of Education commented on how vitamin D production may also be associated with changing light levels,

“…studies show there is a lag of about eight weeks between the peak in intensity of ultraviolet radiation and the onset of SAD, and this correlates with the time it takes for UV radiation to be processed by the body into vitamin D.”

Talk to your naturopathic doctor or conventional physician to determine your vitamin D levels and the best protocol for supplementation. 

Macular degeneration, seasonal affective disorder, and vitamin D all play a role in navigating optimal health. Stay on top of your preventative choices by eating a high plant-based diet, exercising regularly and protecting yourself from outside and inside macular degeneration risks.