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Abu Dhabi, UAESunday 20 January 2019

As the heat begins to rise, so too do rates of depression

Getting plenty of sunshine is good for our physical and mental health, writes Justin Thomas.

Driving around Dubai and knowing what I know about vitamin D, I opened my car’s sunroof. I expected to feel the warm, vitamin D enhancing, rays of the sun flood my car – but no. The tall tower blocks lining the road cast long shadows, sabotaging my attempt at a vitamin D top-up. This is what I call the Arabian paradox: a land of perennial sunshine where vitamin D deficiency is endemic.

In one recent UAE study, published in the International Journal of Medicine and Medical Sciences, the rate of vitamin D deficiency among a sample of indoor workers was 92.3 per cent, with 63.2 per cent classed as severely deficient. Studies undertaken in Qatar, Kuwait and Saudi Arabia all report equally alarming results.

This current vitamin D deficiency “epidemic” is largely a consequence of where we live and how we live.

Urbanisation, sedentary lifestyles and obesity all conspire to reduce our contact with sunlight. This is a major concern, because vitamin D deficiency is linked with an array of physical health problems including osteoporosis, heart disease, and diabetes. However, as a psychologist I’m particularly drawn to the possible mood altering implications of vitamin D deficiency (VTD) too.

In recent years, research teams from around the globe have systematically explored the link between VTD and depression.

A 2013 study published in the British Journal of Psychiatry reviewed this body of research – a combined sample of over 31,000 participants – to get an overview of the findings. In the biomedical sciences, this type of study, known as a meta-analytic systematic review, is one of the most powerful sources of scientific evidence available. This particular meta-analysis authoritatively confirmed the relationship between vitamin D deficiency and depression, and advocated further research into the effects of vitamin D enhancement in the treatment of depression.

In our own research, published in the International Journal of Mental Health Promotion, we have explored the links between vitamin D deficiency and depression among Emirati university students. Not only did we find the expected relationship between VTD and depression, but we also found a shared pattern of seasonal variation. In other words, vitamin D levels tend to dip in the summer accompanied by a rise in depression scores, whereas the converse pattern is true for the winter: vitamin D levels rise, and depression scores fall.

In our most recent project we undertook a pilot study exploring the effects of a new behavioural intervention targeting vitamin D levels and depressive symptoms simultaneously. We termed this new treatment: Sun Enhanced Behavioural Activation, or SEBA for short.

SEBA is based on a well-established and highly effective psychotherapeutic technique known as behavioural activation. This technique is used in the treatment of depression, especially when an individual has become withdrawn and unmotivated. Like regular behavioural activation, SEBA encourages individuals to increase activity levels, both routine and pleasurable, however in SEBA there is a special emphasis on activities that will increase exposure to the sun.

This can include very small changes, such as parking the car a little further from the mall entrance and walking in the sunshine, or taking breakfast outside in the garden. The cultivation of such outdoor habits is intended to result in lasting changes to vitamin D levels over time.

Our small pilot study was a huge success. After just eight sessions, those receiving SEBA showed marked increases in vitamin D levels, as well as significant reductions in depression levels. Whereas the individuals in the control group actually deteriorated over the same time frame (showing further decreases in vitamin D and increases in depressive symptoms). Our intention now is to repeat this study, with a larger sample and a more sophisticated research design. However, there is a clear message from this small pilot study: increased outdoor activity is good for your mind and body.

As the UAE’s beautiful winter weather begins to fade, we might start to think about how we can make small behavioural changes, ensuring we get regular doses of safe sun all year round. Our quality of life, and our ability to be fruitful contributors to society, may depend on it.

Justin Thomas is an associate professor of Psychology at Zayed University and author of Psychological Well-Being in the Gulf States

On Twitter: @Jaytee156

Updated: March 23, 2014 04:00 AM

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