Dr. Marie-Annette Brown Answers Your Questions

Q. What is the Body Blues?
A. The Body Blues is a mild form of depression that is very common among women. Two technical terms for this syndrome are “vegetative depressive symptoms” and "subsyndromal depression." (You can see why I came up with a simpler term!)

The main symptoms are:

1. Eating too much and gaining weight
2. Low energy
3. Irritability or tension
4. Sleep difficulties
5. Difficulty concentrating or fuzzy thinking
6. Daytime drowsiness
7. Decreased interest in sex
8. Mild anxiety
9. Mild depression
10. Heightened sensitivity to rejection or criticism

Q. Don't most people have some of these symptoms some of the time?
A. Yes, they do. But women with the Body Blues have them to such a degree that they interfere with their ability to perform at work or at home, strain their relationships, or detract from their overall sense of well-being. The condition can be long-lasting and life-limiting.

Q. What does it feel like to have the BODY BLUES?
A. Women with the Body Blues do not feel deeply depressed. Surprisingly, they may not even feel sad or blue. Their symptoms seem to be concentrated more in their bodies than in their minds. For example, they feel tired and sluggish too much of the time. Their thinking seems slowed down and unfocused. Even more troubling, their eating seems out of control. Typically, they can eat moderately at breakfast and lunch, but their appetite roars to life in the late afternoon. By the end of the day, they’ve eaten more food than they need, frustrating their efforts to attain or maintain a healthy weight. Not suprisingly, many women with the Body Blues are overweight or obese.

Q. How does the Body Blues differ from seasonal depression or SAD?
A. The symptoms are quite similar. The main difference is that women with the Body Blues can be plagued with these symptoms twelve months of the year! It’s as if they had the winter blues all year long. Their symptoms may get worse in the winter, but they don't vanish in June.

Q. How does the Body Blues differ from PMS?
A. The symptoms of the Body Blues are also similar to PMS. But women with the Body Blues can experience PMS-like symptoms at any point of their menstrual cycle.

Q. What can women do to rid themselves of the Body Blues?
A. Until recently, there were two main treatment options: psychotherapy and prescription medications. In my book, When Your Body Gets the Blues I introduce a new, all-natural solution called the “LEVITY Program.” My colleagues and I developed and tested this innovative lifestyle program at the University of Washington.

It consists of three simple but very specific activities:

1) Creating a more natural lighting environment—brighter during the day and darker at night.

2) Going for a 20-minute brisk outdoor walk, five days a week

3) Taking the following vitamins and minerals on a daily basis:

· 50 mgs. each of vitamins B-1, B-2, and B-6
· 400 IU of vitamin D
· 400 mcg. of folic acid
· 200 mcg of selenium.

Q. How did you choose these particular nutrients?
A. We selected them because each one has been clinically proven to enhance mood and/or energy levels in women. Research shows that each one plays a vital role in the production of ”feel good” brain chemicals. Our UW study was the first time that these particular nutrients had been tested in this exact combination.

Q. Do people need to purchase a special vitamin supplement to participate in the program?
A. No, they don't. Each of the ingredients in the formula can be found at any well-stocked pharmacy or health food store. However, there is a commercial product available called the LEVITY Mood-Elevating Supplement™ that contains all six of the ingredients in the recommended doses. Many women prefer this supplement because it is relatively inexpensive and more convenient than taking several pills. I want to stress that my coauthor and I have no financial interest in the company that manufactures this formula. (You can find the supplements in our on-line store.)

Q. We all know that exercise is good for us. What’s new and different about the kind of exercise in the LEVITY Program?
A. The program uses short-duration (20 minutes), moderate-intensity exercise, which research now shows is the best mood booster of all. While more vigorous exercise is better at improving cardiovascular fitness and burning calories, it is less effective at relieving depression and anxiety. In fact, high-intensity exercise can even add to a person’s stress level. (It produces what researchers call “tense arousal” rather than the more desirable “energetic arousal.”)

Another new finding is that you only have to exercise for 20 minutes a day to experience a marked change in mood and energy level. Surprisingly, exercising for a longer period of time gives you no further mood benefits. If you’re exercising to feel good, 20 minutes is enough! In my work with patients, I’ve learned that this amount of exercise can be added to even the most hectic schedule. This is a "no excuses" program.

Q. Why is exercising outdoors such an important part of the program?
A. When people exercise outdoors during daylight hours, they are exposed to very bright light. (Even on a very cloudy day, there is 5 times more light outdoors than indoors. On a sunny day, there may be 500 times as much!) Research shows that bright light alone can relieve many of the symptoms of the Body Blues, including overeating, carbohydrate cravings, fatigue, and low mood. It can even help women lose weight. When bright light is added to exercise, which happens during an outdoor walk, the mood benefits are doubled.

Q. Do I need to purchase a light therapy device?
A. The light you get outdoors, even on a cloudy overcast day, is enough to boost your mood—and it's free! Participants in our study did not use light therapy devices, but increased their light exposure by walking outdoors during the rainy Seattle fall months. But some people find it difficult to get outdoors every day and want to maximize the benefits that bright light can provide. Light therapy devices have improved tremendously in the past few years and can be a wonderful tool for improving mood. Learn more about what kind of light is best.

Q. What proof do you have that the LEVITY Program “works?”

A. My colleagues and I demonstrated the effectiveness of the program in a randomized, placebo-controlled study involving 112 moderately depressed women ages 19-78. The women who took part in the program scored better than the group given placebos on all five of the standardized mood tests that we used, a consistency that is rare in clinical research. The results of our study were published in the scientific journal Women and Health.

Q. Will your program help women going through peri-menopause and menopause?
A. Yes, indeed. I'm quite excited about this. We found that the LEVITY program relieves ten of the most common symptoms of menopause and aging, including confused thinking, irritability, fatigue, bone loss, overeating, and weight gain. This makes the program especially valuable for women 40 and older who are looking for alternatives to hormone replacement therapy. (The LEVITY Program does not help with purely estrogen-related symptoms such as hot flashes and urinary incontinence, however.)

Q. Do men ever experience the Body Blues?
A. Yes, they do, primarily after the age of 40, which is when their testosterone levels begin to decline. Research suggests that low testosterone levels, just like low estrogen levels, can trigger the Body Blues. But I estimate that two to three times more women than men battle the Body Blues.

Q. Why are women more susceptible to this disorder?
A. First, a woman’s hormone production is much more volatile. We now know that when a woman’s estrogen production falls during the second week of the menstrual cycle, her “feel-good” brain chemicals decline as well. This triggers the symptoms of the Body Blues. Men are spared these cyclical dips in mood because their hormone production is relatively constant from day to day.

Second, men and women respond to stress in somewhat different ways. In both sexes, stress depletes serotonin, the brain’s primary feel-good hormone. But a recent finding is that men may replace their serotonin 50 percent faster than women, which hastens their recovery and reduces the risk of having the Body Blues.

Third, living in a low-light environment in and off itself can trigger the Body Blues, and women, as a rule, are more light-deprived than men. (You’ll read more about this in my book.)

Q. All women of reproductive age have hormonal mood swings. Why do some escape the Body Blues?
A. Women who are physically active and spend time outdoors every day are less likely to have the Body Blues. Another protective factor is eating foods rich in the B-complex vitamins, vitamin D, and selenium— nutrients that boost brain chemical production. Genetics play a role as well. Some women inherit the types of brain receptors that enhance the serotonin activity in their brains, reducing the risk of all types of depression, including the Body Blues.

Q. You say that the Body Blues is women’s most misdiagnosed and under-treated mood problem. Why is this?
A. There are a number of reasons. First, most health care practitioners are trained to look for signs of serious depression. Too often, they overlook mild mood disorders such as the Body Blues.

Second, until recently, most depression research focused on men. We are now learning that there are differences in the way that men and women experience depression. For example, depressed men are more likely to lose their appetite, lose weight, and express little or no feelings. Depressed women, on the other hand, are more likely to overeat, gain weight, and have marked mood swings. Many practitioners are not aware of these gender differences and therefore fail to see that many of their female patients are struggling with depression.

Finally, until the LEVITY Program, the only proven therapies for mild depression were psychotherapy or antidepressants. Unfortunately, counseling has become prohibitively expensive for many women because few health care plans reimburse the expense. Antidepressants are not an ideal solution either, due to potential side effects, cost, and because many physicians are reluctant to prescribe medications for people with moderate mood symptoms. Just as important, many women do not want to solve their mood problems with a pill. For these reasons and more, most cases of the Body Blues go undiagnosed and untreated. The LEVITY Program has the potential to fill this huge gap in mental health care.

Q. What moved you to write: WHEN YOUR BODY GETS THE BLUES?
A. As a researcher and professor, I have been involved in numerous research projects. The Body Blues research stands out from all the others because the program is so easy to do and produces such remarkable benefits. It’s amazing to me that such a simple lifestyle program can cut women’s depression scores in half—this is what one hopes to see from antidepressants! It is very rewarding to be able to introduce such a simple and effective program to so many women.