My dd just told me she's depressed.

[smilesonly]

i have suspected this, but her anxiety and frequent panic attacks usually take the front burner.

 

i just read the symptoms of teenage depression and she definitely has many of them.

 

it's so hard to know what the difference is between normal teen behavior and actual depression.:confused:

 

i will obviously bring this up to her counselor, but that won't be for over 3 more weeks.

 

if she truly is depressed, meds willbe the last resort due to her high risk for other genetic illnesses.

 

suggestions??

 

thx

[Dana]

Can you call her counsellor?

Let them know before the next appointment?

[TechWife]

i will obviously bring this up to her counselor, but that won't be for over 3 more weeks.

 

You need to go ahead and call. Perhaps she can get an early appointment or talk to the counselor on the phone for help. Really, there is no reason she should suffer for another 3 weeks w/out some help.

 

if she truly is depressed, meds willbe the last resort due to her high risk for other genetic illnesses.

 

It sounds like you may need to talk to a psychiatrist for some input. I firmly believer that psychologists & other counselors have a role in the mental health system, as do family physicians & pediatricians, but for a complex case you need to see a specialist.

[meggie]

I agree with the above, but would like to add that you should tell her she can talk to you whenever she wants and will get no judgment from you. If I were you, I'd also check on her every night after she goes to bed.

[datgh]

From my personal experience as an anxiety sufferer you can only deal with the anxiety weighing you down for so long before the depression starts creeping in. Definitely give her counselor a call if you feel this warents a sooner visit. I would also find out if the counselor works closely with a psychiatrist when it comes to treating a patient with antidepressents so you are prepared if it comes to that. For me I needed more than just counseling. Sometimes you need the medication to get things under control enough to jump start the help you will get from counseling which is where you are going to learn what you need to cope long term. A good psychiatrist will know what will work best for your daughter and will track her closely to make sure the medication is the right one for her. When you have the right counselor and the right meds if you need them, it is amazing how well you can once again feel. Tell your daughter not to give up hope. It is a lot of hard work but she will be stronger for it when she comes out the other side.

 

If the counselor has given her things like relaxation techniques, etc. to be practicing, make sure she does. They can be amazingly helpful. Twenty years later I still use these techniques when I can tell my anxiety levels are starting to reach the critical point.

[Sandra in FL]

Give her fish oil (Carlson's lemon-flavored is mild) and a good B-complex (with high doses of Bs) and please seek help.

[MamaSheep]

I agree that it would be good to get in touch with the counsellor. In the mean time, help her get on as regular a sleep schedule as possible, spend at least a little time outdoors every day, get some exercise, even if it's just a quick walk around the block, and eat lots of fruits and veggies and whole grains. It might also help for her to journal about what she's feeling (she shouldn't be forced to show this to anyone unless she wants to). And tell her you love her as often as you can.

[celticmom]

Exercise especially outdoors would be a good idea. Does she get worse during the winter? Seasonal Affective Disorder could be a possibility this time of year.

[jjins]

When I was feeling (seriously) depressed several years ago I made a conscious effort to be upfront with close friends and family, so that I had someone to talk with, eat food that promote a good mental and emotional health and increase physical activity. This was the hardest one, but seemed to be the most important. I got my hands on a elliptical machine and forced myself to use it for 30 minutes EVERY day.

 

I started noticing an improvement after 3 weeks and then after a couple months I could not even imagine having been as depressed and unmotivated as I was.

 

This should not replace therapy, but you may want to talk to her's about these things as an PRE-medicine option.

 

:grouphug:

[Tohru]

Give her fish oil (Carlson's lemon-flavored is mild) and a good B-complex (with high doses of Bs) and please seek help.

 

:iagree:

 

Exercise especially outdoors would be a good idea. Does she get worse during the winter? Seasonal Affective Disorder could be a possibility this time of year.

 

:iagree:

 

While you wait for the counselor, try giving her some Emergen-C and get some exercise - a hike, mall-walk, something. The exercise will definitely help her serotonin levels.

[Sandra in FL]

Also, check her vitamin D level and if necessary, supplement with D3 (bring level up to 80).

[Rosie_0801]

I agree that it would be good to get in touch with the counsellor. In the mean time, help her get on as regular a sleep schedule as possible, spend at least a little time outdoors every day, get some exercise, even if it's just a quick walk around the block, and eat lots of fruits and veggies and whole grains. It might also help for her to journal about what she's feeling (she shouldn't be forced to show this to anyone unless she wants to). And tell her you love her as often as you can.

 

:iagree: Also look up serotonin deficiency too and see what sleep and dietary changes you can. They don't work quickly, but the sooner you start, the sooner they can make you feel better. Whenever possible, let her sleep past dawn since it is those two hours after dawn when the body makes most of its serotonin. Also, if she is eating a high carb breakfast and a more protein heavy dinner, switch them around.

 

Rosie

[Dolphin]

Talk to her. Let her know that anxiety can cause depression. Let her know that this happens to A LOT of people, and that it will get better. Normalize it as much as possible. I remember when I was a teen I used to have panic attacks about feeling depressed. It is a horrible cycle.

 

Is her counselor working with her on behavior modification techniques? I always found talking out the worries and realizing what thoughts were spiraling helped. Help her to gain control over whatever she can at the moment, then things won't seem so out of control.

 

Silly thing, my youngest sister is 8 years younger than me. When her anxiety was the worst, she liked more cuddles, but away from where everyone else could see (she was 16 after all) I came home a lot on weekends for her during this time. She really liked me to lie in bed with her and rub her back as she was going to sleep. She said she slept better those nights, and that made her feel better.

[Shellers]

My 15 year old DD has battled depression off and on since she was 8 years old. She had a really rough time at the beginning of the year with depression but once that got under control anxiety surfaced. Her doctor told us depression and anxiety often go hand in hand. When one gets under control the other will often surface. He also said in retrospect she was most likely dealing with anxiety back when she was 8 but that it had been masked by depression. Even he missed that all those years ago.

 

I suggest moving up her appointment ASAP. There's no shame in treating depression with medication. In winter months my daughter uses a sunlamp which seems to make her feel better but she still needs to stay on her Rx. My DD's doctor also recommended getting plenty of sleep. He had my daughter establish a bedtime routine and take melatonine to help her feel sleepy.

[Negin]

Everyone has given great advice. Some more to share. Sorry if some of these have been mentioned already. Sorry to hear that your dd (and of course, you) are suffering. :grouphug:

 

BOOKS THAT I LOVE

Positive Thinking Every Day by Norman Vincent Peale

 

Man’s Search for Meaning by Victor Frankl – if I could, I would give a copy of this to almost every friend and acquaintance

 

Some books that may be of help. Never read them, but have heard very good things about them.

The Mood Cure - she gives very practical and detailed, individualized info. - Here is her site.

 

SUPPLEMENTS

I always believe in a healthy diet first and foremost. Supplements come after. I've tried and taken most of these. Not all. I don't take supplements every single day. I usually like to give myself a break 1-2 days a week. I also take a break from certain supplements for a month or so at a time. The body, otherwise, becomes overly efficient and the supplement, I find, is not as effective, as when I take a break from it.

 

A good fish oil – such as Carlson’s - A recent large study found that rates of depression were nearly 30% lower in people who regularly take fish oil, probably because of the healthy omega -3 fatty acids it contains.

 

Vitamin D3 – Mood swings, depression, and bipolar disorders are all linked to a Vitamin D deficiency. Vitamin D helps normalize brain function. Take 2000-5000 IU daily.

If you're under 50, take at least 2,000 IU per day.

If you're 50 or over, take at least 5,000 IU per day of vitamin D3.

Always take your vitamin D with a fat-containing meal to ensure absorption.

Your need for vitamin D3 is affected by age, skin color, and the severity of any deficiency

 

St. John’s Wort – 300-1000 mg

To raise serotonin levels

Help relieve chronic insomnia

Help relieve mild depression – especially if you’re healthy and not taking other medications.

Because this herb can sensitize the skin to sunlight, take it in the evening after the sun has set.

 

Magnesium – depression and anxiety are symptoms of a magnesium deficiency

Magnesium is crucial for the synthesis of serotonin and other neurotransmitters. Magnesium is usually lacking in those with depression. In fact, one study reported “rapid recovery from major depression” after treatment with magnesium, and found that magnesium helped relieve the anxiety and insomnia often associated with depression.

Many women have an undiagnosed magnesium deficiency ,which can contribute to anxiety.

Some say to take equal amounts of calcium and magnesium.

For most people on a healthy diet, 500 mg of each supplement should be enough.

If you have symptoms of magnesium deficiency (and most of us do!) – if you’re feeling edgy, have muscle cramps, suffer insomnia, crave chocolate, or notice increased urination, adjust your calcium-magnesium ratio, so that you’re taking at least as much magnesium or—ideally—twice as much magnesium as calcium.

400-1200 mg daily of Magnesium is helpful but use according to bowel tolerance. Your body knows how much magnesium you can tolerate from bowel tolerance – take as much magnesium as your bowels can tolerate

If you can, add 100 mg of magnesium to your nutritional supplements, and increase it by 100 mg every few days until your stools are soft, but not uncomfortably loose.

Take in divided doses and with meals to ensure optimal absorption – preferably more at night

Some say to not take magnesium with calcium - I think that that is preferable.

Calcium, magnesium, and many other minerals are best absorbed when they are bound to an acidic carrier such as citrate, aspartate, picolinate, or amino acid chelate. Minerals need an acidic base to break down and get used.

The most absorbable forms are magnesium citrate, glycinate taurate, or aspartate, although magnesium bound to Kreb cycle chelates (malate, succinate, fumarate) are also good.

Avoid magnesium carbonate, oxide, sulfate, and gluconate. They are poorly absorbed (and the cheapest and most common forms found in supplements).

Side effects from too much magnesium include diarrhea, which can be avoided if you switch to magnesium glycinate.

People with kidney disease or severe heart disease should take magnesium only under a doctor's supervision.

 

GABA CALM – take sublingually before bedtime or a few hours before sleeping

100-500 mg daily

Try to avoid eating or drinking anything for 20 minutes before and after taking this

YOU LACK GABA IF YOU:

• Frequently experience back pain or muscle tension

• Worry excessively

• Often feel nervous, jumpy, or anxious

• Sleep problems

• Stress-related physical symptoms: headaches, IBS, and muscle aches

• Elevated cortisol levels which can lead to belly fat

• Are an emotional eater

 

GABA is the brain’s natural calming agent.

• Helps de-stress

• Relaxes muscles

• Suppresses cravings and helps curb emotional eating.

• Anti-depressant

• Helpful for day-to-day anxiety

 

5-HTP

Helps with:

• Sleep problems – quality and duration

• Emotional eating and evening cravings – helps suppress appetite

• Anxiety and depression as it increases serotonin levels

• Melatonin production

• Serotonin production

 

Best if taken sublingually - opening the capsule and pouring the contents on your tongue.

Try to avoid eating or drinking anything for 20 minutes before and after taking it.

No more than about 3 capsules a day – can safely take up to 400 mg per day – although most need less.

Loses its efficacy if taken every single day – best if you take breaks – sometimes alternating days – and sometimes take a break for an entire month or so

It may take 1-2 weeks to notice any effects and up to 6 weeks to notice the full benefits.

Be cautious about taking this if you’re on anti-depressants

 

Zinc is required by the brain in order to produce GABA, a compound that eases anxiety and irritability.

25-50 mg per day

DO NOT TAKE MORE THAN 100 mg

Use zinc gluconate lozenges or OptiZinc for best absorption

According to a study, women who took a daily zinc supplement in addition to a multivitamin for 10 weeks experienced significantly less anger and depression than those who took only a multivitamin.

 

The Bach Flower Remedies represent a form of psychotherapy in a bottle, a noninvasive modality to address negative emotional states like:

• Anxiety

• Depression

• Impatience

A Welsh homeopath, Dr. Edward Bach recognized in the 1920s that, if herbs have healing powers, so must flowers. Over many years, he experimented with numerous flowers and trees to create a total of 38 plant-based Bach Flower Remedies.

Bach Rescue Remedy is used in many emergency rooms to help alleviate trauma.

Centuary is useful for boundary issues, especially for people who give too much of themselves

Impatiens is good for irritability and short tempers.

Oak is for those determined types who struggle on (despite setbacks) through adversity or illness.

Rock water can ease tension for those who tend to be hard on themselves.

Edited December 18, 2011 by Negin in Grenada

[Negin]

NUTRITION

Amino acids help the body produce neurotransmitters that affect your mood. The body uses the amino acid L-tryptophan to make serotonin and the amino acid L-tyrosine to make norephinephrine. Amino acids are found in turkey, cheese, chicken, fish, beans, almonds, avocados, bananas, and pumpkins seeds.

 

3-4 weekly servings of oily fish such as salmon, tuna, or mackerel can lift symptoms of depression – even in cases where drugs like Prozac don’t help. Such fish are rich in DHA, a fatty acid that is also a major component of brain tissue. When DHA levels are high, brain biochemistry works optimally, leading to greater output of feel-good neurotransmitters like dopamine.

 

Mediterranean Diet helps reduce the risk of depression – these diets fight inflammation – diets that are high in omega-3 fats from chia seeds, fish oil, and flaxseed oil as well as gamma linolenic acid (GLA) from black currant seed, borage, and evening primrose oils provides anti-inflammatory prostaglandins. These good fats ease depression and offer a whole ton of other benefits

Eating a diet high in processed food increases the risk of depression, research suggests.

Too much sugar intake can lead to chronic depression.

What is more, people who ate plenty of vegetables, fruit and fish actually had a lower risk of depression.

They split the participants into two types of diet - those who ate a diet largely based on whole foods, which includes lots of fruit, vegetables and fish, and those who ate a mainly processed food diet, such as sweetened desserts, fried food, processed meat, refined grains and high-fat dairy products.

After accounting for factors such as gender, age, education, physical activity, smoking habits and chronic diseases, they found a significant difference in future depression risk with the different diets.

Those who ate the most whole foods had a 26% lower risk of future depression than those who at the least whole foods.

By contrast people with a diet high in processed food had a 58% higher risk of depression than those who ate very few processed foods.

 

Reviewing beverage consumption in this country, Harvard researchers also link sugary drinks—everything from soft drinks, sweetened teas and lemonade, fruitades, energy drinks, and even vitamin waters—to inflammation.

Sugar is the underlying cause of so many disorders—including depression.

 

Magnesium is crucial for the synthesis of serotonin and other neurotransmitters. Magnesium is usually lacking in those with depression. In fact, one study reported “rapid recovery from major depression†after treatment with magnesium, and found that magnesium helped relieve the anxiety and insomnia often associated with depression.

Many women have an undiagnosed magnesium deficiency ,which can contribute to anxiety. Get 400-500 mg daily.

Magnesium is found in oat bran, halibut, spinach, barley, pumpkinseeds, beans, and artichokes.

 

Zinc is required by the brain in order to produce GABA, a compound that eases anxiety and irritability.

Zinc is found in oysters, crab, turkey, lentils, barley, yogurt, and pumpkinseeds.

 

Look for foods that are high in the amino acid tryptophan. This amino acid may help mitigate insomnia and depression by boosting serotonin and melatonin levels in the brain.

Whole grains – Fiber-rich foods such as brown rice, oats, and quinoa

Sunflower Seeds

Fruit – Bananas, mangoes, figs, and dates

Tuna, turkey, whole grain crackers, yogurt

[Negin]

EXERCISE is key

Do something that you enjoy - even if you don't, once you get into a routine (say after 6 weeks, you'll see amazing benefits). Whatever you choose, it will help. Exercise will calm you down, lift your mood and help with depression.

People who exercise for 30 minutes 3 times a week see mood improvements similar to those who take the antidepressant Zoloft.

Many yoga poses and the regular practice of yoga help relieve symptoms of depression and anxiety.

Take a walk for well-being – walking or just being outdoors helps greatly with depression and anxiety

 

OTHER TIPS

Vanilla is calming and boosts serotonin levels in the brain. Just like comfort food, vanilla can bring us back to a place of security and peace. Burn a vanilla-scented candle or inhale the aroma of vanilla beans.

 

Lavender contains linalool, a substance that blocks the stress response in the body and relaxes the muscles.

Perfect if you have neck and shoulder pains

Add 6 drops of lavender essential oil to your moisturizing lotion.

 

COGNITIVE BEHAVIORAL THERAPY

I've heard great things about Cognitive Behavioral Therapy.

 

http://www.nacbt.org/whatiscbt.htm

 

MINOR DEPRESSION VERSUS MAJOR DEPRESSIVE DISORDER (MDD)

Minor depression is a transient and time-limited condition.

Feeling blue from time to time, usually in response to a stressful or traumatic life situation – such as: a painful divorce, a scary medical diagnosis, or the loss of a job

But if your blues last longer than a few weeks, or if they occur outside the context of a major life change, you may have MDD.

[Haiku]

We battled depression with my dd for over three years. We did counseling and biofeedback and nutrition therapy and it didn't help. We resisted medicine for some reason I don't really recall ... I think we felt it was a cop-out. In the end, we wasted 3 years of dd's life, as she improved significantly within several weeks of beginning a low dose of citalopram.

 

Tara

[Joanne]

What a great, helpful thread in response to the OP.

 

:)

 

I have nothing to add except well wishes. You already have a counselor, but if you wanted private feedback on a specific issue, you can PM me.

[smilesonly]

thanks for the advice and support!:grouphug:

 

she only met with this one counselor one time to address the past bullying issues. she's not a CB therapist. anyway, she is out of town for the next 3 weeks-she is in practice alone, so i can't just ask for someone else. since we're not into a "relationship" with this lady, i think i may look elsewhere.

 

Negin-thanks for that incredible list!! i just printed it out.:grouphug:

 

she was up till 3 last night-even after 3 mg of melatonin. then said she felt sick to her stomach and her back hurt. her upper back was bothering her earlier, but now it was her lower back.

 

she went to the bathroom, did her #2 business;) and said she got her period.:001_huh:

 

i rubbed her back and cuddled on the couch with her till she fell asleep.

 

someone mentioned something about checking on her-she has been terrified of dying since she was little but i have talked to her about coming to me or anyone if she felt like she wanted to harm herself.

 

i'm heading to the health food store to get some supplements this afternoon and dh is taking both dc ice skating.

 

ahhhh.....thank you again!

[deacongirl]

These may be relevant and helpful.

 

http://www.hoagiesgifted.org/dabrowskis_theory_existential_depression_feb09.pdf

 

http://www.davidsongifted.org/db/Articles_id_10345.aspx

 

http://www.sengifted.org/articles_counseling/Ellsworth_AdolescenceAndGiftedAddressingExistentialDread.shtml

[smilesonly]

These may be relevant and helpful.

 

http://www.hoagiesgifted.org/dabrowskis_theory_existential_depression_feb09.pdf

 

http://www.davidsongifted.org/db/Articles_id_10345.aspx

 

http://www.sengifted.org/articles_counseling/Ellsworth_AdolescenceAndGiftedAddressingExistentialDread.shtml

 

wow. thanks. very helpful!!:grouphug:

[freesia]

Also, check her vitamin D level and if necessary, supplement with D3 (bring level up to 80).

 

Definitely, taking D3 makes a huge difference for me. The first thing dh and bff ask me when I get anxious and depressed is if I am taking my D vitamins. It is that extreme. Exercise and sleep also help a ton.

[smilesonly]

 

Magnesium – depression and anxiety are symptoms of a magnesium deficiency

Magnesium is crucial for the synthesis of serotonin and other neurotransmitters. Magnesium is usually lacking in those with depression. In fact, one study reported “rapid recovery from major depression†after treatment with magnesium, and found that magnesium helped relieve the anxiety and insomnia often associated with depression.

Many women have an undiagnosed magnesium deficiency ,which can contribute to anxiety.

Some say to take equal amounts of calcium and magnesium.

For most people on a healthy diet, 500 mg of each supplement should be enough.

If you have symptoms of magnesium deficiency (and most of us do!) – if you’re feeling edgy, have muscle cramps, suffer insomnia, crave chocolate, or notice increased urination, adjust your calcium-magnesium ratio, so that you’re taking at least as much magnesium or—ideally—twice as much magnesium as calcium.

400-1200 mg daily of Magnesium is helpful but use according to bowel tolerance. Your body knows how much magnesium you can tolerate from bowel tolerance – take as much magnesium as your bowels can tolerate

If you can, add 100 mg of magnesium to your nutritional supplements, and increase it by 100 mg every few days until your stools are soft, but not uncomfortably loose.

Take in divided doses and with meals to ensure optimal absorption – preferably more at night

Some say to not take magnesium with calcium - I think that that is preferable.

Calcium, magnesium, and many other minerals are best absorbed when they are bound to an acidic carrier such as citrate, aspartate, picolinate, or amino acid chelate. Minerals need an acidic base to break down and get used.

The most absorbable forms are magnesium citrate, glycinate taurate, or aspartate, although magnesium bound to Kreb cycle chelates (malate, succinate, fumarate) are also good.

Avoid magnesium carbonate, oxide, sulfate, and gluconate. They are poorly absorbed (and the cheapest and most common forms found in supplements).

Side effects from too much magnesium include diarrhea, which can be avoided if you switch to magnesium glycinate.

People with kidney disease or severe heart disease should take magnesium only under a doctor's supervision.

 

GABA CALM – take sublingually before bedtime or a few hours before sleeping

100-500 mg daily

Try to avoid eating or drinking anything for 20 minutes before and after taking this

YOU LACK GABA IF YOU:

• Frequently experience back pain or muscle tension

• Worry excessively

• Often feel nervous, jumpy, or anxious

• Sleep problems

• Stress-related physical symptoms: headaches, IBS, and muscle aches

• Elevated cortisol levels which can lead to belly fat

• Are an emotional eater

 

GABA is the brain’s natural calming agent.

• Helps de-stress

• Relaxes muscles

• Suppresses cravings and helps curb emotional eating.

• Anti-depressant

• Helpful for day-to-day anxiety

 

5-HTP

Helps with:

• Sleep problems – quality and duration

• Emotional eating and evening cravings – helps suppress appetite

• Anxiety and depression as it increases serotonin levels

• Melatonin production

• Serotonin production

 

Best if taken sublingually - opening the capsule and pouring the contents on your tongue.

Try to avoid eating or drinking anything for 20 minutes before and after taking it.

No more than about 3 capsules a day – can safely take up to 400 mg per day – although most need less.

Loses its efficacy if taken every single day – best if you take breaks – sometimes alternating days – and sometimes take a break for an entire month or so

It may take 1-2 weeks to notice any effects and up to 6 weeks to notice the full benefits.

Be cautious about taking this if you’re on anti-depressants

 

 

The Bach Flower Remedies represent a form of psychotherapy in a bottle, a noninvasive modality to address negative emotional states like:

• Anxiety

• Depression

• Impatience

A Welsh homeopath, Dr. Edward Bach recognized in the 1920s that, if herbs have healing powers, so must flowers. Over many years, he experimented with numerous flowers and trees to create a total of 38 plant-based Bach Flower Remedies.

Bach Rescue Remedy is used in many emergency rooms to help alleviate trauma.

Centuary is useful for boundary issues, especially for people who give too much of themselves

Impatiens is good for irritability and short tempers.

Oak is for those determined types who struggle on (despite setbacks) through adversity or illness.

Rock water can ease tension for those who tend to be hard on themselves.

 

Negin,

 

what do you think about /www.vitacost.com/Peter-Gillham-Natural-Calm for a magnesium supplement?

 

thx!

[TranquilMind]

i have suspected this, but her anxiety and frequent panic attacks usually take the front burner.

 

i just read the symptoms of teenage depression and she definitely has many of them.

 

it's so hard to know what the difference is between normal teen behavior and actual depression.:confused:

 

i will obviously bring this up to her counselor, but that won't be for over 3 more weeks.

 

if she truly is depressed, meds willbe the last resort due to her high risk for other genetic illnesses.

 

suggestions??

 

thx

I wouldn't be quick to label her. ALL teens are depressed one minute and flying high another. Last night we had "My life is awful; woe is me" at one point, with accompanying acting out, and happiness and appreciation 4 hours later. Crazytown, I tell you.

 

If she is truly depressed, she will exhibit many signs over a long period of time. Is she getting enough sun (who is?) and exercise right now? That makes a difference.

[Negin]

Negin,

what do you think about /www.vitacost.com/Peter-Gillham-Natural-Calm for a magnesium supplement?

thx!

I don't know the exact type of magnesium they use, but it should be fine. The reviews seem very good and it doesn't have any artificial colors, etc. in it, so that's a good thing. :)

 

I wouldn't be quick to label her. ALL teens are depressed one minute and flying high another. Last night we had "My life is awful; woe is me" at one point, with accompanying acting out, and happiness and appreciation 4 hours later. Crazytown, I tell you.

If she is truly depressed, she will exhibit many signs over a long period of time. Is she getting enough sun (who is?) and exercise right now? That makes a difference.

:iagree: with this. Fully agree on all counts.

What counts is how she feels and behaves over the long-term. See the big picture.

And yes, sun (or even those light things that many people rave about, which we in the tropics obviously don't need) and exercise are essential.