There is a chill in the morning air, leaves have started falling, pumpkins have begun appearing on front porches, and many people with the winter blues or Seasonal Affective Disorder have started thinking, “here we go again.”
Seasonal Affective Disorder (SAD) is a full-blown depression that has a seasonal pattern, reoccurring regularly with the start of the fall and winter. It can also occur in the spring and summer but that is less common. The winter blues is a term used to describe subclinical forms of low mood that don’t reach the severity of a full major depression.
As with other types of depression, cognitive behavioral psychotherapy and antidepressant medication are helpful in treating SAD. An association between the falling light levels of autumn and winter and the onset of winter depression has been recognized for some time. Since the 1980’s, bright light therapy, often used to treat circadian rhythm sleep disorders, has become an accepted treatment for SAD and the winter blues. Research has shown that morning light exposure is not only beneficial for many who suffer from SAD and the winter blues, but may also be helpful with non-seasonal clinical depression.
Bright light therapy is administered with the use of specially designed bright light boxes. These units are available on-line from a number of companies including Verilux and Phillips. (Full disclosure: I have no commercial interests in these companies.) These units provide bright light in a number of different formats. Some units are quite large, while others are more compact. Most have a fairly small footprint and are made to be kept about a meter or less from the user.
Treatment usually involves sitting with the bright light on for anywhere from 15 minutes up to an hour. These are very bright lights and are not meant to be stared at. The lights should be placed to your side while you are, for example, reading the newspaper or having breakfast. The brightness and wavelength of the light as well as individual tolerance and response will determine the optimal length of exposure for any given person. Information about these variables can be obtained from the user manuals and from professionals who recommend light therapy.
It is helpful, especially for those coping with a full seasonal depression, to discuss treatment with a knowledgeable sleep or health care professional before beginning therapy. Light therapy must be administered in the proper way, considering both dosage (amount of time and brightness of the light) and appropriate time during the day. For example, use of bright light at night could cause insomnia and has even been associated with the onset of manic episodes.
Bright light exposure can cause problems such as eyestrain and is not indicated for people with certain medical conditions, for those who are taking medications that increase photosensitivity, or for those who have had cataract surgery. If you do obtain a light box, be sure to carefully read the manufacture’s instructions and warnings and make sure it is appropriate for you. If you have a history of eye problems be sure to consult your ophthalmologist before starting therapy to be sure you don’t have any medical problems that may be made worse by the use of bright light. Start therapy in the early fall with a short daily morning exposure and gradually increase it over a number of days. The initial starting dose will depend on the brightness and wavelength of the light box source and the user manual will be helpful in determining this along with suggestions from your health care provider. If you have a history of bipolar disorder, it is important to discuss light therapy with your mental health provider before starting. It may not be an appropriate therapy for you.
Phototherapy has great potential to be of benefit to people suffering with SAD or the winter blues. If light therapy is going to work for you, you will know in a few weeks. For many with SAD, bright light is indeed a key to a release from the darkness- so, let there be light!