Therapy

Light Therapy for Seasonal Affective Disorder

How to use a light box for seasonal depression.

Posted Feb 03, 2015

Emily Johnson, CC 1.0

Seasonal affective disorder (SAD): is depression, often accompanied by sleep disturbance, that begins or is exacerbated during the parts of the year with little sunlight..

A light box (sometimes called a light therapy box) is a first-line treatment. Within a week, it helps half of patients and, according to the National Association for the Mentally Ill Fact Sheet on SAD, most people experience no side effects.

Here is a summary of how to use a light box.

First assess its safety for you.  Light boxes are available over the counter. ClevelandClinic.com’s section on seasonal depression says, “Light therapy is generally safe and well tolerated. However, there are some contraindications (e.g., conditions such as diabetes or retinopathies, certain medications) because of the potential risk of damage to the retina of the eye. Bright light therapy can cause hypomanic or manic symptoms; therefore, individuals with bipolar affective disorder require medical supervision to use light therapy.”

The Mayo Clinic says “It's always a good idea to talk to a doctor before starting light therapy, but it's especially important if:

  • You have a condition that makes your skin especially sensitive to light, such as systemic lupus erythematosus
  • You take medications that increase your sensitivity to sunlight, such as certain antibiotics, anti-inflammatories or the herbal supplement St. John's Wort.
  • You have an eye condition that makes your eyes vulnerable to light damage
  • You have a history of skin cancer.”

Where to position it?  Depending on the unit and your comfort needs, twelve to 30 inches away from you. Position it at or slightly above eye level but to the side so that you’re not looking right into the light.

When: The Mayo Clinic says it may be most effective if you use the light box shortly after waking, perhaps while you’re getting dressed and/or eating breakfast

How long? 30 minutes is standard but the Mayo Clinic suggests that you might want to start with 15 and gradually extend to 30.

How intense? 10,000 lux is the standard intensity—approximately the brightness of a sunny day outside. The Sunbox Company recommends starting there and if you’re among the small percentage of people who develop a side effect such as headache or eye strain, simply move the light a few inches further away or cut the amount of time.

You may well see improvement within a week but you need to continue to use the light box daily until as late as early May.

Which light box?

The Mayo Clinic suggests getting a light box that is specifically for seasonal affective disorder and that emits white light and that blocks out 99% or more of the UV light. LED lights are cooler and use less electricity.

Lightphoria has all of the above characteristics, has three light levels (5,000, 8,000, and 10,000 lux) and is the #1 bestselling light box on Amazon.com ($69.67) with more than 1,000 reviews with an average of 4.5 stars. Among its pluses is portability. That can be important because if you use it for a half hour in the morning, you might, for example, keep it with you while you’re getting dressed and then take it into the kitchen as you’re eating breakfast. 

In addition

In addition to proper use of a light box, exercise—especially outdoors—can help as well as spending plenty of indoor time in a bright room—open those window shades. And if possible, take a winter vacation in a sunny location.

If your seasonal affective disorder is still not manageable, psychotherapy and/or an antidepressant may help.

In sum

Seasonal affective disorder can sometimes be adequately treated without drugs or psychotherapy. Often, you can significantly improve with just a light box, exercise, and time in bright places, ideally including that week in Hawaii.

Marty Nemko's bio is in Wikipedia.