Dealing with Depression: Shedding Light on Seasonal Affective Disorder (SAD)

In the popular Twilight movie saga, moody, brooding, vampires and teenagers roam the lush and scenic forests of the rainy Olympic Peninsula. On top of all the challenges associated with being “undead”, a teenager, or both, the lack of natural sunlight makes them major candidates for a form of clinical depression known as Seasonal Affective Disorder (SAD). Like other patients diagnosed with depression, SAD patients are commonly treated with traditional prescription antidepressants. However, in many cases, light therapy has been shown to be as effective as antidepressants for treating SAD. If you feel that you or someone you know might be suffering from SAD, here’s a brief look at the disorder and the role that light therapy can play in its treatment.

Typically triggered by the shorter days and reduced light of fall and winter, SAD has been estimated to affect six percent of Americans and two to three percent of Canadians. More common in women than men, SAD can be quite debilitating, causing people to have problems functioning in their personal lives and at work.

SAD appears to be brought on in the winter months by the effects of reduced light on the light-dark cycle which normally keeps the body’s seasonal rhythms in balance. Biochemically, SAD is thought to be associated with higher levels of melatonin, a sleep-inducing hormone produced by the body more abundantly in darkness. It’s also thought to be caused by decreases in chemicals found in the brain, such as serotonin, the antidepressant benefits of which have been clearly shown. Like other types of depression, SAD cannot be self-diagnosed. Once the diagnosis is made the prescribed treatment depends on the severity of the symptoms. Although antidepressants are frequently used, “light box” therapy has been shown to be beneficial, either alone or along with antidepressants to make them more effective, often at lower doses and with less side effects.

The key to effective light therapy is finding a light box that will give off a bright enough light. To get the best therapeutic benefit, studies have shown that patients need at least 30 minutes of exposure per day to a 10,000 lux light box. Another option is to use a less intense 2,500 lux light box, but the exposure time should be increased to at least 2 hours. To give you an idea of the relative intensity of light boxes, typical indoor lighting   supplies around 300 lux.

When using a light box, you need to keep your eyes OPEN, as light must enter through the eyes to be effective. However, you should never stare directly at the light, as that could cause retinal damage. Although sunglasses may up your “cool factor” when worn indoors, they should not be worn during light therapy. Should you experience eyestrain, headache, nausea or agitation during light box therapy, you should try decreasing your exposure time accordingly.

While light boxes may be obtained without a prescription, it’s important to check with your doctor or pharmacist to make sure you get the light box that will best suit your needs. As all commercially available light boxes are not created equal, here are a few things to look for in choosing a light box, based on the recent recommendations of the Mayo Clinic.

1. Make sure the light box is specifically designed for SAD: Being that light therapy is also prescribed for the treatment of certain skin disorders, make sure that your light box is designed specifically for the treatment of SAD only. Otherwise, the light box you choose may be unsafe or ineffective in treating your depression. You could also be exposing your eyes to damaging UV rays, as light boxes designed for the skin emit ultraviolet light. Although SAD light boxes are designed to filter out UV light, some give off more UV than others, so be sure to look for one that emits the least UV.  Make sure you follow the brightness guidelines previously discussed.
2. Understand which light source is best: Although light boxes in the past used either fluorescent or incandescent bulbs, newer boxes may use LEDs. Being lighter and more efficient than standard lights, LEDs seem to work as well as incandescent and fluorescent bulbs. Another option you’ll find are light boxes that give off blue light. Blue light is a shorter wavelength than traditional white light, and some studies suggest that it might be more effective. However, blue light poses a greater risk of damaging the eyes, all the more reason to never look directly at the light source.
3. Sunrise Simulation may be helpful: Some light boxes are designed to simulate the breaking dawn. (Isn’t that the title of a Twilight movie?) The lights in these boxes turn on before you wake up and gradually get brighter, as if the sun were rising. While this feature may provide extra benefit in regulating sleep patterns, therapeutic relief of the symptoms of depression can only come from “eyes open” exposure to bright light for at least 30 minutes.
4. Style and features: Like all devices it’s important to find a light box with the style and features best suited to your needs. Light boxes come in many shapes and sizes, from upright lamps to small rectangles. Some are even designed to be used in pairs. In addition, many light boxes come with features beyond the simple on-off switch, such as programmable timers and brightness adjustment. The key to getting the most benefit is evaluating your needs and then deciding the style and features that will work best for you.
5. Be cost-conscious: Ranging anywhere from $100.00 to $500.00, light boxes can be a considerable investment. However, cost does not always represent benefits, meaning that a less expensive light box may work just as well for you as a flashier and more costly model. Although your health insurance carriers may not appear to cover the cost, a letter from your physician indicating the light box as a medical necessity might qualify you for full or partial reimbursement.

Geoff Harding is a freelance writer who specializes in writing about depression.

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