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SAD Treatments: Light Therapy

Although researchers have yet to find a cure for seasonal affective disorder (SAD), they have identified some treatment options that are effective at minimizing the symptoms of this disorder. SAD is a mood disorder in which a person suffers from depression, fatigue and irritability during certain seasons of the year, namely during fall and winter.

Light therapy is the primary treatment for seasonal affective disorder, which is also referred to as the winter blues or winter depression.

Causes of SAD

While studies continue to investigate the precise causes of SAD, researchers and some medical experts have speculated that the significant reduction in natural light and warmth associated with the winter season is primarily responsible for causing seasonal affective disorder.

Another leading theory suggests that SAD results from the body’s increased production of melanin, a neurotransmitter linked to sleep and depression. As the days get shorter and winter brings less and less light, this theory speculates that the body responds by increasing its melanin levels, which, in turn, triggers the development of SAD.

Regardless of the theory they support, many doctors believe that incorporating bright light therapy into a SAD patient’s daily routine may lift spirits, acting as a natural antidepressant. In fact, light therapy is effective in treating about 85 percent of SAD cases. If an individual suffering from seasonal affective disorder is not suicidal, then light therapy is generally the first line of treatment for SAD.

How Light Therapy Works

While light therapy, also called phototherapy, is one of the most effective treatment options for SAD, medical experts are still unsure of exactly why this treatment is so effective. The leading theory, however, suggests that increasing an individual’s exposure to light (either natural or artificial) tends to raise his serotonin levels. Serotonin, a neurotransmitter naturally produced by the body, has been associated with elevated, happier moods.

These increased levels of serotonin work to balance out the higher levels of melatonin that are thought to cause the onset of seasonal affective disorder.

How to Start Light Therapy

To practice light therapy, SAD patients must sit near lights that are significantly stronger than the light produced by a common bulb. Experts recommend that SAD patients:

avoid looking directly at the bulbs to prevent damage to vision
incorporate light therapy into their morning routines (Practicing light therapy in the morning, rather than in the evening before you sleep, will prevent you from possibly suffering from sleep problems, such as insomnia.)
practice light therapy for about 15-30 minutes
practice light therapy regularly (Those who practice light therapy everyday will have far better results than those who only practice it occasionally.)
sit within a few feet of a bulb
use bulbs that are 10 to 20 times stronger than typical household bulbs.

If, however, SAD persists with this course of light therapy for a longer than a few weeks, patients may need to increase the time they spend practicing light therapy to an hour or more. During these lengthened treatment sessions, SAD patients may want to read or work on a computer to help them pass the time.

Light Therapy Side Effects

While light therapy is a non-invasive, effective treatment for SAD, it can cause some side effects, including:

headaches
hyperactivity (hypomania)
moodiness and irritability
nausea
sleeping difficulties, especially if light therapy is practiced in the evening
visual sensitivity, especially if SAD patients look directly at the light
worsening fatigue.

Most of these symptoms will subside within a few days, with or without discontinuing use of the light box.

The Effectiveness of Light Therapy

Individuals will generally see positive results from light therapy within anywhere from a few days to three weeks of practicing this course of treatment. Daily sessions, lasting from 30-90 minutes, should begin in the late fall and continue through spring. If no significant improvement occurs within six weeks, your doctor may suggest other treatments, including antidepressant medication, behavioral techniques or negative ion reception.

Keep in mind that light therapy can be combined with other SAD treatments, rather than being replaced by them. For example, combining antidepressants with light therapy is also a possible course of treatment. However, some drugs may increase retinal sensitivity and require monitoring by a specialist. Any individual with eye disease should always consult with an ophthalmologist before starting light therapy treatment.

Types of Light Therapy

Light therapy can refer to the use of a variety of different types of lights, including:

Blue spectrum lights: Because blue spectrum lights can cause macular degeneration and other damage to the eyes, they currently aren’t a viable source of light therapy. However, researchers are conducting studies to find ways to make blue spectrum lights safer for light therapy use.
Dawn simulators: For those who don't have time to sit in front of a light box each day, dawn simulators can be effective. These programmable devices start emitting low light at a preset time, slowly increasing the light’s intensity to a fully bright light to simulate a normal waking pattern.
Fluorescent bulbs: These deliver bright light therapy through a framed enclosure that typically comes in a tabletop, box design or as a lamp. Visors with attachable fluorescent lights are also available, although there is some controversy as to their effectiveness.
Tanning beds: While tanning beds can provide the necessary light to make light therapy effective, they are generally not recommended as they emit UV rays that are damaging to the skin and eyes.

Seasonal Affective Disorder Lights

A seasonal affective disorder light box is easy to use at home or, in many cases, at work. However, keep in mind that not all light boxes are safe for treating seasonal affective disorder. Light boxes range widely in price and size. Because health insurance may not cover the expense, so it's best to check first.

Consider the following factors when choosing the right light therapy box:

Directional light: The box should be designed with bulbs directing light downward rather than from below or level with the line of sight.
Light intensity: Look for boxes with 10,000 lux settings. In addition, you'll want to know the range of light exposure. In other words, find out how close will you have to sit to receive the maximum benefits.
Size: While larger boxes are not as portable, they will offer a wider perimeter of therapeutic illumination. As a result, decide whether or not you need to have a portable light box before committing to specific size.
UV (ultraviolet) and blue light spectrum: Both of these can cause ocular damage and harm the skin. Select a box that produces low levels of each or provides a guarantee that shields are in place for protection.

If depression is interfering with your social interactions and daily activities, see your doctor for a proper SAD diagnosis. Once you have been diagnosed with SAD, starting light therapy can lift your mood and help you get your lift back on track.

Resources

Mayoclinic.com (2006). Seasonal affective disorder treatment: Choosing a light therapy box. Retrieved December 8, 2007, from the Mayo Foundation for Medical Education and Research Web site: http://www.mayoclinic.com/health/seasonal-affective-disorder-
treatment/DN00013.

Ncpamd.com (2004). What is SAD? Retrieved December 8, 2007, from the Northern County Psychiatric Associates Web site: http://www.ncpamd.com/seasonal.htm.

Seasonal-affective-disorder.net (n.d.). Treatments for Seasonal Affective Disorder. Retrieved December 8, 2007, from the Seasonal Affective Disorder Web site: http://www.seasonal-affective-disorder.net/sad_treatments.html.

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