Temperatures are dropping, daylight hours are decreasing, and the holiday season is upon us. The Michigan winter is here!! For many people, shorter and darker days mean an increase in depression symptoms. For some, these symptoms result in Seasonal Affective Disorder, or SAD.
What is Seasonal Affective Disorder?
Seasonal Affective Disorder (SAD) is a form of depression that occurs at the same time each year, usually beginning in the late fall to early winter months and ending in the spring. Mild forms of SAD are commonly referred to as “winter blues,” but some people have a more severe form which requires treatment.
What causes SAD?
No one is exactly sure what causes SAD, but it may be related to the fewer hours of daylight during the autumn and winter. The reduced amount of sunlight can affect levels of chemicals and hormones in the brain such as serotonin and melatonin. Serotonin plays a role in lifting mood, and melatonin affects sleep and mood patterns. People with SAD are thought to respond to a decrease in light by producing too little or too much of these chemicals.
What are the symptoms?
- Low mood for most of the day
- Increased sleep
- Increased appetite
- Weight gain
- Difficulty getting along with others
- A heavy feeling in the arms and legs
- In extreme cases, suicidal thoughts
What is the treatment for SAD?
People can take a number of steps to lessen the effects of SAD.
- Live and work in bright environments when possible
- Plan a daily outdoor activity
- Sit near windows when inside
- Exercise daily
- Eat a well-balanced diet
- Practice relaxation and stress management
- Follow a consistent sleep routine
- Seek professional counseling
- Take antidepressant medication therapy when prescribed for depression
- Use a sunlight-simulating electronic device (light therapy)
What is light therapy?
Research has shown that exposure to bright artificial light can improve symptoms in two out of three cases of SAD. A 10,000-lux light box administers light therapy (“Lux” is a unit that measures illumination). This light is at least 10 times stronger than normal light bulbs, is very similar to natural daylight, and won’t harm the eyes.
How is light therapy used?
- For most people, light therapy is most effective if used in the morning, upon waking.
- Sit in front of the light box so that the light is on your face, but you don’t need to look directly into the light. Most people do their light therapy while they read, eat, watch TV, or sit at the computer.
- Generally, therapy begins with daily sessions of 10 to 15 minutes, which are gradually increased to 30-to-45-minute sessions.
- It is recommended that people begin light therapy in the early fall and continue the therapy until spring, when outdoor light alone is sufficient.
How soon does light therapy work?
Most people notice improvement in 2 to 4 days. In some cases, symptoms may not improve for several weeks. If symptoms get worse or do not improve after 4 to 6 weeks, consider additional treatment options.
Are there any side effects or risks with light therapy?
Side effects are uncommon but may include:
- Difficulty sleeping (if used late in the day)
- Eye strain
Criteria for light boxes
Depending on the product you buy, the cost of light boxes can range from $150 to $400. Keep in mind some insurance companies will help with the cost and you can also use your Health Flexible Spending Account towards this purchase.
Never use homemade light units, such as tanning lights or beds, for light therapy. The light given off by these units is high in UV rays and can harm your skin and eyes.
Consider these factors when considering buying a light box:
- It should provide 10,000 lux. If the light has a lower lux, increase the time of exposure. Example: 10,000 lux = 30 min., 5,000 lux = 1 hour, 2,400 lux = 2 hours.
- Fluorescent lamps should have a smooth diffusing screen that filters UV rays
- Lamps should give off a white light rather than colored light. There is no evidence that “full spectrum” lamps or blue (or bluish) lamps work better.
- Light should be projected downward toward the eyes at an angle to minimize visual glare.
- Smaller is not better: when using a compact light box, even a small head movement will take the eyes out of the range of light that provides benefit.
This information has been brought to you by the M-DOCC program, a unique, telephone-based collaborative care program for depression management that complements care provided by a patient’s physician. Care managers are experienced mental health social workers who work on behalf of the referring clinician and provide direct feedback to the patient’s treating team. Find out more.