Bright Light Therapy for Seasonal Affective Disorder, Winter Depression, Cabin Fever
Many people dread winter, and get depressed when forced to spend long hours indoors. Many people also can't wait for the return of natural sunlight.
However many suffers of the winter blues or 'cabin fever' have found relief from the winter blues using bright light therapy.
There are a variety of bright light boxes on the market and many people turn them on every morning and basks in the bright light for about 30 minutes to re-set their biological clocks and get relief from the winter blues.
Millions of Americans, each year suffer from mild to severe winter blues and depression which has been given the name SAD - Seasonal Affective Disorder.
There are a variety of treatments used including antidepressants but bright light therapy works for many people as a natural therapy with few side effects.
What is bight light therapy used for, and why does it work?
- Your natural in-built biological clock cycle is usually longer than 24 hours and without light in the morning you can get out of sync. You need a bright light first thing in the morning that replaces the dawn in summer to reset your clock back to the 24 hour cycle and keep it on track throughout the day. With the natural dawn being later in winter and being inside - you may miss it, your body rhythms drift and if you can't reset them many people get depressed and shoe symptoms of Seasonal Affective Disorder.
- Lights for bright light therapy can be bought for about $200 in various sizes. Inside is a bank of fluorescent tubes or bulbs fitted inside a metal or plastic box and covered with a diffusing screen. The box is usually set up on a desk top or table, so that you can sit comfortably reading a book for half an hour while the light streams onto your face. The light box can be as small as 9 by 11 inches and 5 inches deep. Some people have sessions in the morning or evening.
- Treatment involves sitting close to the light box, with lights on and the eyes open. People can undertake various activities such as writing or reading or even eating meals. What is vitally important is to face the head and body in the direction of the lights, concentrating on doing things on the illuminated surfaces, and not directly in the lights itself.
- Treatment sessions vary between people and can extend from as little as15 minutes to an hour, and in some cases up to three hours, once or twice a day, depending on the equipment used and individual needs of the user. Usually 30 minutes is sufficient for most patients depending on the brightness of the lights. Each individual needs to find what treatment works for them.
- It is important that the level of light from the box matches, or is brighter than, that of the light outdoors shortly after sunrise or before sunset. Light intensity is vital for the therapy and the level of light required varies between people. Normal room lighting is insufficient.
- The time of day of light therapy is also important. Most people do a session just after they wake up. Some people find it works better in the evening. There is an optimum time of day for each individual.
- Will the normal lights in the house work just as well? Research studies have shown that most sufferers of winter depression and SAD require exposure to light intensities much brighter than ordinary indoor lamps or ceiling lights. The light levels may need to be 5-20 times more intense. Some individuals respond well to simply spending more time in the sun, despite the winter temperatures rather than using the lamps. However, the best time is very early in the morning around 6.00 - 7.00am when it is still quite dark outdoors during long winter nights. Going outside may not be realistic for most people early in the morning.
- Light therapy may also provide therapy for many other major non-seasonal type of depression and also with some types of sleep disorders. Because of its few side effects, it can be used to treat elderly people with dementia and to treat depression during pregnancy. It is also being investigated for the treatment of severe premenstrual syndrome, bulimia nervosa, bipolar disorder and attention deficit hyperactivity disorder.
- Do the lights really work? Researchers at more than fifteen research and medical centers throughout the world have had excellent success with light therapy in patients with long histories of SAD. The American Psychiatric Association suggests that bright-light therapy is an effective treatment, with low risk of side effects, for both SAD and non-seasonal major depressive disorder. In 2006 a study of 96 subjects compared the effectiveness of bright-light therapy with the antidepressant Prozac (fluoxetine) found the light treatment just as effective for alleviating winter depression. The light therapy produced faster results, usually within a week, and had much fewer, if any side effects. Symptoms usually return after about a week when the lights are withdrawn.
- Why does Light Therapy Work? - The exact reason why light treatment works is unknown but most researchers believe it is related to resetting the body's biological clock that is normally “set” by natural light beaming in the windows every the morning in summer, but is missing during the winter months. Light is known to affect on various hormones and affects the brain’s hypothalamus, which plays a vital role regulating energy, mood and appetite. The hormone melatonin, which is normally secreted at night is suppressed by light. Light affects other hormones such as epinephrine and serotonin that have a known role in neurotransmitter systems that affect general depression.
- Most users, start a regular daily routine beginning in fall or winter, and usually keep the sessions going until the end of April, when the natural light has returned and is adequate. Some people can miss treatments for several days or longer. But most people start to get symptoms again when treatment is stopped for several days or a week.
- Are there any known side effects? Side effects have been shown to be minimal. Some people experience eyestrain/irritation, headaches or some mild nausea at the start of treatment. However these problems are usually mild and decline after a few days. Rarely the treatment can induce and overactive state, leading to problems with sleeping, and people become restless or irritable.
- Do the lights cause tanning and risk of skin cancer? The light boxes should not cause any problems because they do not release UV light or most UV light is filtered out.
- What about Simulating a Sunrise? - Research is being conducted on so-called Dawn simulation. This involves a person receiving light exposure during the final stage of sleep. A lamp is turned on by a timer, while the person is asleep. This simulates the usual dawn during springtime dawn. The light intensity is much lower than with than with the light boxes. Dawn simulation has been shown in various research studies to suppress melatonin secretion, reset the biological clock and to produce an antidepressant effect.
- Despite the positive research, not many doctors prescribe bright-light therapy as a treatment for the symptoms of SAD, perhaps because they are hooked on drug treatments. Many doctors claim that people are not patient enough to sit in front of a bright light, every morning for 30 to 45 minutes.
- Many people who use bright-light therapy say that it is good for prevention of severe depression, but it is not effective for reversing the depression once it has started.
© 2011 Dr. John Anderson
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