Help ease SAD symptoms with light therapy
Therapy lamps can be `transformational' for those who find right one and use it correctly
When it really works, it can make you feel so much better. It's amazing. Your energy comes back, your mood improves, your view of life improves.
For some people, winter triggers a shift in their mood and behaviour, causing what's known as seasonal affective disorder, or SAD.
This winter, the onset of SAD may be exacerbated by the coronavirus pandemic.
“Folks are noticing it a lot more because of trying to maintain their social distancing and follow the rules related to stayat-home,” said Dorothy Sit, an associate professor of psychiatry at Northwestern University.
SAD is a form of clinical depression. Symptoms include sadness, loss of interest in activities you once enjoyed, difficulty concentrating, fatigue and in extreme cases, thoughts of suicide or death. But experts say there is a simple and effective treatment: light therapy via specially designed lamps.
“It can be transformational,” said Norman Rosenthal, who led the team of researchers that first described SAD in the 1980s and helped develop light therapy. “When it really works, it can make you feel so much better. It's amazing. Your energy comes back, your mood improves, your view of life improves.”
Here's what you need to know about light therapy.
Q What are SAD lamps?
A They mimic the “light intensity that comes from the sky at sunrise on a clear day,” said Kelly Rohan, professor of psychological science at the University of Vermont. “What we're trying to do is simulate an early dawn.”
The light, usually from fluorescent bulbs, is UV filtered to protect people's eyes and skin from damage.
Q Why does light help?
A A change in photoperiod, the number of daylight hours, is believed to have more of an influence on mood and behaviour than temperature, precipitation and the brightness of the light during the day.
This change in photoperiod is thought to affect the circadian clocks of people with SAD.
Light therapy first thing in the morning is believed to “jumpstart those circadian rhythms back into the normal phase like they would be in the summertime when the individual with seasonal affective disorder is typically feeling at their best,” Rohan said.
“There is a special class of cells in the retina that detect the brightness of environmental light,” said Dr. Paul Desan, director of the Winter Depression Research Clinic at the Yale School of Medicine.
Though experts may not know exactly why SAD lamps are effective, “there is very solid research that exposure to bright light first thing in the morning is a very powerful treatment for the majority of people with seasonal affective disorder,” Desan said.
A 2005 meta-analysis published in the American Journal of Psychiatry found bright light therapy significantly reduced the severity of depression in people with SAD and nonseasonal depression, comparable to the effects found in antidepressants.
If used properly and with guidance from a clinician, research has shown the devices can help people with other mental health conditions, such as prenatal depression and bipolar depression.
“It's a very, very valuable addition to our therapeutic arsenal,” said Rosenthal, clinical professor of psychiatry at Georgetown University School of Medicine.
Q How do I know if I should get a SAD lamp?
A Light boxes can help people with the “winter blues” as well as those diagnosed with SAD. But regardless of how severe your seasonal depression is, experts recommend talking to a clinician before starting light therapy.
“There's no one size fits all” when it comes to light therapy treatment, Rohan said. “How
many minutes today, what time or times of day does this person need to use it to maximize benefit, minimize side-effects? It's a bit of a trial-error process even for those of us who know what we're doing. To try to do that on your own is, I think, a daunting task.”
Desan cautioned that unsupervised use of light therapy by people with complex mental health issues could worsen their condition. “You really don't want to treat yourself for depression,” he said.
Q What should I look for when buying a lamp?
A “If someone with SAD goes online to buy a light box, the vast majority of stuff that they're going to find online is not appropriate, and a few of them are even unsafe,” Desan said.
Experts recommend looking for a box that emits light at 10,000 lux, the standard for effective treatment. Ideally, it should be fairly large, Sit said, “pretty much the size of a desktop monitor.”
Be wary of small lights boasting 10,000 lux as they may require you to position them very close to your face.
“The manufacturer should tell you explicitly at what distance from the device it makes 10,000 lux,” Desan said. Apps you can download on your phone measure lux, “so you can see how far away from your device you have to be to get 10,000 lux.”
Prices can range widely. Among the devices that Desan recommends, the least expensive is about $100. You can find a quality device “that will last forever” for about $300, he said.
Q How do I use my lamp?
A Use it daily at the same time to be effective. Experts recommend sitting roughly a foot away for about 30 minutes shortly after waking up.
Make sure it's shining on your face and your eyes are open — the light must reach your eyes, so the retina cells can send the right signals — but do not stare directly into the light. Use the time for other activities that are part of your routine, such as reading the paper or eating breakfast.
“We find a way to weave it into their daily system and they can sort of improve their daily use and they're likely to get some good benefit,” Sit said.
Q When will I start feeling the effects?
A “It may take two to four weeks,” Desan said. “But usually people start getting an effect within days, which is much quicker than with an antidepressant. Do the treatment before 8 a.m. for a solid month before you decide it doesn't work for you.”
Sit said it's critical to stick to a regimen. “If people skip treatment, they can quickly experience the symptoms coming back,” she said.
Q Are there any side-effects?
A While it's widely regarded as a safe treatment, “anything can be overdone,” Rosenthal said. Too much exposure may cause headaches or eye strain. And some people have reported feeling “revved up like you've been drinking too much coffee.”
If you experience such problems, dial it back. Move the box slightly farther away or adjust the intensity.
People with retinal problems, for instance, should exercise caution, Rosenthal said. “Absolutely consult your eye doctor.”
Q Are there alternatives to SAD lamps?
A Antidepressant medication and cognitive behavioural therapy, or CBT, are effective in treating SAD. While CBT and light therapy produce similar results over the short-term, Rohan added, over the long-term, “the people who get treated with CBT have less severe depression symptoms.”
If you're looking for more general ways to improve mood and energy, experts suggest increasing your exposure to natural sunlight. Take walks in the morning or spend more time near windows during the day.
Desan recommended “a holistic approach” that includes regular exercise, a healthy sleep routine, maintaining social connections and avoiding excess use of alcohol or other substances.