SEASONAL AFFECTIVE DISORDER

Shedding Light on an Effective Treatment for Depression

The diagnosis of Seasonal Affective Disorder was first recognized almost 30 years ago when researchers at the National Institute of Mental Health identified patients who experienced regular fall/winter depressions and either full improvements or hypomania during the spring and summer. In tandem with this diagnostic discovery, it was found that bright light therapy, administered with a high intensity light box, generated rapid and often complete elimination of these seasonally-linked depressive symptoms. The era of light therapy was born.

Since these initial investigations, dozens of studies have been conducted that have verified the original observations, clarified how and when to best use light, and determined the optimal types of light to use. This subsequent research has confirmed that bright light therapy is a first line treatment for Seasonal Affective Disorder, being equally effective as antidepressant medication. It has also been found that bright light therapy is effective for non-seasonal depression, again producing equivalent results to that of antidepressants. Light therapy has two additional advantages over medication: it generally acts more quickly, typically producing improvements within one to two weeks. Second, it is safer, avoiding most of the side effects that go along with orally administered, systemic medications.

The most recent wave of light therapy research has examined its use in special groups of depressive patients: the elderly, pregnant women, and those with bipolar depression. In each case, very promising initial results have been found.

A note of caution: light therapy is not a treatment to be considered casually. It is a powerful biological intervention that can cause serious mood and other side-effects if not administered correctly. Do not simply go out, buy and plug in the cheapest light box you can find. As with any treatment, find a competent clinician who can conduct a thorough evaluation, decide if light therapy is appropriate and, if so, provide counsel on the right light box to use, the correct methods and the optimal timing and duration. The Center for Environmental Therapeutics has a wonderful website, www.cet.org, that provides a complete overview of light-based and other non-pharmacologic treatments for depression.

At this point, bright light therapy is an established antidepressant option for both seasonal and non-seasonal depression and a logical choice for those who cannot tolerate or those who prefer not to use medication. It is an easy-to-use, home-based treatment that can be utilized on its own or in combination with pharmacotherapy. When considering antidepressant treatments, make sure light therapy is given a place at the table.

John F. Gottlieb, M.D.
—Rebecca’s Dream Scientific Advisory Board