Proper use of Light therapy for seasonal affective disorder

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Seasonal affective disorder or seasonal depression is depressive symptoms or mood instability that occurs on a seasonal basis, most commonly during winter months.

Additional symptoms may include fatigue, weight gain, increased appetite, oversleeping (1).

Treatment includes medications, counseling, lifestyle habits, and counseling.

What are some lifestyle habits that can help with Seasonal affective disorder?

  • Sleep hygiene
  • Aerobic exercise upto 1 hour, 2-3 times per week (2)
  • Daily walks outside upto an hour (3).
  • Light therapy (1).

With technological advances, many light boxes are now available at a more affordable cost.  It is recommended that you discuss with your health care professional to see if light therapy is right for you.

For proper use of light therapy, The Mayo clinic advises the following (4):

  • It’s best to talk with your health care provider about choosing and using a light therapy box.
  • If you’re experiencing both SAD and bipolar disorder, the advisability and timing of using a light box should be carefully reviewed with your doctor.
  • Increasing exposure too fast or using the light box for too long each time may induce manic symptoms if you have bipolar disorder.
  • If you have past or current eye problems such as glaucoma, cataracts or eye damage from diabetes, get advice from your eye doctor before starting light therapy.
  • Generally, the light box should:
    • Provide an exposure to 10,000 lux of light
    • Emit as little UV light as possible
  • Typical recommendations include using the light box:
  • Regarding timing, use within the first hour of waking up:
    • For about 20 to 30 minutes
    • At a distance of about 16 to 24 inches (41 to 61 centimeters) from the face
    • With eyes open, but not looking directly at the light

Additional information can be found here: https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/ART-20048298?p=1

Additional thoughts:

  • Daily use is most likely to produce benefit.
  • Some may need to use it daily for a few weeks before having a noticeable benefit.
  • Some people may benefit from using light therapy starting out at 30 minutes and working your way up to 1 hour per day.
  • More information on seasonal affective disorder click here.

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References

  1. https://u.osu.edu/emotionalfitness/2019/01/29/study-light-therapy-for-s-a-d-may-also-help-with-sleep-alertness/
  1. Partonen T, Leppämäki S, Hurme J, Lönnqvist J. Randomized trial of physical exercise alone or combined with bright light on mood and health-related quality of life. Psychol Med 1998; 28:1359.
  2. Wirz-Justice A, Graw P, Kräuchi K, et al. ‘Natural’ light treatment of seasonal affective disorder. J Affect Disord 1996; 37:109.
  1. https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/ART-20048298?p=1

Using Systems + Goals to increase success

“You do not rise to the level of your goals. You fall to the level of your systems.  Your goal is your desired outcome. Your system is the collection of daily habits that will get you there.” James Clear (6)

Many people start the new year by setting goals but less than 10 % of people keep their New Year’s resolutions each year (1, 2).

Is there a better way?

First, to set effective goals, consider the following:

  • For goal setting, consider S.M.A.R.T. goals (Specific, Measurable, Achievable, Realistic, Time bound) (4).
  • A goal card (5) may also be helpful.

After effective goal setting, focus on the system:

In his book Atomic Habits, author James Clear suggests the following strategies to think of systems (6):

  • Goals are good for setting a direction, but systems are best for making sustained progress (6).
  • For example, you might ahave a goal to clean up a messy room (6). But if you maintain the same sloppy, pack-rat habits (system) that led to a messy room in the first place, soon you’ll be looking at a new pile of clutter and hoping for another burst of motivation (6).
  • If you’re a student, instead of getting an A, a better goal could be to become a better student (a system).  This would shift your focus to the daily process:
    • How often and how much you study
    • Improve your study skills
    • With whom and where you study
    • How you address difficult topics
    • Your eating, sleeping, and exercise habits.
    • Your method for tracking progress before grades/exam. This could be in terms of quizzing or testing yourself, etc.

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

 

References:

  1. https://www.iflscience.com/brain/psychology-new-year-s-resolutions/
  2. Norcross, John & Mrykalo, Marci & Blagys, Matthew. (2002). Auld Lang Syne: Success Predictors, Change Processes, and Self-Reported Outcomes of New Year’s Resolvers and Nonresolvers. Journal of clinical psychology. 58. 397-405. 10.1002/jclp.1151.
  3. https://www.healthdirect.gov.au/goal-setting#:~:text=Setting%20goals%20is%20an%20effective,the%20recovery%20from%20mental%20illness.
  4. https://www.cdc.gov/dhdsp/evaluation_resources/guides/writing-smart-objectives.htm
  5. Goal card: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954583/figure/fig1-2055102918774674/
  6. Atomic Habits: Tiny Changes, Remarkable Results by James Clear

Technology, Electronics, and Mental Health

With online classes, distance learning, homework time, and remote work; people are increasingly spending more time with electronic devices and technology than in the past.  This increased screen time for work, school may cause previously used screen time for leisure activities not as restorative; as this may increase total screen time and sedentary behavior.

Zhai and colleague’s review of 24 studies shows that too much screen time (> 6 hours per day) can impact depression (1).  Similar, a review of 31 studies concluded that sedentary behavior may also impact anxiety (2).

More devices are now available than ever before: computers, televisions, tablet pcs, smartphones, smart watches, etc.

While healthy technology use can have benefits of productivity, social connection, entertainment,  and improved health; unhealthy technology use can worsen our distraction,  isolate us socially, increase stress, expose us negative social influences; and negatively impact our health.

The American Psychological Association (3) offers the following strategies to use technology in healthy ways:

  1. Avoid distracted driving (3): APA advises us to turn off notifications and place your phone out of reach when driving.
  2. Avoid electronic devices before bedtime (3). Previous research showed blue light from electronic devices used at bedtime can impact sleep (4), stressful material on electronic devices can also interfere with our ability to fall asleep (3).
  3. When smartphone users turned off smartphone notifications, they reported lower levels of inattention and hyperactivity than they did during weeks when their notifications were turned on (3, 5).  Frequent notifications were also associated with lower levels of productivity, social connectedness and psychological well-being (3,5).
  4. Schedule time for email, when possible. People who checked email continuously reported more stress than those who checked email only three times per day (3, 6).
  5. Manage expectations (3). If possible, schedule time to check messages, email, notifications etc and if possible, let others (family members, boss, etc) know how often you do this, to help manage their expectations.
  6. While social media can help us connect with others, it can also impact feelings of sadness or depression (3, 7), other people may find it helpful. Consider how social media use makes you feel and adjust your use accordingly.
  7. Face to face interactions are important for mental health. The 2017 Stress in America survey found 44 percent of people who check email, texts and social media often or constantly report feeling disconnected from their family, even when they’re together (3). When you’re with friends and family, make an effort to unplug: consider silencing your phone and put it out of reach at dinnertime or during family outings (3).
  8. Disconnect: Instead of grabbing your phone during spare time, disconnect from electronics to reflect, recharge, relax; and collect yourself (3).

To counteract excessive screen time, sedentary behavior from remote work/learning, consider the following:

  • Periodic breaks away from the screen, even a few minutes per hour may help.
  • Stretching, walking during these breaks may be helpful.
  • Instead of mindless “infinite” scrolling, consider your goal before starting a device or program.
  • Consider time outside, in nature and other leisure activities for mental health.
  • Exercise, playing sports can also help address the negative mental health effects of excessive sedentary behavior and screen time.
  • Check out mindful technology use by OSU Digital Flagship

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Zhai L, Zhang Y, Zhang D. Sedentary behaviour and the risk of depression: a meta-analysis. Br J Sports Med. 2015 Jun;49(11):705-9. doi: 10.1136/bjsports-2014-093613. Epub 2014 Sep 2. PMID: 25183627.
  2. Stanczykiewicz B, Banik A, Knoll N, Keller J, Hohl DH, Rosińczuk J, Luszczynska A. Sedentary behaviors and anxiety among children, adolescents and adults: a systematic review and meta-analysis. BMC Public Health. 2019 Apr 30;19(1):459. doi: 10.1186/s12889-019-6715-3. PMID: 31039760; PMCID: PMC6492316.
  3. Ballard D. Connected and content: Managing healthy technology use. American Psychological Association.  https://www.apa.org/topics/healthy-technology-use
  4. https://u.osu.edu/emotionalfitness/2015/07/17/blue-blockers-and-other-ways-to-reduce-electronics-induced-sleep-disruption-and-daytime-tiredness/
  5. Kostadin Kushlev, Jason Proulx, and Elizabeth W. Dunn. 2016. “Silence Your Phones”: Smartphone Notifications Increase Inattention and Hyperactivity Symptoms. In Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems (CHI ’16). Association for Computing Machinery, New York, NY, USA, 1011–1020. DOI:https://doi.org/10.1145/2858036.2858359
  6. Kostadin Kushlev, Elizabeth W. Dunn, Checking email less frequently reduces stress, Computers in Human Behavior, Volume 43, 2015, Pages 220-228, ISSN 0747-5632, https://doi.org/10.1016/j.chb.2014.11.005.

(http://www.sciencedirect.com/science/article/pii/S0747563214005810)

  1. Lin LY, Sidani JE, Shensa A, Radovic A, Miller E, Colditz JB, Hoffman BL, Giles LM, Primack BA. ASSOCIATION BETWEEN SOCIAL MEDIA USE AND DEPRESSION AMONG U.S. YOUNG ADULTS. Depress Anxiety. 2016 Apr;33(4):323-31. doi: 10.1002/da.22466. Epub 2016 Jan 19. PMID: 26783723; PMCID: PMC4853817.