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

Study: Light therapy for S.A.D. may also help with sleep, alertness

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

S.A.D. or Seasonal Affective Disorder, is depression that occurs in a seasonal pattern, most commonly in the winter months, and sometimes it is called “winter depression” (1).

Additional symptoms may include fatigue, weight gain, increased appetite, oversleeping (1) occurring in a seasonal pattern.

SAD may often co-occur with a variety of other mental health conditions.

It can often occur as part of other mood disorders such as depressive disorders, bipolar disorder, etc (2).

What are some Treatment options for S.A.D.? (3)

  • Counseling
  • Medication
  • Vitamin D (5)
  • Light therapy
  • Other helpful strategies for improving depression may include :  nutrition (6 ), exercise (7 ), and being socially active.

A recent study looked at the impact of light therapy on sleep and circadian rhythm.

What was the study?

The study authors (8) identified and reviewed 40 available studies on the subject.

What were the results?

  • The study authors (8) found that while both bright light and SSRi’s helped mood, bright light therapy also helped with sleep wake cycle.
  • Separately (9), an analysis of 3 randomized trials found that dawn simulation ( a type of light therapy delivered in the mornings) helped with mood and reduced difficulty awakening and reduced morning drowsiness (9).

What are some caveats?

While the treatments are beneficial:

  • Light therapy can have side effects (10) such as mania, hyperactivity, irritability, headaches, etc.
  • Other treatment options mentioned above can also have side effects.

For this reason, if you are experiencing a seasonal pattern of depression, please seek the help of a mental health professional to determine IF and how much and what type of treatment may be best for you.

What are some of OSU’s campus resources for S.A.D. ?
•  OSU Office of Student Life- Counseling and Consultation Service
OSU Wilce Student health center

• OSU Student Wellness center (Wellness coaching, nutrition)
• Exercise at the RPAC

Are there any other helpful resources?

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. http://www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder.html
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013.
  3. Lam RW, Levitt AJ (editors). Canadian Consensus Guidelines for the Treatment of Seasonal Affective Disorder. Vancouver, British Columbia, Clinical & Academic Publishing, 1999. http://www.ubcsad.ca/.
  4. American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder, Third Edition. October, 2010. http://psychiatryonline.org/guidelines
  5. https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml
  6. https://u.osu.edu/emotionalfitness/2018/06/28/food-choices-to-improve-depression/
  7. https://u.osu.edu/emotionalfitness/2017/10/20/weight-lifting-exercise-and-mental-health/
  8. Menculini G, Verdolini N, Murru A, et. al. Depressive mood and circadian rhythms disturbances as outcomes of seasonal affective disorder treatment: A systematic review. J Affect Disord. 2018 Dec 1;241:608-626. doi: 10.1016/j.jad.2018.08.071. Epub 2018 Aug 15.
  9. Avery DH, Kouri ME, Monaghan K, Bolte MA, Hellekson C, Eder D. Is dawn simulation effective in ameliorating the difficulty awakening in seasonal affective disorder associated with hypersomnia? J Affect Disord. 2002 May;69(1-3):231-6.
  10. https://www.mayoclinic.org/tests-procedures/light-therapy/about/pac-20384604

 

Bothered by Winter? Could you have Seasonal Affective Disorder?

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

Job # 071125 Snow DEC-05-2007 Photo by Jo McCulty The Ohio State UniversityWinter can be a difficult time of year. For some students, it could be seasonal affective disorder (SAD).

What is SAD?
SAD is depressive symptoms that come and go during a particular time of year. SAD is now considered a subtype of either depression or bipolar illness (1).
Two seasonal patterns of SAD are fall-onset SAD and the summer-onset SAD. The fall-onset type, also known as “winter depression,” is more common; with depressive symptoms starting in the fall and improving by spring or summer. A spring-onset, fall-offset pattern is quite rare (2).

How common is SAD?
•SAD can occur in up to roughly 10% of the population across 20 retrospective studies (5) and a milder form among 10% to 20 % of the population (7).
• It is more common at higher northern latitudes (further away from the equator) (6), possibly because of less sunlight.
• People who relocate to higher latitudes from lower latitudes can be more vulnerable (5).

What are the symptoms of SAD?
Fall-onset tends to have what I call, “hypoactive type” symptoms depression (1,3), with symptoms of:
• Depressed mood AND
• Increased sleep, increased appetite with carbohydrate craving
• Increased weight
• Irritability
• Interpersonal difficulties (including sensitivity to rejection)
• Heavy, leaden feelings in arms or legs

Spring-onset SAD can have “hyperactive type” symptoms of depression such as insomnia, poor appetite, and weight loss.

What can students do to prevent or lessen SAD symptoms?
• Get active by exercising (check with your doctor first)
• Eat a healthy balanced diet of protein/veggies/fruit/whole grains, Omega 3’s
• Don’t isolate from family, friends, or colleagues and get involved on campus
• Take advantage of sunny days (open blinds, study near windows, time outside if possible, etc)
• Counseling
• Talk to your doctor about light therapy, medication options.

What are some of OSU’s campus resources for SAD?
Student Wellness center (Wellness coaching, nutrition)
• Exercise at the RPAC
•  Counseling and Consultation Service
Wilce Student health center

Are there any other helpful resources?

• Medline plus (4)
NAMI (National Alliance for Mental Illness)

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. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington, VA 2013
2. Wehr TA, Sack DA, Rosenthal NE. Seasonal affective disorder with summer depression and winter hypomania. Am J Psychiatry 1987; 144:1602.
3. Tam EM, Lam RW, Robertson HA, et al. Atypical depressive symptoms in seasonal and non-seasonal mood disorders. J Affect Disord 1997; 44:39.
4. http://www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder.html
5. Magnusson A. An overview of epidemiological studies on seasonal affective disorder. Acta Psychiatr Scand 2000; 101:176.
6. Mersch PP, Middendorp HM, Bouhuys AL, et al. Seasonal affective disorder and latitude: a review of the literature. J Affect Disord 1999; 53:35.
7. Kasper S, Wehr TA, Bartko JJ, et al. Epidemiological findings of seasonal changes in mood and behavior. A telephone survey of Montgomery County, Maryland. Arch Gen Psychiatry 1989; 46:823.
8. Uptodate.com Seasonal Affective disorder. Accessed 2/3/2015.