Treating Seasonal Affective Disorder: Light Therapy And Other Treatments
By: Julia Thomas
Updated March 07, 2020
Medically Reviewed By: Whitney White, MS. CMHC, NCC., LPC
Seasonal affective disorder is a condition that causes people to have symptoms of depression during the winter season. They have low energy, feel worthless, can't concentrate, have little pleasure, and have strong cravings for sweet and high-carbohydrate foods. After a winter with these symptoms, they emerge in the spring happier, but out of shape and with damaged relationships. However, some treatments can help with seasonal affective disorder. Light therapy, also called phototherapy, is one of several options.
What Is Light Therapy?
Light therapy is a treatment for medical and mental health conditions, including SAD. Light therapy boxes supply the light that people who have seasonal affective disorder need during the winter. The person sits in front of the light box for a specific amount of time each day to absorb the light. For SAD, light therapy can be used alone or with other treatments.
What Is A Light Therapy Box?
A light therapy box for SAD is a device that provides a specific wavelength of light. What is the right type of light? It's important to talk to your doctor or therapist and ask what they recommend in terms of the type of light and other factors in light therapy for SAD.
Types Of Light Boxes
Several different research studies have explored which wavelength works best. For example, in one study, the researchers concluded that 607 microWcm2 blue light was more effective than dimmer red light for treating SAD.
The brightness of the light can be measured in lux as well. For reference, typical indoor lighting is rated at 100 lux, and a bright sunny day could be 50,000 lux or more. Another study found that short wavelength light of less than 2500 lux was effective for treating the seasonal affective disorder. In fact, the subjects' depression ratings decreased an average of 82%. A third study found that short-wavelength LED lights worked well at fewer lux than fluorescent lights.
Scientists are also exploring new types of SAD light therapy boxes. One idea is to use a box that gradually increases the intensity from darkness until it reaches a sunrise effect at 300 lux. Another option is to use blue light to have a more powerful impact on the retina than white light.
However, Mayo Clinic and others suggest a full-spectrum light therapy box supplying light of 10,000 lux that filters out the UV light. The brighter the light is, the less time you'll need to use it.
Also, make sure you get a box that's designed to use for SAD treatment instead of one that's made to treat skin disorders or other conditions. The UV filter is critical for SAD light therapy because, without it, eye damage can occur. This is one reason light therapy boxes made for skin disorders are harmful for use as SAD lights; the presence of UV is a key feature in helping with skin disorders.
There are also other factors to consider when using light therapy boxes. You need to sit a specific distance away from the SAD light therapy box. The right time of day to do this is typically early in the morning when you first wake up. Your eyes must be open, but you can't look directly at the light. And, you'll need to use the light therapy box for a specified amount of time each day.
Why Does Light Therapy Help?
Scientists haven't yet concluded why some people have seasonal affective disorder while others have no symptoms of depression during the winter. However, light does seem to be a factor. This has to do with the part of the brain called the hypothalamus, which controls your circadian rhythms to signal to your brain whether it's night or day. When you use a seasonal depression light therapy box, the light activates the hypothalamus, restoring your normal circadian rhythms. When that happens, the depression typically lifts.
SAD light therapy has very few side effects. However, some people should not use it. It's best to talk to a professional to make sure it's right for you. Light therapy can bring on hypomania or mania for people with bipolar disorder. Also, people with diabetes or eye diseases may experience retinal damage.
Light therapy for depression might not be right for people with lupus, who may experience skin problems when using SAD light therapy. If you're taking medications or herbal supplements that increase your sensitivity light, the side effects may be more severe.
Other mild and short-term side effects include:
If you do have mild side effects, they may go away a few days after you begin treatment. You can also adjust your distance away from the light, the time of day you use it, or by taking breaks during sessions. By working with a professional, you can fine-tune the therapy so that it works best for you.
Reasons to Choose Light Therapy For SAD
Aside from the fact that light therapy can help with seasonal affective disorder, why might you want to choose it? After all, there are many types of treatment for depression. Here are some reasons to consider:
- Doctors often recommend it.
- It's at least as effective as antidepressants.
- It's relatively safe for most people and has only a few side effects.
- It's safer for a most pregnant woman than medications.
- It may boost the effectiveness of an antidepressant you're taking.
- Combining light therapy with mental health counseling may improve your condition.
Other Types of Treatment For Seasonal Affective Disorder
Besides light therapy, SAD can be helped with other treatments. Sometimes, more than one treatment may be used for maximum effect and to reduce treatment time. The other most common treatments used are medications, psychotherapy, mind-body techniques, and Vitamin D supplements.
For people with severe symptoms of SAD, antidepressant medication can be a helpful treatment. Often, extended-release bupropion is used, and this treatment has been approved for the treatment of SAD. However, other antidepressants, called SSRIs, are also used. They include:
- Fluoxetine (Prozac)
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
Many doctors prefer to prescribe bupropion because it has fewer side effects than SSRIs. The SSRIs can cause weight gain and loss of sex drive, for example. Your doctor or psychiatrist will assess your condition, risk factors for side effects, and other factors to determine which is the best option for you. It's important to be patient with antidepressant medications because you might not feel the full effects for several weeks.
Psychotherapy has been used to treat all kinds of depression for a long time before SAD lights existed. Now, it can be used alone or combined with light therapy and medications to improve the outcome of treatment. Psychotherapy consists of talking to a therapist who guides you as you work out problems and resolve mental health issues.
Cognitive behavioral therapy is one type of psychotherapy that can help with SAD. Basically, the process entails identifying the thoughts behind your feelings or behaviors, questioning their validity, deciding whether to hold onto those thoughts and then replacing them with more helpful thoughts if needed.
CBT can help with the seasonal affective disorder in several ways. First, it can help you change thoughts that are causing you to feel worse. Also, you can learn coping skills that will help you deal with the symptoms of SAD. You can learn to diminish avoidance behavior and work on scheduling helpful activities. Finally, you can learn to deal with stress more effectively.
Most people use mind-body techniques on their own or with a class or group. They aren't typically the main focus of regular psychotherapy, although your therapist may include them as a part of your treatment. Some mind-body techniques include:
- Meditation, especially mindfulness meditation
- Guided imagery
- Tai Chi
- Music therapy
- Art therapy
- Relaxation techniques
Vitamin D is called the sunshine vitamin because you can get it from sunlight. If your body is low on Vitamin D, supplements can help bring that level up to normal. However, if your Vitamin D levels are already normal or higher, these supplements will not help. Also, consider that research results have not shown conclusively that Vitamin D is helpful for seasonal depression.
Self-Help For SAD
While it's important to get the professional care you need, there are also several things you can do to help yourself. Some of these include:
- Spend time outside when the sun is shining.
- Take a vacation to a sunnier locale.
- Make sure you get no more than nine hours of sleep at night and don't sleep during the day.
Getting Treatment for Seasonal Affective Disorder
Before you assume you have a seasonal affective disorder and need a light therapy box, it's important to make sure of your diagnosis. Talk to a physician or mental health profession to find out if you truly do have SAD.
If you do find out you have SAD, your doctor or therapist will suggest treatments to help you deal with it. Again, if they suggest a light box, be sure it is a seasonal affective disorder light therapy box that meets the specifications your doctor gives you. Then, use it in the way they recommend you use it. You can also talk to a counselor at BetterHelp for online therapy to help you manage your disorder and its symptoms. When you get the treatment you need, your winters may go much smoother so that you can enjoy spring even more.