Winter is Here: Do the Darker Days Darken your Mood?

Anywhere from 1.5% to 9% of people experience depression that follows a seasonal pattern. The depression gets worse in the Autumn and Winter months. It gets better in the Spring. When the symptoms are mild, it is called the "Winter Blues". The Winter Blues can include low mood, low energy, and carbohydrate cravings which lead people to overeat. In more severe cases, a Major Depressive Episode may be triggered by the seasonal changes. Major Depressive Episodes can be cause deep feelings of hopelessness, helplessness, worthlessness, and thoughts that life is no longer worth living. This condition used to be called "Seasonal Affective Disorder". In 2013, the name was changed to "Major Depressive Disorder with Seasonal Pattern".

Since the late 1990's, studies have shown that "Light Therapy" is an effective treatment for Major Depressive Disorder with Seasonal Pattern.

The Can-SAD study was published in 2006. For this study, over the course of 3 winter seasons, doctors at 4 different Canadian medical centers treated severely depressed people with either an 8 week long course of Light Therapy or an 8 week long course of an antidepressant medication (Prozac). What did they find? Both Light Therapy and Prozac helped. With both treatments, Severe Depression became Mild Depression.

The Can-SAD study was rather small. Only 81 people participated. In 2011, to look at this issue on a larger scale, the results of different studies were combined into one big "meta-analysis". That meta-analysis came to the same conclusion as the Can-SAD study. Both Light Therapy and Antidepressant Medications are equally effective.

What does Light Therapy entail?

Essentially, you sit in front of a high intensity Light Box for 30 minutes each morning.

The light box emits bright, artificial light which mimics natural, outdoor sunlight.

It is important to make sure that the Light Box you purchase filters out ultraviolet (UV) light. UV light can damage your eyes and skin.

Light Therapy is "Low Cost". Light Boxes can be purchased online. The cost generally ranges from $35 - $200.

And, Light Therapy is "Low Risk". If any side effects do occur, they are generally mild and short-lived. Such side-effects may include symptoms such as headache, eye strain, troubles sleeping, decreased appetite, and nervousness. There may be a very rare risk of a "manic switch" in people who have Bipolar Disorder. So, anyone who has been diagnosed with Bipolar Disorder should speak with a psychiatrist before embarking on Light Therapy.

Some details to keep in mind:

What:

It is important to get the "right" Light Box.

Make sure that it emits a high-intensity, bright "10,000 lux"light.

Make sure that it filters out UV light.

How:

It is also important to use the Light Box properly.

The light must shine indirectly into your eyes.

Don't look directly into the light.

Don't block your eyes from indirect exposure to the light (no sunglasses!).

The Light Box should be roughly 14 - 24 inches from your face.

That is about the length of your forearm (from your elbow to your fingertip).

When:

Start using it when you notice the beginnings of Seasonal Depression symptoms.

Once you start Light Therapy, be consistent with it.

Ideally, use the Light Box every morning (even on weekends!).

Ideally, use it right after you wake up.

For How Long:

20 - 30 minutes each morning.

Interestingly, Sleep Deprivation has been shown to rapidly reduce depression. A type of treatment called Wake Therapy employs Sleep Deprivation to "kick start" antidepressant treatments (that includes antidepressant medications, Light Therapy, and others). Light Therapy itself tends to work quickly (within days). The rate of response can be further boosted with Wake Therapy, which has an antidepressant effect within hours.

It is best to consult with a psychiatrist before embarking on a course of Wake Therapy.

Basically, it entails depriving yourself of sleep every other night.

Night 1: Stay awake allll night long. You can spend your time freely: take walks, take a bath, talk with family/friends if they are awake, watch TV, cook, listen to music, read, work on your computer, drink coffee, etc... No naps the following day.

Night 2: Go to sleep at 8PM.

Wake up no later than 8AM the following day.

Repeat.

Wake Therapy cycles can be continued for 1 - 2 weeks (up to 7 sleep deprivation nights over 2 weeks).

Combined use of Wake Therapy and Light Therapy have been more effective than either of the two treatments used independently.