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A bit about Seasonal Affective Disorder and light therapy

PosTMOd

Well-Known TRIBEr
From Maclean's... January 14th, 2002

Surviving the winter

KRISTIN JENKINS

Wu was suicidal before he learned to treat his problem

David Wu, 32, a registered acupuncturist who lives in Richmond, B.C., had seen many doctors and taken many medications before being diagnosed just over a year ago with seasonal affective disorder, or SAD. Until then, nothing worked. For two decades, Wu had struggled to cope with the mental, physical and emotional lethargy that started as early as August and didn't ease up until April. The disorder had a profound impact on everything from personal relationships to his schoolwork and vacation schedule. He changed his major from biology because he lost the ability to sustain the effort. "My interests became more introspective," he says, and he switched to psychology. Still, it was a nine-year struggle to complete his degree at the University of British Columbia.

Then in December, 2000, Wu's state worsened. "I had an overwhelming impulse to end my life," he says, and he ended up in hospital. But when doctors analyzed the patterns of his moods with the help of journals he'd been keeping, Wu finally came to understand what was bothering him. Now, back into the winter months, Wu is being careful to stick to his new treatment regimen, one that includes exercise, psychotherapy, an antidepressant -- and anywhere from 30 to 45 minutes of light therapy first thing in the morning.

Welcome to the world of SAD, also known as the winter blues. On dark mornings, some people's biological clocks don't receive a strong enough light signal to get them going. The result is a sluggish, irritable feeling that persists throughout the day. Although Wu's case may be extreme, seasonal affective disorder leaves at least 600,000 Canadians mildly to moderately depressed each winter. In most cases, the condition surfaces in October, then disappears with the return of longer days in April. Many Canadians suffer for years before being diagnosed. Others don't seek treatment because they don't think anything can be done.

Now dozens of clinical studies have shown that light therapy -- simply exposing a patient to bright light for a period of time each day -- can be highly effective in treating two-thirds of SAD patients. Other studies have established that antidepressant medications can also help. But just who will respond to light therapy, to an antidepressant, or to both, remains a mystery.

Soon, much-anticipated findings from a unique cross-Canada investigation will pave the way for doctors to make that determination. The three-winter SAD study, currently in its second year, will enrol 210 patients all told in Vancouver, Winnipeg, Toronto and Saint John, N.B. "There were no good studies where both light therapy and antidepressants are used," says Dr. Raymond Lam, professor of psychiatry at the University of British Columbia and principal investigator in the study.

If therapy can be individually tailored, that could greatly improve the success rate for treating people with SAD, says Dr. Anthony Levitt, associate professor of psychiatry at the University of Toronto and one of five researchers conducting the national study. It could also help patients avoid unnecessary medication. "People are sitting on the edge of their chairs waiting for the results," says Levitt.

Help could also be on the way in the form of a highly portable light-producing device called Litebook. If it proves to be as effective as the larger, heavier units in general use, says Lam, Litebook could provide "a significant advance" for the treatment of SAD as well as other conditions that appear to respond to light therapy. One of those conditions is jet lag. "Travellers and business people," Lam notes, "generally don't have the luxury of several days to recover after a long flight."

The brainchild of Medicine Hat, Alta., entrepreneur Larry Pederson, Litebook uses light-emitting diodes (LEDs) to create an intense beam while consuming just one-tenth the power of an incandescent bulb. Pederson, 44, who has suffered from SAD since his teens, admits to being skeptical about light therapy. But in the fall of 1994, he found that sitting in front of a big light box every morning for 30 minutes "literally changed my life." The problem was that he, like other light therapy users, found the large unit inconvenient and something less than portable. There was also, he says, a stigma attached to its appearance: "It looked like a medical device."

Deciding to "build a better mousetrap," Pederson took his idea to a former schoolmate at the Defence Research Establishment Suffield, 40 km northwest of Medicine Hat. There, high-tech experts working on robotic land mine detection systems devoted their own time to producing a design for a light box the size of a laptop computer. Too big, Pederson told them -- he wanted something he could hold in one hand. Then in November, 1999, Pederson read an article in an obscure electronics journal about the invention of a white LED that shone a beam about half the diameter of a pencil. "I couldn't believe how bright it was," says Pederson. "And there was no heat and no ultraviolet."

Armed with this information, he enlisted the help of two industrial design students who came up with a device no bigger than a portable CD player. "It looked like Sony or Phillips had built it," says Pederson. "Everybody loved it." Last winter, he sent 20 prototypes out to be tested by SAD sufferers as well as business travellers and flight crews seeking relief from jet lag. His problem then? "I had trouble getting them back."

Now Pederson is selling the units, for $549, in a growing number of home care and natural food stores. While the anecdotal evidence looks good, it could be a year or two before there is clinical verification of the effectiveness of the Litebook for treating SAD. But there is plenty of evidence that existing light boxes, widely available for $300 to $500, do actually work.

For David Wu, the diagnosis of SAD was a turning point. But his quest for a better quality of life continues. Wu knows he needs more than light therapy, medication and counselling to prevent the return of depression. "I make a point of keeping a busy schedule, doing a lot of physical exercise and talking to supportive friends," he says. "I do things that give me joy, like singing in a choir and volunteering one morning a week at a local preschool." Wu, who swims and practises martial arts, also plans to escape to a retreat in Southern California this winter. There, for a week to 10 days, he will work outdoors planting and harvesting fruits and vegetables -- and soaking up the sun. "I know I'm vulnerable," says Wu. "I have to take care of myself."

LET THERE BE LIGHT

Researchers report some success in using light therapy to treat health problems, other than seasonal affective disorder (SAD), that may result from disruption of the body's internal clock, or circadian rhythm. Major breakthroughs in treatment may take time, however, as the fledgling industries that produce light therapy equipment don't have deep pockets for research. The story so far:

  • Sleep disorders: There is clinical evidence light therapy can help night owls who have trouble falling asleep until the wee hours, as well as people who suffer from excessive daytime sleepiness.
  • Non-seasonal depression: Several studies indicate that light therapy may relieve symptoms quickly. Still to be determined is whether it works as well as the new antidepressants.
  • Jet lag: Light therapy -- not just exposure to light but also avoiding it -- has helped treat jet lag among travellers who cross several time zones. Beyond that, time is the only cure for the flyer's lethargy, lack of alertness and inability to concentrate.
  • Premenstrual syndrome: In San Diego, Dr. Barbara Parry has shown that light therapy can reduce such SAD-like symptoms as depression and an increased need for sleep and food among women with PMS.
  • Bulimia: Light therapy may reduce symptoms in women with the binging/purging eating disorder, particularly in the third of sufferers whose symptoms get worse in the winter.
  • Depression during pregnancy: A clinical trial under way at Yale, Columbia and the University of Louisville is studying the use of light to treat depression among pregnant women. Depression affects up to 10 per cent of expectant mothers, and a non-drug therapy is particularly important for these patients to avoid any risk to their unborn children.
 

PosTMOd

Well-Known TRIBEr
Also, from the other thread, from deep:

<font face="Verdana, Arial" size="2">1. It's the brightness of the light, and not necessarily the spectrum, that is necessary for a positive benefit. The commercial lightboxes have a fuller spectrum but are more expensive. Things like the 500w halogen lamp I was talking about don't have the same spectrum but do have the brightness. The level of brightness necessary for positive benefit ranges between 2500 to 10000 lux. A single 500watt halogen bulb will provide 10,000 lux. You can estimate whether or not the light you're getting is full spectrum or not by whether it's yellow (not full spectrum) or white (full spectrum).

2. The light has to be at a certain distance from your eyes, and the light has to be able to get into your eyes unimpeded (no glasses, no eyes closed, etc). Try to keep the light within a little less of a meter of your eyes.

3. Exposure time should be a half hour daily @ 10,000 lux, 1 hour at 5000 lux, etc.</font>
 

PosTMOd

Well-Known TRIBEr
For conversions, since most bulbs give a rating in lumens...

1 lumen/square meter = 1 lux

But, since you don't have to really care about the surface area you are shining onto, you can say that 1 lumen = 1 lux... at a distance of one metre...

Light intensity follows an inverse square law, so if you double the distance, the intensity is 1/4, or if you quadruple the distance, the intesity is 1/16...

Example: 10,000 lumens (or lux) at one metre... you move so that you are two metres away (twice as far)-- the intensity goes down to 2500 lumens (or lux)... if you move to four metres away, the intensity is only 625 lumens (or lux)...
 

DJ Doublecross

TRIBE Member
Any idea about heat generation? If you sit with a 10,000 lux light 1 metre from your head, are you going to lose 50 pounds each session from sweating?

Rob
 

PosTMOd

Well-Known TRIBEr
To reiterate
  • Use a bright light... 500W halogen is good...
  • The brightness of the light is more important than the spectrum-- UV is not necessary, and in fact can be harmful
  • 30 minutes a day is usually good enough.. effects take from 3 days to 1.5 weeks to notice... the morning is when it should be done, or your internal clock may get completely messed...
 
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PosTMOd

Well-Known TRIBEr
<font face="Verdana, Arial" size="2">Originally posted by DJ Doublecross:
Any idea about heat generation? </font>
Incandescent bulbs are very effective heaters... they convert about 2% of the electricity into light, and the rest into heat... get a fan


In the Maclean's article, a newer device is mentioned that uses white LEDs, which are extremely efficient in producing light...

I'm thinking seriously of looking into building something like that and marketing it... it shouldn't cost $500 like in the article...
 

deep

TRIBE Member
<font face="Verdana, Arial" size="2">Originally posted by DJ Doublecross:
Any idea about heat generation? If you sit with a 10,000 lux light 1 metre from your head, are you going to lose 50 pounds each session from sweating?

Rob
</font>
I don't find it at all uncomfortable, letalone break a sweat. In fact it's kind of nice, the warmth.
 

deep

TRIBE Member
<font face="Verdana, Arial" size="2">Originally posted by DJ Doublecross:
So I can finally read tribe in the nude without getting cold?</font>
If you're worried about shrinkage point the light at your willy
 
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feisty boy

TRIBE Member
<font face="Verdana, Arial" size="2">Originally posted by PosTMOd:

In the Maclean's article, a newer device is mentioned that uses white LEDs, which are extremely efficient in producing light...

I'm thinking seriously of looking into building something like that and marketing it... it shouldn't cost $500 like in the article...
</font>
white LED's are the future of lighting... flat panel units which produce huge amounts of bright white light, with hardly any energy input or heat output.

it's probably possible to a good unit fairly cheaply, with an existing plan - but i don't know about the logistics of trying to mass produce, sell, and make a profit.
 

deep

TRIBE Member
<font face="Verdana, Arial" size="2">Originally posted by janiecakes:
guys, where would one buy one of these lamp thingamadoos?

</font>
the specialty commercial boxes cost around $200-300

a 500w halogen worklamp at home depot costs $25
 

PosTMOd

Well-Known TRIBEr
<font face="Verdana, Arial" size="2">Originally posted by janiecakes:
guys, where would one buy one of these lamp thingamadoos?</font>
Canadian Tire or Home Depot... they both have worklights on stands of various constructivenessivesnessnissum.
 
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deep

TRIBE Member
hahah, allison didn't type out a response...

(her nick on the board is sugar. that's why it's funny...to me only)
 

t-boy

TRIBE Member
you guys are so silly


i just found out my dad has one of these in the basement!!! woohoo! i'm gonna expose myself tommorow morning. are you supposed to stare at the light? or just kinda be there?
 
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deep

TRIBE Member
<font face="Verdana, Arial" size="2">Originally posted by t-boy:
you guys are so silly


i just found out my dad has one of these in the basement!!! woohoo! i'm gonna expose myself tommorow morning. are you supposed to stare at the light? or just kinda be there?
</font>
Don't stare into it, set it to the side pointing at you so that it's still aimed at your eyes but not directly

Alternatively you can stare into it and try to chase someone around afterwards for giggles
 

loopdokter

TRIBE Promoter
This article was very informative. It's often been suggested to me that I may have SAD - although I've been yet to be diagnosed.

I'm actually going to my docs tomorrow and I'm going to ask him about it and see what he says.

As of right now, I'm on 2 different brandnames of anti-depressants (Celexa and Wellbutrin SR) and have been diagnosed with a sleeping disorder too (a sleep apnea). On top of that, I'm a complete night hawk!

So I'm truly wondering if light therapy may the trick to finding my joy because I do notice that I'm much happier in the spring and summer months.

Thanks for the post!

Cheers,
Jay K.
 
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