Let there be light – it’s plea many of us make at this darkest time of year, when the sun shines so briefly each day.
Humans have yet to find a way to make more sunshine. But for some people, the next best thing is something called a light box, a table-top device that produces very bright light and is typically used for 30 minutes or more each morning.
Light boxes have been around for decades and are considered a standard mood-lifting therapy for seasonal affective disorder (SAD), a form of major depression that typically peaks in winter. But SAD patients are not the only people buying light boxes these days, experts say.
“They are definitely increasingly used,” for conditions including the run-of-the-mill winter blahs, says Raymond Lam, a professor of psychiatry at the University of British Columbia. One reason, he says, is that “they are widely available. You can buy them at Costco.” You also can buy them from many other retailers and directly from manufacturers, usually for about $100 to $300.
Studies suggest light boxes might indeed help some people who do not have full blown depression but do feel a bit blue in the winter, Lam and other researchers say. There’s also interest in using light therapy for conditions ranging from Alzheimer’s disease to bulimia and jet lag, says Kathryn Roecklein, an assistant professor of psychology at the University of Pittsburgh.
But the strongest evidence surrounds depression – not only SAD but the more common kind that can strike at any time of year, leaving people feeling sad, hopeless, low on energy and unable to find pleasure in life.
Lam led a recent study of 122 patients with non-seasonal depression. Those treated with light therapy alone or light therapy paired with antidepressant pills did better than those getting placebos (fake pills and boxes that hummed but did not light up). Those getting a combination of light and medicine did best: after 8 weeks, 58% recovered, vs. 33% for placebo.
The findings do not mean everyone with depression should get a light box, Lam says. “Many people prefer to take a pill,” he says, and sitting in one place for 30 minutes or more each morning “is a tough sell,” for many busy people. But, he says, it’s an option in addition to medication and talk therapy.
Researchers are not sure how light therapy works. The leading theory is that artificial light, like the natural dawn our ancestors saw each day, helps keeps our body clocks in sync with the world, regulating everything from alertness to appetite, sleep and mood. The light might also directly affect certain brain chemicals, Lam says.
Most people today spend too little time outdoors, Lam says, to get the same effects from daylight alone. “And, unfortunately, just sitting near an open window won’t help much, unless you have your face plastered against the window,” he says.
But even for SAD patients, light therapy is not the only – or necessarily best – choice, says Kelly Rohan, a psychology professor at the University of Vermont. In recent studies, Rohan found that both light therapy and a specialized form of talk therapy could relieve SAD in the short term. But talk therapy had more lasting effects, year to year.
The talk therapy, also known as cognitive behavioral therapy, or CBT, was specifically aimed at changing thinking patterns that amount to “hating winter” and expecting it to be depressing, Rohan says.
“It’s kind of normal at high latitudes to have some negative attitudes about winter,” she says. “But these people are extremely negative.” The aim, she says, is “to go from saying ‘I hate winter, I hate winter, I hate winter,’ to saying ‘I prefer spring and summer.’ ” Patients also are urged to be at least as active and social in winter as they are at other times of year.
Lam, Roecklein and Rohan agree that anyone who suspects depression, at any time of year, should see a health professional to confirm the diagnosis and consider treatment options.
Even non-depressed people just looking for a winter pick-up will likely do better with light devices if they first get some advice from a knowledgeable health professional, Roecklein says: “If you are going to do it, do it right.”
Here are few more things to know about light boxes:
• The boxes used in most studies produce 10,000 lux (a measure of light intensity, with usual indoor lighting producing a few hundred lux). “The brightness is the same as being outdoors at 7 a.m. on a summer day,” Lam says.
• Most use white light. Blue light devices are available but have not been studied as much. Also less studied are dawn-simulating alarm clocks, which gradually increase light to awaken you.
• These are not tanning lights – and you should not use tanning devices because the ultraviolet light they emit can cause skin cancer and eye damage.
• Side effects can include headache, nausea, eye strain and, in rare cases, mania. The devices are not recommended for people with eye diseases, such as macular degeneration.
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