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Shining a light on SAD: Does phototherapy help?

Winter can wear on you: short days, long nights, cold temps and cloudy skies. It’s no surprise you begin feeling like you’re in a funk.

The routine self-diagnosis we make is seasonal affective disorder — it even comes with the fitting abbreviation SAD. And the popular remedy? Bright light. A quick search of online retail stores displays loads of light therapy options promising to supplement the sun, restore off-kilter sleep cycles and lift your spirits.

But Megan Schabbing, MD, medical director of Psychiatric Emergency Services for OhioHealth Behavioral Health, suggests that true seasonal affective disorder is different than the winter doldrums, and in those cases, light may not be the best medicine.

Seasonal affective disorder is depression

“It’s important to understand that seasonal affective disorder isn’t just missing the sun. It’s actually a subtype of clinical depression,” explains Schabbing. “It’s not just feeling down, but having low mood along with other symptoms most of the day, nearly every day, for at least a few weeks.”

Schabbing says the symptoms that accompany seasonal affective disorder are similar to the symptoms of depression:

  •  Too much or not enough sleep
  • Changes in appetite that bring on significant weight gain or loss
  • Loss of interest in work or activities you enjoy
  • Feelings of guilt or hopelessness

“What we look for in a diagnosis of seasonal affective disorder is impairment in functioning. Are you not performing well at work? Have you disengaged in your relationships with your spouse or friends and family? Are your symptoms interfering with your ability to concentrate or focus?” says Schabbing.

Have an illuminating conversation with your doctor

So does that mean lights out for light therapy? Schabbing says no. “There is definitely evidence to support the use of light therapy as an effective tool in treating seasonal depression, but at OhioHealth we recommend, as first-line treatment, a combination of antidepressant medication and cognitive behavioral therapy. If your condition has a seasonal pattern, then light therapy can be incorporated into your treatment plan.”

Schabbing stresses that people should not go it alone with light. “In order to have light therapy help you, you need to have the right diagnosis. What you think is the winter blues could be a thyroid disorder or anemia, or you could have a behavioral condition that’s actually worsened by extensive exposure to bright light.”

Furthermore, to experience clinical improvement, it is important to use the appropriate light box. “In phototherapy for seasonal affective disorder, we prescribe bright light with as little ultraviolet radiation as possible,” she continues. “Incorrectly using a phototherapy system intended for skin disorders could damage your skin and eyes.”

“Your doctor will help you choose the right light, the right time of day, and the right length of time to use therapeutic light.”

Whether it’s the weather or something more, Schabbing says your first step should be starting a conversation with your doctor. “You can discuss your symptoms, sleep patterns, other health problems or stressors, and any medications or vitamins you are taking. In the end, you must have an understanding of the problem before it can be fixed.”


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