Light therapy can brighten lives of SAD sufferers

Posted: Monday, October 06, 2003

FAIRBANKS - Coping with the dark days of winter may only be a matter of seeing the light.

Like bears, many humans also sink into hibernation mode during the dark months of winter. But unlike other mammals, humans can't crawl into warm, cozy caves.

They are expected to carry on no matter the season or the changes in their circadian rhythms, and the result can be depression, fatigue, carbohydrate cravings, inability to concentrate, anxiety, weight gain and lower energy levels.

Scientists believe seasonal affective disorder is the result of sunlight deprivation, which can shift the body's 24-hour clock.

Strong light is needed to reset humans' internal body clocks, said Gloria Bourque, a psychiatric nurse practitioner at Fairbanks Psychiatric and Neurological Clinic.

"Not all of human nature enjoys the wintertime," she said.

Bourque and Susan DeLisa of Northern Therapies talked about the common winter disorder SAD at a recent forum organized by the health ministries of St. Matthew's Episcopal Church and Sacred Heart Cathedral.

SAD, also known as winter depression, is quite distinct from holiday blues or clinical depression, Bourque said.

The seasonal pattern of depression is one of the tip-offs that someone is suffering from SAD. It typically begins in late summer, but may show up in the dead of winter or, for some people, at the onset of spring.

Light plays an important role, entering the body through the eyes and affecting the brain's production of melatonin and other chemicals that control patterns of sleep and wakefulness.

SAD is four times more common in women than men, likely because women are more sensitive to hormonal changes, Bourque said. It is most commonly diagnosed in adults age 20 and older, and seen less in older people. Children aren't as likely to be affected, she said, but teens may show symptoms.

Untreated, SAD usually goes away by mid-February, March or April, Bourque said. However, if symptoms get worse, it may result in clinical depression.

"Holiday blues go away after the holidays," Bourque said.

Bourque recommends planning and keeping holiday activities at a manageable level and not giving in to commercialization.

Clinical depression is more complicated and treatable, Bourque said.

"Depression is not a character flaw. It is not a punishment from God, and you can't make yourself snap out of it. It is a physical, chemical imbalance of the body," she said.

Bourque said symptoms of clinical depression include prolonged sadness, crying spells, dramatic changes in eating and sleeping patterns, pessimism, negative thinking and loss of energy, guilt feelings over being depressed, indecisiveness, inability to take pleasure in anything, unexplained aches and pains and recurring thoughts of death or suicide.

"If anyone experiences five or more of these symptoms, they need to see a doctor," Bourque said.

The difference between SAD and major depression, said Bourque, is the degree and length of time a person has symptoms and the time of year.

Depression affects 10 million to 14 million Americans each year and can be treated with psychotherapy and medication.

Treatment for SAD, Bourque said, always starts out with light therapy, and most insurance companies will cover a doctor's recommendation for phototherapy lights, which cost between $200-400, depending on size.

According to DeLisa, about 10 percent of people living in northern latitudes experience SAD, and another 15 percent suffer from a milder version called sub-syndromal SAD or winter blues.

"That's a total of about 25 percent of people affected by lack of light to such an extent it decreases their functionality," said DeLisa, a 28-year resident who has been using light therapy herself for the past decade.

Since light deprivation is the main cause of SAD, DeLisa recommends Alaskans get outside daily - even the sun reflecting off the snow is beneficial - exercise daily, avoid stress, eat healthy food and brighten their home or workplace with lights.

But more light often is needed for SAD sufferers.

Research suggests the extra light is best used in the morning or early afternoon. Carmen Fernandez, like others at the forum, lingered afterward to look at the light display. She attended the forum to find out more about the symptoms of sadness she first experienced at the beginning of winter last year.

"This year it came earlier," she said. "I don't want the snow to come."

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