Depression: Light therapy

IT IS the season to be jolly, but about 18.5 percent (1 in 5) or 43.8 million adults in the United States experiences some type of mental illness during this time of the year, or in a given year, and 10 million (4.2 percent) have the serious form which adversely affects their life. One in five (21.4 percent) of those between the ages of 13 and 18 battles with severe depression at some point in their life. For those between 8 and 15, the prevalence is about 13 percent. Bipolar disorder is seen in 2.16 percent and 1.1 percent live with schizophrenia, while 18.1 percent have anxiety disorder like PTSD (post traumatic stress disorder, phobias, and obsessive-compulsive disorder.

Increased risk for suicide

Barely 41 percent of adults in the US with a mental health condition received mental health services in the past year because many elected not to seek medical care for various reasons. Depression is more common among women and those between 40 and 59, and those in the poverty level are about two-and-a-half times more prone to have the illness. The condition is serious, with physical symptoms, affecting cognitive function and mood. It is associated with increased rates of chronic diseases, medical utilization and impaired overall performance. Depression costs the United States about $193.2 billion in lost earnings per year. It is estimated that an average of 20 veterans commit suicide and more than 90 percent of children who committed suicide had mental health condition.

All of us have had some degree of depression at one time or the other because of the stressors we face in life. But this type of depression is a mild, transient, natural mental reaction to usual challenges we encounter and not the clinical disease we call mental disorder. It is when it persists, becomes worse and negatively impacts our daily activities that we label it serious depression.

Let there be light

Light therapy has been found effective in the treatment of seasonal affective disorder (SAD), which happens at a certain time of the year, mainly in the fall or winter, during the week of Thanksgiving, Christmas, and first part of the new year. These are the periods when people have very little exposure to natural light, the sun, because they stay indoors to avoid the cold and wintry season, or a family member is missed, a time of the year when loneliness could be overpowering, especially for parents with empty nest syndrome and seniors who live alone.

Light or phototherapy has also been shown to benefit those with moderate to severe depression in combination with drug regimen. Other conditions where light therapy is useful include jet lag, in transit to a nighttime work schedule, sleep disorders and dementia. Some of the reasons why phototherapy is used are: it is effective in SAD; to complement antidepressant medications, or lessen drug dosage; for non-seasonal depression with insomnia; avoidance of antidepressants during pregnancy or while breast-feeding; light therapy has been proven safe, effective and has few side-effects.

Light treatment for skin diseases, like psoriasis, uses a different lamp, one with UV light, which has greater potential risk and complications, like skin and eye damage. Your physician can recommend the particular proven and safe light box to use.

Application

A light therapy box emits bright light that mimics natural outdoor sunlight. The person works, watches TV, does computing, reading, or simply sits by this box at a duration and intensity prescribed by his physician. This exposure affects brain chemicals associated with our mood much like exposure to the sunlight, easing SAD symptoms or depression. Going outdoors to do chores, to be with friends and family, or simply to walk, taking advantage of Mother Nature’s good old sun, which costs no money, is a great way to prevent SAD or improve our mental health throughout the year. This is different from sun-bathing or using artificial sun-tanning, which are unhealthy and dangerous for our skin and body and increases the risk for skin cancer.

Risks and side effects

While light therapy (where the harmful UV light is filtered out) is generally safe, there are possible side-effects, albeit mild and short-lasting. They include headache, eye strain, nausea, agitation, irritability. Those with bipolar disorder (manic-depressive) might “push” the situation to the other extreme and experience mania, hyperactivity, euphoria and agitation, the opposite symptoms of depression. This is why medical consultation is strongly recommended before anyone starts with light therapy or any other form of treatment. Tanning beds, which are unsafe and could be life-threatening, are not a substitute for the light therapy we are discussing here.

The side effects are usually transient and dose-related (time of exposure and distance from the light box), disappearing within a few days. Each person reacts differently, others more sensitive than some, so the physician can tailor the treatment for each individual. The skin is more sensitive when one has lupus, taking certain antibiotics, anti-inflammatory drugs or herbal St. John’s Wort, or has an eye condition or a personal or family history of skin cancer. It is harmful to the eyes to look at the light box directly just like looking at the sun directly, but the eyes must be open when getting light therapy.

Key elements

For best results, the Mayo clinic posted these three key elements for effective phototherapy:

Duration. When you first start light therapy, your doctor may recommend treatment for shorter blocks of time, such as 15 minutes. You gradually work up to longer periods. Eventually, light therapy typically involves daily sessions ranging from 30 minutes to two hours, depending on your light box’s intensity.

Timing. For most people, light therapy is most effective when it’s done early in the morning, after you first wake up. Your doctor can help you find the light therapy schedule that works best.

Intensity. The intensity of the light box is recorded in lux, which is a measure of the amount of light you receive at a specific distance from a light source. Light therapy boxes usually produce between 2,500 lux and 10,000 lux. The intensity of your light box affects how far you sit from it and the length of time you need to use it. A 10,000-lux light box usually requires 30-minute sessions, while a 2,500-lux light box may require two-hour sessions.

While light therapy is not for everyone, those on it could maximize the benefits by getting the right light box recommended by the physician, being consistent, proper timing of the treatment, continuing other prescribed treatments and regularly consulting with the attending healthcare giver.

Photo therapy may not cure SAD and depression, but it has been effective in easing symptoms, improving energy levels and helping people feel better about themselves, positively impacting their mood and attitude in life.

In many aspects of health and diseases, I cannot help but marvel at, and be endlessly grateful for, the many wonderful natural gifts Planet Earth blesses us with everyday. In return, perhaps, we should show our appreciation by protecting it.

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