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Seasonal Affective Disorder

Keneke

Muse
Joined
Jan 16, 2003
Messages
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In a search on the JREF boards, it seems the general consensus that S.A.D. is pretty much a real phenomenon. Furthermore, I am pretty sure I have it. Fall has always affected me. I want to buy one of those sun lamps for my office, but the claims of some of these websites selling lamps is just too similar to other websites selling less-than-proven methods. Do sun lamps really counter SAD, and which brands should I look into buying?
 
A couple of studies. Taken together, it sounds like you'd want lots of natural light and exercise:

Levitt AJ. Lam RW. Levitan R.
Title
A comparison of open treatment of seasonal major and minor depression with light therapy.
Source
Journal of Affective Disorders. 71(1-3):243-8, 2002 Sep.
Abstract
BACKGROUND: Although several investigators have described a milder form of seasonal affective disorder (SAD), called subsyndromal SAD, little is known about the effect of light therapy in this group. The current study evaluates 3 weeks of open treatment with light therapy in SAD and subsyndromal SAD patients. METHODS: Subjects with major or minor depression according to DSM-IV with a seasonal pattern were recruited during the winter of 1998-1999 from clinic patients and media advertising. Subjects were commenced on open treatment of morning light therapy, for 30 min daily using a new fluorescent light therapy unit that produced approximately 5,000 lux at a distance of 12 inches. The treatment lasted 3 weeks and at the end of the first and second week of treatment the duration of exposure could be increased to a maximum of 60 min at the discretion of the clinician. The Structured Interview Guide for the Hamilton Depression Rating Scale-SAD version (SIGH-SAD) was administered weekly to evaluate outcome. Response was defined in a variety of ways to reflect the fact that subsyndromal SAD subjects had milder symptoms. RESULTS: Forty-six subjects entered treatment and 44 (SAD, n = 29, subsyndromal SAD, n = 15) completed at least 2 weeks. Response rates were generally similar in SAD subjects (64-69%) and subsyndromal SAD (40-67%) patients. There was a trend for longer exposure to be associated with better outcome. CONCLUSIONS: Light therapy may be an effective treatment for subjects with both major and minor depression with a seasonal pattern. Optimal duration, for the light therapy unit used in this study, is likely 45-60 min daily.



Leppamaki SJ. Partonen TT. Hurme J. Haukka JK. Lonnqvist JK.
Title
Randomized trial of the efficacy of bright-light exposure and aerobic exercise on depressive symptoms and serum lipids.

Source
Journal of Clinical Psychiatry. 63(4):316-21, 2002 Apr.

Abstract
BACKGROUND: Season-related subsyndromal depressive symptoms during winter are common among populations at high latitudes. Both physical exercise and exposure to bright light can relieve the fatigue and downturn of mood associated with the shortening length of day. Serum cholesterol level may be related
to changes in mood, but the evidence is contradictory. Our objective was to compare the effect of aerobic exercise with or without bright-light exposure on health-related quality of life, mood, and serum lipids in a sample of relatively healthy adult subjects. METHOD: A randomized controlled trial was conducted with subjects allocated to group aerobics training in a gym with bright light (2500-4000 lux) (N = 40) or normal illumination (N = 42) or to relaxation/stretching sessions in bright light as a control group (N = 42) twice a week for a period of 8 weeks. Changes in mood were recorded using questionnaires at the beginning of the study, at weeks 4 and 8. and at follow-up 4 months after the study. A blood sample was drawn before and after the 8-week intervention to measure the concentrations of serum lipids. RESULTS: Ninety-eight subjects completed the 8-week study. Both exercise and bright light effectively relieved depressive symptoms. Bright light reduced atypical depressive symptoms more than exercise (p = .03), based on the atypical symptoms subscore of the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorders Version Self-Rating Format. There were no significant differences between the study groups in the changes in serum lipid levels. CONCLUSION: Bright light administered twice a week, alone or combined with physical exercise, seems to be a useful intervention for relieving seasonal mood slumps.


Avery DH. Eder DN. Bolte MA. Hellekson CJ. Dunner DL. Vitiello MV. Prinz PN.
Title
Dawn simulation and bright light in the treatment of SAD: a controlled study.

Source
Biological Psychiatry. 50(3):205-16, 2001 Aug 1.

Abstract
BACKGROUND: Some small controlled studies have found that dawn simulation is effective in treating seasonal affective disorder (SAD). With a larger sample size and a longer duration of treatment, we compared dawn simulation with bright light therapy and a placebo condition in patients with SAD. METHOD: Medication-free patients with SAD were randomly assigned to one of three conditions: bright light therapy (10,000 lux for 30 min, from 6:00 AM to 6:30 AM), dawn simulation (1.5 hour dawn signal from 4:30 AM to 6:00 AM peaking at 250 lux), and a placebo condition, a dim red light (1.5 hour dawn signal from 4:30 am to 6:00 AM peaking at 0.5 lux.) Over the subsequent 6 weeks, the subjects were blindly rated by a psychiatrist using the Structured Interview Guide for the Hamilton Depression Rating-Seasonal Affective Disorder Version (SIGH-SAD). We modeled the profiles of the remissions (SIGH-SAD < or = 8) and response (> or =50% decrease in SIGH-SAD) to treatment over time using Cox proportional hazards models. RESULTS: The sample consisted of 95 subjects who were randomized to the three conditions: bright light (n = 33), dawn simulation (n = 31) and placebo (n = 31). Dawn simulation was associated with greater remission (p <.05) and response (p <.001) rates compared to the placebo. Bright light did not differ significantly from the placebo. Dawn simulation was associated with greater remission (p <.01) and response (p <.001) rates compared to the bright light therapy. The mean daily hours of sunshine during the week before each visit were associated with a significant increase in likelihood of both remission (p <.001) and response (p <.001). CONCLUSIONS: Dawn simulation was associated with greater remission and response rates compared to the placebo and compared to bright light therapy. The hours of sunshine during the week before each assessment were associated with a positive clinical response.
 
fishbob said:
Fishing season is over. The days are too short for much natural light and I am too depressed to excercise.


Perhaps you need simulated light, esp while you exercise.

Actually, I couldn't tell from your post if your kidding or not. Care to clarify?
 
Just kidding, except about the fishing season being over part, and the being depressed about it part, and the part about losing daylight.
 
I'll admit that I don't have much direct experience with this phenomenon yet, but what little I do know (and IIRC) the light therapy stuff is on the up and up. It does have to do with the pineal gland (again, IIRC) and the sensativity some people have to excess levels of naturally produced melatonin that create a sort of "hibernation effect" when the sun is not out as much in the winter months (summer, of course, in the Southern Hemisphere). That wave length of light on your retina (which is literally, embryologically and anatomically speaking, an extension of your brain) fires right into the old pineal and suppresses the release of melatonin (or, is that what one of those studies posted above that I skimmed over already said... ;) ).

Just my 2 cents.

-TT
 
And yet some of these high-lux lights on the internet are nothing more than specialized desk lamps that go upward of $200! Does this mean that simply having more light isn't going to do the trick, that I need a special type of light? Is producing the frequency I need going to break my wallet?
 
I always feel down in the dumps this time of year. It first starts when I see Menards putting out their christmas displays in the middle of (get ready)...August! I was so disgusted that I called up the corporate headquarters to complain. I told them that this triggers off all kinds of negativity in me. It reminds me that winter is coming. It reminds me I have to get more serious about taxes. It reminds me I have to spend money on Christmas presents. It reminds me that a month before Christmas comes, my mother will start talking about who all is coming, and.....

As far as the light association goes? Hmmmm. With me, I'd be depressed even if it were sunny every day. I know what MY problem is: I start getting claustrophobic. It is a control thing. You have no control when you know you have to stay cooped up in the house on a cold winter day, rather than go out and mow the beautiful green grass, and then sit outside reading the paper, talking to the neighbors outside while the kids are frollicking about, and having a beer. And going outside to cook out seems like a feable attempt at trying to pretend, when it is winter. Winter is just one big bummer. You can't golf in the winter. You can rear end people at stop lights on icy snow. You can get 'snowed in'.

Achhhhh...I got to get off this subject. It's depressing me.:eek:

San Diego? Hmmmm. To pull up roots and start over ain't easy...especially when you have real estate holdings and a business going.
 

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