LIGHT THERAPY & DEPRESSION
How Does Light Therapy Help Depression?
Since the beginning of time, people have realized the healing power of light. We feel rejuvenated when we’re in sunshine, and we literally whither in the dark. In the early eighties, researchers discovered that specialized bright light (20 times brighter than normal indoor light), was the most effective treatment for winter depression. Now tests are con
firming that this light is effective for non-seasonal depression as well.
It turns out that light is more than psychological. Light actually produces hormones and neurotransmitters that affect our mood and well being. One of these hormones, serotonin, is thought to be a major factor in depression. One recent study that was reprinted in The Lancet, showed that bright light significantly increased serotonin levels, while dark or cloudy days caused serotonin to plummet.
Dozens of clinical, placebo controlled studies have been done using light therapy to treat depression. These studies confirm that light is not only as effective as other methods, but it causes no long-term side effects. Additionally, people responded within a week to light instead of several weeks with medications, and different medication trials were needed before an effective regimen was found.
More Effective Than Medication Alone
Studies also suggest that the most effective treatment for depression may be a combination of light and medication. Both light and medication elicited a quicker and higher quality response than either light or medication alone. More people responded, and they experienced fewer side effects. These studies have led leading researchers to comment,
“It appears that bright light combined with wake therapy and medication might produce a much better antidepressant response much more rapidly than our available antidepressant drugs.”
-- Daniel Kripke, MD
Journal of Affective Disorders, 1998
This revelation is highly significant, because medications have never been the panacea people hoped they would be. Medications seem to only cover some symptoms of depression and cause a multitude of unwanted side effects. Most people feel that medications aren’t completely helpful, and they are very difficult to discontinue using.
The reason light is so effective is that it appears to correct some of the root causes of depression. One reason people become depressed is because their brain center that controls these hormone cycles has malfunctioned. This brain center is called the Suprachaismatic Nucleus or body clock, and it can easily become imbalanced from trauma, stress, surgery, age or the lack of light. When the body clock becomes imbalanced, it produces the wrong hormones, causing insomnia, energy and mood problems.
Depression and the Body Clock
Because depression sufferers also had difficulty sleeping and generally felt worse in the morning, researchers realized that depression may be related to the body clock. Knowing that specialized light effectively regulates the body clock, researchers applied light to depression studies. These studies show that Specialized bright light causes an antidepressant response in three ways:
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Bright light activates the production of brain serotonin. In 2002, the Lancet reported that exposure to bright light immediately increased brain serontonin, while dark and cloudy days depleted serotonin levels.
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Bright light regulates the Suprachaismatic Nucleus, or body clock. With the discovery of specialized light in 1984, researchers discovered that the body clock, located in the hypothalamus, was responsible for sleep/wake and energy/mood cycles. In addition to becoming imbalanced from the lack of light (As with Seasonal Affective Disorder, researchers have also learned that the body clock can easily become inbalanced from stress, trauma, surgery, age, etc. Many people who suffer from depression also have a body clock problem, as they suffer from sleep problems and feel worse at a particular time of day.
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Bright light suppresses the hormone melatonin. Melatonin is released in the evening time as a signal for the body to withdraw and prepare for sleep. Melatonin is converted from serotonin, and so lowers available serotonin. It also causes feelings of irritablity, withdrawl and sadness. Melatonin is important as a nighttime hormone but daytime or too much melatonin can cause mood problems.
Several studies have documented the advantage of specialized light for depression. Patients responed to light within a week verses several weeks for medication, and light posed no long-term negative side effects. A review of light therapy in Archves of General Psychiatry concluded the following:
“The evidence is in that light is an active neurobiological agent. But light therapy has little chance to be widely and properly used for a variety of ills, as long as it appears to the policymakers and grantgivers to lie uncomfortably between pharmaceutical company neglect (for obvious reasons) and the molecular reductionism of academe. These attitudes strikingly contrast with patients' acceptance of light therapy. Light therapy is easy to administer in outpatient settings, lacks major side effects, and, importantly, is cost-effective. Whatever its mode of action, it demands inclusion in the antidepressant armamentarium, now.”
—Archives of General Psychiatry, October 1998
More Effective Than Medication
Although light has been found to be effective by itself, studies show that a combination of light and medication is more effective than either method alone. Patients responded much quicker with a higher quality of response. Sleep problems improved as well.
In addition to standard light therapy, a novel new treatment, called wake therapy offers relief within 24 hours. Wake therapy involves partial sleep deprivation and morning light therapy to sustain the anti depressant effects of wake therapy. As with standard light therapy treatment, a combination of wake therapy, bright light and medication is most effective.
Offical Recommendation
Specialized bright light is recommended by the American Psychiatric Association (APA) as well as the American Acadamy of Sleep Medicine. In January 2004, the Cochrane Medical Library issued the Cochrane Review of all depression related light therapy studies, and recommends light therapy for depression treatment. (Cochrane is considered by the medical industry to be the gold standard in medical review.) |