Bright Lights, Less Depression?
Whoever thought that a daily bath of bright fluorescent light would take its place alongside the pill bottle and the therapist’s couch as an accepted and effective treatment for winter depression?
Then again, who 20 years ago would have imagined that the blues that sometimes creep in as the mercury dips and the days darken would take a place alongside phobia and anxiety in the psychiatric field’s phone book-thick manual of common disorders?
Now, as light therapy for seasonal affective disorder, or SAD, has matured into a mainstream treatment for a very mainstream malady, researchers are finding evidence that light may also have a place in treating more chronic, year-round depression.
A small study published late last year by researchers at Wesleyan University in Middletown, Conn., and Columbia University in New York found that an hourlong bath of bright light worked as well as antidepressant medications in half of the patients studied.
The researchers also found that treatment with high-density negative ions was equally effective. The negative ions--charged particles of oxygen--are blown through a high-powered air purifier.
“The startling thing about chronic depression is it is [resistant] to treatment,” said Michael Terman, director of the winter depression program at Columbia Presbyterian Medical Center in Manhattan. “If light is a factor, at least we can treat it easily.”
Terman and Namni Goel, an assistant professor of psychology at Wesleyan, are trying to recruit 60 chronically depressed people in Connecticut and New York to participate in a controlled trial comparing the effectiveness of bright light, high-density negative ions and low-density negative ions in elevating spirits.
Ellen, a 37-year-old Connecticut woman, enrolled in Goel’s first study about a year ago, in part because she was nursing her newborn son and did not want to return to the antidepressants that had helped her for several years.
“The thing the light box did for me that the antidepressants didn’t was I found myself being super-energized,” said Ellen, who asked that her last name not be published. Subsequently, she tried the high-density negative ions, which also controlled her depression. But she preferred the light.
After the study period, Ellen returned to the antidepressant medication Zoloft; her insurance covers the drug but not the $200 to $400 cost of a standard light box.
Although some insurers do cover the treatment, Terman and Goel said they hoped that their research, paid for by the National Institutes of Mental Health, might convince more companies that bright light therapy could be cost-effective. Light, they said, might allow chronically depressed patients to take less medication, even if it does not eliminate the need for drugs. In Europe, light and antidepressive medications are already being used in tandem to treat depressed patients in psychiatric hospitals, Terman said.
How light affects mood remains something of a mystery, although some clues are beginning to emerge. The best guess is that something--perhaps a change in melatonin secretion--knocks the body’s biological clock out of whack, causing depression. Melatonin is a hormone that regulates sleep and waking.
“The notion is that when various circadian rhythms get out of sync it causes the onset of depressive symptoms,” Terman said. He is investigating the promise of bright-light therapy in alleviating jet lag for travelers. And with Dr. Neill Epperson, an assistant professor of psychiatry and obstetrics and gynecology at the Yale University School of Medicine in New Haven, Terman is testing bright light in treating depression during pregnancy.
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Hilary Waldman is a staff writer for the Hartford Courant, a Tribune company.
