I am concerned that I have that seasonal depression thing — SAD (I wish I knew what that acronym stands for). I have heard that light therapy is a legitimate option. This seems to be consistent with what I have read about melatonin and its possible connection to serotonin, a chemical associated with depression. Is it true that more melatonin can mean less depression and anxiety?
If I do have SAD, during the winter can I just go to a tanning parlor as opposed to a more expensive light therapy clinic? Are UV tanning parlors really more expensive/dangerous than suntanning on the beach? What about clinical light therapy stations? (Yes, I don't know their official name). I realize that it is summer now, but after last winter, which was truly traumatic for me, I want to come up with a plan for next winter well in advance.
—Guy who needs a really dark tan bad
Dear Guy who needs a really dark tan bad,
It's a great idea to get a head start preparing a plan to cope with the winter. In fact, light therapy guidelines for SAD recommend beginning treatment in the fall, or as soon as symptoms may begin. But before you buy a season pass to the tanning parlor, read on to better understand the safest options.
First of all, SAD stands for seasonal affective disorder. More melatonin, a hormone responsible for controlling basic biological functions such as your body temperature and sleep cycles, is believed to be related to SAD. Melatonin secretion increases normally at night. (This is controlled by our exposure to the daily cycle of the sun, or the "light-dark cycle.") In short, longer nights may result in increased melatonin levels for some people with SAD.
In winter, the sun seems to take a little break from its usually busy schedule — getting up late, leaving early, and often providing us with inadequate lighting (in addition to the already poor lighting most of us have in our homes, offices, and classrooms). When this happens, some people with SAD tend to produce melatonin longer than normal. For example, during other times of the year, you may stop secreting melatonin around 7 a.m. In the winter, however, melatonin secretion might not turn off until closer to lunch time. This wintertime drift in melatonin secretion can cause someone with SAD to sleep longer and experience depressed moods and daytime fatigue more often than during other times of the year. Additionally, the person with SAD might find it increasingly difficult to wake up for work or school.
Light therapy may be a viable option for the treatment of SAD in some people. However, it is important to have health professional (rather than a tanning salon clerk) closely monitor your treatment, preferably someone with some expertise in diagnosing and treating SAD. Light therapy involves a great deal more than simply exposing yourself to high-intensity or full-spectrum rays. A health care provider would also be able to analyze your sleep pattern (usually when you are depressed). Based on this analysis, s/he can provide you with a lamp that has been calibrated to suit your needs and equipped with certain filters to help protect your skin and eyes from irritation and burning. Light therapy can have side effects as well. People with bipolar disorder, eye and skin sensitivities, or who are on certain prescriptions may not be the best candidates for this type of treatment.
Also a note of caution; currently light boxes aren't regulated, and none are specifically approved for treating SAD. For this reason it is even more important to work with a health care provider to find a therapy routine and light box that are safe for you. Light boxes can also be expensive. If you have insurance, you may want to check with your insurance provider to see if they will cover the cost (they may, if it's prescribed by a health care provider).
Now, about tanning parlors…. Researchers once thought that ultraviolet B (UVB) rays, which are mainly responsible for sunburn and skin cancer, were the only dangerous component of sunlight, and that the longer wavelength ultraviolet A (UVA) rays helped you tan without harming the skin. Tanning parlors, which use high-intensity light sources emitting predominantly UVA radiation, based their claims to safe tanning on this idea of safe UVA radiation. But now it appears that UVA radiation is harmful, too. It penetrates into the skin more deeply, possibly causing premature aging, and it can sensitize the skin so that sunlight is more likely to cause skin cancer. UVA rays can also damage your eyes; cause direct damage to your body's cells; and, cause adverse reactions if you're taking other drugs, such as antibiotics, antihistamines, birth control pills, oral diabetes medications, tricyclic antidepressants, lithium, and melatonin. Skipping the tanning parlors, continuing to use sunscreen if you take a trip somewhere sunny, and visiting a health professional is your safest option for treating SAD.
Finally, on to the relationship between serotonin and melatonin…. They certainly have a connection. In fact, chemically, melatonin is derived from serotonin; however it is serotonin and not melatonin that could have anti-depressive effects for a person with SAD. Certain prescription drugs can enhance serotonin activity in the brain. These drugs can be used in conjunction with, or as an alternative to, light therapy. As you may have guessed, these drugs can have side-effects, such as increased feelings of agitation or decreased sex drive. As with light therapy, it is important to work closely with a health care provider when using these prescription drugs.
If you are a Columbia student, you can see a counselor in Counseling and Psychological Services (x4-2878) for a diagnosis and/or referral. Additionally, the Winter Depression Program at the Columbia-Presbyterian Medical Center (CPMC) is open to Columbia students and staff who qualify as eligible volunteers for certain free clinical trials; call 212.543.5714 for an initial confidential phone inquiry. If you're not affiliated with the University, contact your primary health care provider for a referral, or make an appointment directly with a counselor.
Two organizations you can contact for more information are:
Wishing you relief this winter,Alice!