Hi Alice,

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,

Lack of light leaving you feeling low? SAD could be what you’re experiencing; it stands for seasonal affective disorder and is similar to depression and other mood disorders, except that symptoms wax and wane with the seasons. Most people with SAD experience the symptoms most acutely in the winter, and this is likely related to the body’s shifting levels of melatonin and serotonin during the darker, colder months (more on this later). And, while light therapy has been demonstrated to be an effective treatment for SAD when monitored by a health care professional, tanning salons are not recommended and tanning beds emit dangerous levels of ultraviolet (UV) radiation. In short, while increasing your exposure to natural light can lift your spirits when the temperature drops, you can get the same results without a summer tan!

First, a little brain chemistry 101: Melatonin is a hormone responsible for controlling basic biological functions, including body temperature and sleep cycles. Secretions typically increase at night and taper off in the morning in response to daily exposure to sunlight. However, during the winter months, the sun tends to rise later, set earlier, and frequently overcast skies can result in inadequate lighting during the daylight hours. This can be compounded by spending more time in poorly lit indoor areas like homes, offices, and classrooms. Under these gloomy conditions, melatonin secretion is prolonged, shutting off much later in the day. This can cause someone with SAD to experience depressed mood and daytime fatigue, making it increasingly difficult to wake up for work or school in the mornings — in other words, increased melatonin may actually worsen the symptoms of depression. Serotonin, on the other hand, can have anti-depressive effects that help to counteract the gloom. Certain prescription drugs, like selective serotonin reuptake inhibitors (SSRIs), can enhance serotonin activity in the brain, which may help to alleviate some of the symptoms of SAD. These drugs, when prescribed by a health care provider, may be used in conjunction with, or as an alternative to talk therapy or light therapy.

As for fighting the winter blues by staying on the bright side: light therapy may be a viable option for treating SAD. Studies have shown that, in some people, light therapy can be just as effective as anti-depressants for alleviating the symptoms of SAD.  It’s unclear what you mean by clinical light therapy stations, but light therapy typically involves sitting or working near a light therapy box for a set amount of time after you first wake up in the morning. A light therapy box is a device that emits a bright light that mimics natural sunlight, and is also usually designed to filter out harmful UV radiation. For winter-onset SAD, it’s usually recommended that light therapy start in the fall, or as soon as symptoms begin, as it can take a few weeks to start seeing an improvement in your mood — so summer time is a great time to start thinking about getting treatment.

It’s worth noting, however, that light therapy still has some drawbacks. For example, light boxes are not currently regulated by the Federal Drug Administration (FDA), and none are specifically approved for treating SAD. This means that pairing up with a health care or mental health provider may be beneficial for safe and effective light therapy — in addition to monitoring your condition, they can also help you determine the appropriate combination of light intensity, duration, and timing of your treatments. It might also help to keep in mind that people with bipolar disorder, eye and skin sensitivities, or folks taking certain prescriptions may not be the best candidates for this type of treatment. Finally, light boxes can be expensive, so you might want to check with your insurance provider to see if they will cover the cost (they may, especially if it's prescribed by a health care provider). Given all these considerations, it can be helpful to carefully discuss the pros and cons with your health care provider before treatment starts.

Ultimately, Guy who needs a really dark tan bad, while light therapy is one way to battle the power of the dark side, it isn’t your only option. Noticing that your shift in moods might be related to seasonal changes is a great start — a good next step to tackling SAD is to consider making an appointment with a mental health provider who can assess your symptoms and talk with you about treatment options that can help you get some spring back in your step.

Wishing you a warmer, brighter winter,

Alice!

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