Center for Environmental Therapeutics

A psychiatrist friend of mine recommends this web site. She says it has a self-administered diagnostic test for seasonal affective disorder that tells you exactly when to use light therapy.

We have enormous, aging light boxes all over the basement, but we've never known when to use them. We got them because John (Ratey) told me he'd visited the NIMH and all the shrink researchers there had light boxes on their desks. That was enough for me. We used to train one on Jimmy every day.

Today's Times has an article. (sorry - this is a paid subscription link, I believe - can't get the Times link generator pages to open.)

In 2001, Dr. Thomas A. Wehr and Dr. Norman E. Rosenthal, psychiatrists at the National Institute of Mental Health, ran an intriguing experiment. They studied two patient groups for 24 hours in winter and summer, one group with seasonal depression and one without.

A major biological signal tracking seasonal sunlight changes is melatonin, a brain chemical turned on by darkness and off by light. Dr. Wehr and Dr. Rosenthal found that the patients with seasonal depression had a longer duration of nocturnal melatonin secretion in the winter than in the summer, just as with other mammals with seasonal behavior.

Why did the normal patients show no seasonal change in melatonin secretion? One possibility is exposure to industrial light, which can suppress melatonin. Perhaps by keeping artificial light constant during the year, we can suppress the “natural” variation in melatonin experienced by SAD patients.

There might have been a survival advantage, a few hundred thousand years back, to slowing down and conserving energy — sleeping and eating more — in winter. Could people with seasonal depression be the unlucky descendants of those well-adapted hominids?

Regardless, no one with SAD has to wait for spring and summer to feel better. “Bright light in the early morning is a powerful, fast and effective treatment for seasonal depression,” said Dr. Rosenthal, now a professor of clinical psychiatry at the Georgetown Medical School and author of “Winter Blues” (Guilford, 1998). “Light is a nutrient of sorts for these patients.”

The timing of phototherapy is critical. “To determine the best time for light therapy, you need to know about a person’s individual circadian rhythm,” said Michael Terman, director of the Center for Light Treatment and Biological Rhythms at the Columbia University Medical Center.

People are most responsive to light therapy early in the morning, just when melatonin secretion begins to wane, about eight to nine hours after the nighttime surge begins.

How can the average person figure that out without a blood test? By a simple questionnaire that assesses “morningness” or “eveningness” and that strongly correlates with plasma melatonin levels, according to Dr. Terman.

The nonprofit Center for Environmental Therapeutics has a questionnaire on its Web site (www.cet.org).

Once you know the optimal time, the standard course is 30 minutes of fluorescent soft-white light at 10,000 lux a day.

and....

It may sound suspiciously close to snake oil, but the newest promising therapy for SAD is negative air ionization. Dr. Terman found it serendipitously when he used a negative ion generator as a placebo control for bright light, only to discover that high-flow negative ions had positive effects on mood.

Now that is exciting. I've been interested in negative ions forever. Negatives ions probably explain why it's impossible to be depressed on the beach.

Santa may be bringing me a negative ionizer for Christmas.


source:
Brought on by Darkness, Disorder Needs Light
December 18, 2007
Brought on by Darkness, Disorder Needs Light
By RICHARD A. FRIEDMAN, M.D.

Shadow Syndromes