Light Therapy is Used to Ease Symptoms of Depression, Regulate Sleeping Patterns, Boost Mood

By Gary Soulsman
Staff Reporter 05/17/2003

This article appears with permission from the Wilmington News Journal, a subsidiary of Gannett News Corporation.

Wilmington psychologist Kevin Keough has glimpsed the future and says it will be filled with mood-elevating light.

In recent years, modern medicine has used indoor light mimicking the sun to combat the winter blues. Now, says Keough, there is a growing body of research that shows daily doses of bright light are useful to all sorts of Americans year-round.

"Someone once asked if I 'really believed in this stuff,' which is like asking a physician if they really believe in antibiotics," he says. The studies have so impressed Keough that he is suggesting light therapy for people struggling with many issues, including depression, insomnia and the tendency in kids to delay bedtime.

He is also suggesting light therapy for shift workers to help them reset their sleep cycle and adjust to the changes in work patterns that occur every few weeks.

"Light has an important future in medicine," says Keough, who believes light therapy is an underutilized health intervention.

Using light to regulate energy and activity levels is an idea winning wider acceptance as researchers explore the theory that light triggers the release and suppression of important body chemicals. Mental health professionals are especially enthused about the ability of light to help with depression. That's because light therapy is easy to administer and tends to have fewer side effects than some antidepressants.

"We find light therapy is often useful with depression," says Dr. Carol Tavani, a Wilmington neuropsychiatrist. "We use it with people on anti-depressants. But we all have patients who are sensitive to medication or they want to try something else first. We have patients who show improvements on light therapy alone."

Experts say light therapy is usually effective in the first week, if treatments are going to work. By comparison, antidepressants can take several weeks to be effective.

Treatment at Home is Easy

Light therapy is taken at home or in the workplace with daily doses of light far brighter than what's found in the average living room or office. Often people sit next to a high-intensity tabletop light for 30 minutes to an hour, though everyone is different and people are advised by doctors to use lights with care because an overdose is unsettling.

New light boxes are usually rated at 10,000 lux - about the brightness of morning sun - and are relatively inexpensive. One of the leading manufacturers, Apollo Light in Orem, Utah, sells the lights for $149 to $500.

Dr. Rob Abel, a Wilmington ophthalmologist, says the light from light boxes is safe, scattering on the retina without being so powerful as to cause macular degeneration. Harmful rays are blocked, which means people should not tan from exposure. Tavani says she has observed limited side effects, though studies show that light can bring on feelings of mania in some patients with bipolar disorder so such people need to exercise caution. Others say if they sit too close to a light or sit there too long they feel jittery, nauseous or may get a headache.

Usually side effects can be controlled by lessening the amount of light you take, says Tavani.

Psychologist Frederick Kozma, who works with Tavani at Christiana Psychiatric Services, not only suggests light therapy for depressed clients - he gives himself a dose of light each morning at breakfast.

"I've found it energizes me for the day," says Kozma.

SAD Launched Studies

In 1984 light therapy began to receive attention for its effectiveness in treating the winter blues or seasonal affective disorder (SAD) thanks to the research of Dr. Norman E. Rosenthal, then at the National Institute of Mental Health. Since then, light therapy has become an accepted treatment for SAD. Light therapy is also being tried on everything from premenstrual depression to dementia and chronic fatigue syndrome. For example:

In 2001, the Journal of Clinical Psychiatry reported that 22 patients, who had symptoms of SAD and bulimia, were treated with light therapy. At the conclusion of the four-week trial, 10 patients said the SAD had lifted. Patients in the study also reported a 46 percent decrease in episodes of bingeing.

Last year, 16 pregnant women struggling with depression were given light treatments at Yale University. They experienced a 59 percent improvement in their symptoms during a five-week trial. As the American Journal of Psychiatry reported, light therapy could have a role with pregnant women in that doctors have been reluctant to give them antidepressants "because little is known about how the drugs may affect the developing fetus."

Pat Patnaude, who lives near Newark, says she initially purchased a full-spectrum light to help her 11-year-old daughter Kelsey. Keough suggested light therapy for Kelsey, who has attention-deficit disorder and can feel anxious at times. Kelsey has used the light at breakfast and when doing homework after school.

Her mom says homework that once took an hour now takes 40 minutes. It is neater and more accurately completed. Patnaude adds that her older daughter, Melanie, is finding that light therapy helps her focus on homework, too.

The 41-year-old Patnaude says light therapy has worked for her as well. A 20- to 30-minute dose of bright light in the morning has eased her insomnia. In her cubicle at work, she has used a second light for an hour each day to elevate her mood. She says the light has allowed her to reduce her dosage of the antidepressant Wellbutrin.

"What I also find amusing is that my 'Apollo' light is often missing from my desk in the morning, being used by co-workers who arrive earlier than I do," she says.

Her co-workers now refer to the appliance as "the happy light."

Illuminating Science

There have been 20 studies showing that light has a positive effect on a significant number of people with year-round depression, says Dr. Daniel F. Kripke, a professor of psychiatry at the University of California, San Diego. But neither antidepressants nor light therapy works with everyone, which is why he suggests using them in tandem. The National Institute of Mental Health estimates that 10 percent of the population or 18 million people deal with depression in any given year.

"Think about the dark dungeons of despair, the heart of darkness, the gloominess of a funereal mood," writes Kripke. "This language tells us what people have always known. Sadness rules where it is dark.

"Think about a person who has seen the light. Think about brilliance. Think how we describe the scintillating joy of love by singing, 'You are my sunshine.' We know that light makes us happier."

In recent decades, Kripke says, science has been trying to understand how it is that light is a neurobiological agent with strong effects on the body. One theory is that light enters the eye and travels along a nerve to the hypothalamus, which is involved in the regulation of the body through the secretion of hormones.

In response to bright light, the suprachiasmatic nuclei or body clock resets itself and sends a signal to the pineal gland which produces serotonin. Serotonin is a neurotransmitter that has the effect of elevating the mood of many people.

Often, people use light therapy in the morning. In response the body clock is thought to suppress the production of melatonin until much later in the day when the hormone helps bring on sleep.

Because of these effects, Keough says police on night shift can take a 30-minute dose of bright light at 3 a.m. to help them stay awake. And children can use bright light in the morning to help them feel energized for school, then be ready for sleep at a normal evening hour.

"Full-spectrum lighting is an integral part of addressing a significant number of sleep problems," writes Keough.

Indoor Life Creates Need

Kripke has theorized that modern Americans need doses of bright indoor light because we're spending less time outdoors than in earlier decades. On a typical day, he says, people go from their homes to their cars and into work. Then at the end of the day we reverse the pattern.

He says television, computers and video games also conspire to keep us indoors. "The result is we spend more and more time in front of the tubes and less and less time in daylight," he says.

In several cities, Kripke has studied how much sunlight people receive. He's found the average person is outdoors for less than one hour a day. In his study, he asked people to wear tiny light meters. He found that even in San Diego, known for its pleasant climate, the average person receives an average of 350 lux each day. That's a fraction of what he estimates that people may need to function optimally.

He says people could give themselves a mood lift by spending at least an hour outdoors in strong sunlight. But for many Americans this is not practical because of work and family commitments. That's why he expects more people to turn to bright indoor lights as a way of regulating moods and rhythms.

"I think the human body was designed to be outdoors in daylight as most animals are," says Kripke. "The body doesn't do well if it doesn't get some bright light. That's true for the birds and bees, the flowers and trees. Why not us?"

Reach Gary Soulsman at gsoulsman@delawareonline.com.

To Learn More

Dr. Daniel F. Kripke's e-book on light therapy can be found at www.brightenyourlife.info, which also has links to leading manufacturers. Kripke urges people to check with a doctor first.

For people seeking insurance reimbursement, Apollo Light recommends sending the company a doctor's letter and prescription, as well as the research abstracts and articles the company provides at www.apollolight.com.

Wilmington psychologist Kevin Keough has posted information at www.policepsychconsult.com.