You Are Getting Sleepy by Paul Glovinsky

Author:Paul Glovinsky [Glovinsky, Paul & Spielman, Arthur]
Language: eng
Format: epub
ISBN: 9781682308219
Publisher: Diversion Books
Published: 2017-05-12T04:00:00+00:00

Lighten Up

Light is a natural antidepressant. This is perhaps most clearly exemplified in seasonal affective disorder, or SAD, in which the recurrence of depression is tied to changes in daylength, typically as the photoperiod shortens in the fall and is at low ebb in the winter. Seasonal depression by definition remits with the return of longer days in the spring and summer. However, it can also be treated, as well as prevented from recurring each fall, by using specially designed light boxes that emit intense light with filters in place to block harmful ultraviolet radiation. (This type of treatment is discussed more fully in chapter 6, “Are You Too Out of Sync to Sleep,” since the same devices are used to treat circadian rhythm disorders.)

Following a pioneering study by Daniel Kripke in 1981, research has pointed to a possible role for light therapy in cases of depression even when seasonal variation is not prominent. A recent meta-analysis (a statistical means of combining the outcomes of numerous research studies on a given topic to get a clearer picture of the overall results), published by Stefan Perera and colleagues in the British Journal of Psychiatry, evaluated twenty of the more rigorous studies in this area. While the authors rated the quality of the evidence they examined to be low (due to generally small sample sizes, high risk of experimental biases, and other methodological problems), they did note that the combined results do indicate a small to moderate treatment effect for light in nonseasonal depression. Subjects receiving light therapy were significantly more likely to achieve a 50 percent reduction in depressive symptoms than those in placebo conditions.

While more work may need to be done to nail down the role of light therapy in treatment for nonseasonal depression, in clinical practice it is increasingly being deployed in this context. The prominence of sleep disturbance in your history, persisting along with depression, convinces us that, if light does not pose special risks for you, you shouldn’t wait to get more of it into your life.

These special risks include:

Conditions that render the eyes more vulnerable to damage from bright light, including macular degeneration and retinal dystrophies.

Medical disorders that increase sensitivity to light, such as porphyria and lupus, or a history of skin cancer.

Medications that increase sensitivity to light, including the phenothiazines, antiarrhythmic drugs such as amiodarone, and St. John’s wort.

A history of bipolar disorder, given clinical evidence that bright light treatment can trigger manic or hypomanic episodes.

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