Seasonal Affective Disorder

The Lumiram Aurora™ Full Spectrum Bright Light System is engineered to increase comfort and sense of well-being for people who suffer from Seasonal Affective Disorder (S.A.D.), a condition created by chronic inadequate light exposure.

Seasonal Affective Disorder is a specific type of major depression, which reoccurs at specific times of the year. The most common pattern is the onset of major depression in the fall (September through November) and abating of the symptoms in late winter to early spring (March through May). The frequency of Seasonal Affective Disorder seems to vary with geographic location. It may approach 10% of the general population in northern New England, 5% of the population in the Baltimore/Washington area, and less the 2% of the population of Southern California or Florida.

Symptoms of Seasonal Affective Disorder

The symptoms of Seasonal Affective Disorder include change in appetite or weight, sleep problems, lack of energy, diminished sex drive, body aches or pains, memory loss, inability to make decisions, problems concentrating, low self-esteem, lack of interest in or enjoyment of activities, suicidal thoughts.

As in the case of major depression, the diagnosis of Seasonal Affective Disorder is a clinical one, based on the presence of specific symptoms. To meet the criteria for a seasonal relationship, there should be at least three episodes of mood disturbance in three separate seasons, at least two of which are consecutive. There should be no association between the disturbance and situation stresses, such as being unemployed with each winter.

In many ways the treatment of Seasonal Affective Disorder is similar to that of other major depressive episodes, utilizing antidepressant or mood stabilizing medication and/or psychotherapy. In addition, the exposure to bright light has been found to be an effective means of treating Seasonal Affective Disorder. The individual sits in front of a bright light unit, a specialized, portable box which houses balanced spectrum fluorescent tubes. An individual's needs for light therapy specifies the duration of exposure and the optimal time of day. An individual should meet periodically with their health care professional. The dose of light therapy should be adjusted as needed.

About 75% of Seasonal Affective Disorder sufferers are women, but Seasonal Affective Disorder affects men and children as well. The most typical age of onset is in the twenties, but other onsets are common such as during puberty, middle age, and old age. After women pass through menopause the numbers in men and women become equal. Susceptibility for Seasonal Affective Disorder appears to be inherited.

Causes of Seasonal Affective Disorder

The primary cause of Seasonal Affective Disorder is change in sunlight exposure. The reduction in daylight hours in the fall and winter can affect sufferers of Seasonal Affective Disorder. The most commonly accepted hypothesis for the underlying cause of Seasonal Affective Disorder is that reduced natural sunlight exposure affects the body’s natural daily rhythms, which are not fully precise and rely on the intensity of sunlight to provide adjusting cues. These cues originate in the retina at the back of the eye, creating signals which pass through the optic nerve to the mid-brain, setting in motion a number of chemical changes. These changes include:

• Increase in the neurotransmitter serotonin, necessary for a sense of well being.
• Regulation and suppression of the hormone melatonin, which is a factor in normal sleep patterns and may influence the recuperative benefits of sleep.

Seasonal Affective Disorder can be experienced as an isolated disorder or may be experienced in conjunction with an existing mood disorder or chronic illness. The tendency toward Seasonal Affective Disorder or severity of the symptoms can be influenced by many factors, such as living in a northern latitude, recent cloudy weather patterns, family history of Seasonal Affective Disorder, working in a windowless office, recent illness, or general life stresses.

Treatment for Seasonal Affective Disorder

The most successful treatments for Seasonal Affective Disorder involve identifying how the change in daylight shifts the person's daily circadian rhythms, especially in their sleep cycle. Most people with Seasonal Affective Disorder symptoms show changes in their sleep/wake patterns and melatonin levels. Bright light is known to be a powerful regulator of melatonin and the sleep/wake cycle. Seasonal Affective Disorder and "Winter Blues" sufferers tend to show two common patterns in their sleep phase: Delayed or Advanced.

The most common device used for bright light therapy is a fluorescent light box, which produces a light intensity of 2,500 to 10,000 lux at a comfortable distance (1-2'). Light box intensity ratings are always at a given distance. Fewer headaches and eyestrain are associated with using balanced spectrum light.

The light box is placed in front of the user at the recommended distance for the desired intensity. One should be directly in front of the unit as the light shines into the user's eyes. The eyes need be open, and sunglasses should not be worn. Some may be instructed to look at the light box briefly at regular intervals. The light box intensity of 10,000 lux is much brighter than normal indoor light which is usually 300-500 lux, but not as bright as summer sunlight which can be as bright as 100,000 lux.

It is possible to overuse a light box. Overuse can result in irritability and agitation, which is often followed by fatigue. Irritability, agitation and initial eyestrain for 1-3 days appear to be the main side effects. Inducing mania is seen in about 1% of light box users and mild hypomania may occur from persistent overuse. Some drugs make patients photosensitive, as can contact lenses, and those patients may need to be conservative when using staring light therapy. Those on antidepressants can often reduce their dosage, with their doctor's consent, once light therapy becomes effective. For most patients, light therapy is the most natural and safe treatment for Seasonal Affective Disorder, as well as the most cost-effective.

The Aurora™ bright light system provides a measured amount of balanced spectrum light equivalent to standing outdoors on a clear spring day. This has been shown to help regulate the body clock. Photo biologists point out that the light is registered by the eyes through the retina, which then transfers impulses to the hypothalamus in the brain to normalize the body clock function. The light from the box will help synchronize sleep/wake patterns with one’s work and lifestyle.

Regular daily usage of the Aurora™ bright light systems at the same time each day is recommended until symptoms disappear. After that period the patient may be able to cut session time or split a half-hour morning session into 15 minutes each in the morning and afternoon. Once a routine is established, most people can skip a couple of days without ill-effects. However, by the third day without light therapy most Seasonal Affective Disorder sufferers will see symptoms return. Light therapy sessions should begin at the time of the year before symptoms become obvious or distressing. Most patients will discontinue use in the spring when they receive enough natural light. The times when usage is necessary can be greatly affected by the amount of sunlight or cloudy rainy weather.

Given the effectiveness of treatments for Seasonal Affective Disorder, it would be a shame for anyone suffering from Seasonal Affective Disorder not to seek help. Seasonal Affective Disorder is often correctly self-diagnosed and anyone can purchase light devices. Nevertheless, other illness factors may be at play, and seeking the guidance of a qualified medical practitioner in both the diagnosis and treatment of Seasonal Affective Disorder is highly recommended. (Usage patterns outlined herein represent those most typically given by current clinical practices. They are not intended to encourage self-prescription or to contradict an individual's prescribed therapy.)

Note: Lumiram makes no medical claims and it is recommended to consult your physician or therapist on how to use light therapy.