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You’ve Heard of Light Box Therapy for SAD, But Does It Work?

It’s dark when you wake up. Still dark when you’re getting your coffee. Barely starting to lighten when you get out of the shower. Dreary on your way to work, shadowy on your way home. Then, boom: it’s nighttime before you know it.

Such relentless gloom is a lot for the soul to bear … especially for 4-8 straight months, depending on where you live.

If you’re like many people, then winter just gets you down. While some folks experience a wistful longing for summer, others have a true diagnosable condition: Seasonal Affective Disorder, appropriately shortened to SAD.

According to the American Psychiatric Association, “this disorder is identified as a type of depression – Major Depressive Disorder with Seasonal Pattern,” and may also be referred to as “seasonal depression or winter depression.”

Happily, all is not lost. There are some good tools out there for fighting SAD, prime among them the light box.

What is Light Box Therapy?

A light box is what it sounds like: a small device that produces light. It can take various shapes, from a box to a tablet to a lamp, a globe to a round lamp that looks like a makeup mirror to a pair of glasses.

The names also change from product to product.

You may see light boxes listed as therapy lamps, light therapy lamps, sunlight lamps, therapy lights, and more. (Note: Be careful when shopping to read listings carefully, as “light box” will also pull up screens to help with art tracing, devices to make custom letter signs and photography equipment.)

While the aesthetics and names vary, however, the purpose does not. A therapeutic light box is intended to create bright light that mimics daylight to make up for its lack during the winter months. Its use is pretty basic, but does require some explanation.

A woman sits in front of her light box for light box therapy for SAD
light box therapy for SAD

How Does Light Box Therapy Work?

Human circadian rhythms are tied to the sun just like those of other animals. When it’s bright out, we feel active and energetic because the light produces the right hormones to make us feel that way. When it’s gloomy or the daylight hours are short, we feel sleepier and more passive.

Some people get downright depressed.

A light box, therefore, is intended to replace some of that “missing” sunlight and return us to our normal, sunny selves. (See what we did there?)

Not all are convinced that light box therapy truly works, however. You can find plenty of skepticism online, but for the most part, it seems unwarranted. Research shows that “exposure to bright light at 10,000 lux for 7 days per week for 30 minutes before 8 a.m. results in substantial improvement in SAD and sub-syndromal SAD for most patients.”

For comparison, 10,000 lux is about the same brightness as ambient daylight on a grey day. (A sunny day is closer to 50,000 lux.) It is remarkable, therefore, that exposure to normal daylight levels for only half an hour a day can make such a difference, but it seems to.

Is that really so different, you might wonder, than the normal light with which we illuminate our homes, workplaces, and grocery stores? Turns out: yes.

“Even though it may seem slightly less bright than outdoor light, to our brains it’s actually much less bright,” Katie Sharkey of Brown University’s Alpert Medical School told Vox. “I’m sitting in my office now: I can see perfectly, I can read. But if I went outside, even though it’s overcast here, it’s still orders of magnitude brighter outside to the brain.”

For more on this topic, check out this video:

All That Glitters Is Not Circadian …

More recent research shows that the answer may not be as simple as activating a circadian circuit that equates brightness with wakeful enthusiasm and dimness with sleepy sadness.

“Beyond setting our circadian clock, light exposure also seems to affect higher-functioning areas of the brain,” says Harvard Medical School’s Dr. Richard S. Schwartz. It also activates neural pathways responsible for mood regulation and cognition.

That said, exposure to light as a form of therapy does seem to align with the sleep-wake cycle. As reported by Neuroscience News, animal studies show that light treatment delivered at the end of the dark cycle have an antidepressant effect on mice.

This holds for humans as well: “Light therapy is more efficient in the early morning than in the evening for patients with SAD,” says the same source.

Benefits of Light Box Therapy

Beyond helping regulate the body, the main benefits of light therapy include:

  • Regulating seasonal depression: According to a meta-analysis bright light therapy “showed efficacy in the treatment of SAD when compared to a control condition.” Specifically, 61% of patients saw symptom remission when using light therapy.
  • Helping decrease fatigue: Exposure to 10,000 lumens of light in the morning regulates the body’s sleep-wake cycle, energizing the individual early in the day and causing them to become sleepy late in the day, around bedtime.
  • Minimizing medication use: Many medications for depression work effectively to treat the primary problem, but they can cause a raft of unwanted side effects. While light therapy may cause side effects (discussed below), these are generally less intense than the pharmaceutical variety.
  • Generally lifts mood: By regulating circadian rhythms and affecting other chemical pathways in the brain, as discussed above, light therapy can lead to a healthier and more effective start to the day.

While light box therapy is useful even for those who have not been diagnosed with SAD, it is this condition that is most likely to be prescribed.

Light Box Therapy for Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder is a not-insignificant problem today. Statistics from the American Psychiatric Association show that roughly 5% of adults suffer from SAD. Of those who do, it affects them about 40% of the year and is more common in women than men.

The APA cautions that this isn’t as simple as feeling “bummed out.” SAD, like true depression, can come with serious symptoms such as:

  • Loss of interest in activities that normally cause joy and satisfaction
  • Changes in appetite and sleeping patterns
  • Tics, pacing, and restlessness
  • Difficulty concentrating and making decisions
  • Feelings of guilt, purposelessness, and worthlessness
  • Suicidal ideation

It takes little thought to see what a serious problem this can become. If, therefore, you feel serious “winter blues,” it’s critical to get the condition checked out by a doctor, psychiatrist, nurse practitioner, or other qualified medical professional.

And if you do receive a diagnosis, a light box may be great way to start turning your SAD around. Just talk to your doctor about it and see what they say.

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When and How Often Should You Use It?

As discussed above, light boxes aren’t tools to simply use when you feel like it. Beating SAD requires a systematic and committed approach to changing the chemicals in your brain through intentional light exposure. To use a light box correctly, you should:

  • Purchase a box with the right type of light (discussed below) at the right levels (10,000 lux)
  • Use the light box first thing upon waking, or as soon as you can
  • Expose yourself to it for half an hour, making sure it illuminates your face directly even if you are doing other activities
  • Avoiding the light box before bedtime, when it can wake you up and disrupt your sleep

Now, will just any old light box do? Turns out, no.

The Right Type of Light

Visible light is a spectrum, containing everything from low red wavelengths to high violet wavelengths, bracketed by infrared on one side and ultraviolet on the other.

Together, the colors of the rainbow combine to make white light, but we can separate out these types of light. So is any one of these more ideal than others for treating SAD?

As it happens, yes. Blue light therapy is hard on the retinas so best avoided, says the Yale School of Medicine. Green light therapy may be a good option but hasn’t been studied enough.

According to the study Light therapy for preventing seasonal affective disorder, the best options are white and infrared light. Remember, white is the combination of all wavelengths in the visible spectrum, and mimics daylight the best, since that is also what we get from the sun.

However, infrared light is also beneficial. In fact, it may work even better than white light. To wit, says the above study, “43% (6/14) of participants in the bright light group developed SAD, as well as 33% (5/15) in the infrared light group and 67% (6/9) in the non-treatment group.” Both, in other words, are better than nothing.

What Type of Light Box Works for SAD?

Always consult with a healthcare provider before purchasing a light box or other therapeutic device. They will help guide you in a safe and appropriate choice.

In general, look for a light box that:

  • Delivers white or infrared light
  • Delivers the appropriate level of lux
  • Doesn’t use blue light

Other Conditions Light Box Therapy Can Help

Light box therapy is not only useful in treating SAD. There are other conditions it can help, including:

  • Circadian rhythm disorders: Nonseasonal issues with the natural functioning of the body’s internal clock
  • Mood and anxiety disorders: Mental health disorders that don’t change seasonally but may still respond to light therapy
  • Fatigue: Energy and sleep disorders that occur regardless of seasonality
  • Postpartum and perinatal depression: Changes to mood that occur during and after pregnancy

Before purchasing a light box, you should also understand the risks and precautions.

Risks and Precautions of Using a Light Box

Generally speaking, the risks of using a light box are super low. These include:

  • Headaches
  • Eyestrain and retinal issues
  • Photosensitivity and UV radiation
  • Nausea and dizziness

You should also take precautions if you are elderly, have been diagnosed with bipolar disorder, or have existing eye conditions such as glaucoma. That’s why it’s so important to speak to your doctor before using a light box.

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