By B. Bower
For the past 15 years, a small group of researchers has argued that people who sink into troughs of severe depression every winter can feel much better if they receive daily exposure to artificial bright light for at least a week. But many mental health clinicians have suspected that, instead, light therapy's reported effects reflect depressed volunteers' great expectations about the power of indoor illumination.
Two new studies, both published in the October Archives of General Psychiatry, counter this clinical skepticism with demonstrations that light therapyespecially if administered in the morningdampens winter depression much more than placebo treatments do.
Biological mechanisms through which bright lights produce antidepressant relief remain poorly understood. A third study in the same issue suggests that morning doses of bright light work by moving up by an hour or two the nightly secretion of melatonin, a hormone involved in sleep regulation and daily biochemical rhythms (SN:10/17/98, p. 248).
"Light therapy should be considered a mainstream antidepressant [therapy]," remarks psychologist Anna Wirz-Justice of the Psychiatric University Clinic in Basel, Switzerland, in an accompanying comment. "Light is as effective as [antidepressant] drugs, perhaps more so."
Along with feelings of sadness, anxiety, and lethargy, winter depression also frequently includes difficulty awakening in the morning, daytime drowsiness, cravings for sweet or starchy foods, and big weight gains. An estimated 1 in 10 people in Alaska and other northern regionsand 1 in 100 people in Floridaexperience this condition, which is also known as seasonal affective disorder (SAD; SN: 7/25/92, p. 62).
In one of the new studies, a team led by psychologist Michael Terman of Columbia University recruited 124 volunteers, ages 18 to 65, who exhibited SAD. Over 20 to 28 days, 85 participants received daily 30-minute exposures to bright light from a box mounted above the head. Some had light therapy in the morning, others in the evening, and some switched from one time to the other halfway through the trial.
The remaining volunteers sat for 30 minutes each morning in front of an apparatus called a negative-ion generator, which emitted either low or high densities of air ions. These treatments were intended to serve as placebos.
About 60 percent of those who received morning light therapy displayed marked improvement in SAD symptoms, compared with about 30 percent of those on the evening light regimen. Winter depression eased in only 5 percent of volunteers exposed to low-density ions.
Lessening of SAD also occurred in 40 percent of those exposed to high-density ions, a finding that needs to be explored further, the scientists say.
The second study, directed by psychologist Charmane I. Eastman of Rush-PresbyterianSt. Luke's Medical Center in Chicago, found that nearly 60 percent of volunteers diagnosed with winter depression greatly improved after 4 weeks of daily sessions of morning bright light lasting 90 minutes. The proportion of treatment responders reached only 44 percent for those given evening bright-light doses and 36 percent for volunteers whose daily regimen consisted of sitting in front of a negative-ion generator that made a soft hissing sound but, unknown to them, was not turned on.
Eastman's group studied a total of 96 people diagnosed with SAD.
A third study consisted of 51 people with winter depression and 49 individuals with no psychiatric disorders. Two weeks of 2-hour morning bright-light exposures reduced SAD symptoms much more than comparable evening light therapy did, report psychiatrist Alfred J. Lewy of the Oregon Health Sciences University in Portland and his coworkers. This study contained no placebo treatment.
Morning light therapy also advanced the onset of daily melatonin secretion by nearly 2 hours in the SAD patients, a process that may underlie its antidepressant effects, Lewy theorizes. Healthy participants exhibited no large changes in mood or melatonin secretion.
From Science News, Vol. 154, No. 17, October 24, 1998, p. 260.
Copyright © 1998 by Science Service.
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Eastman, C.I., et al. 1998. Bright light treatment of winter depression. Archives of General Psychiatry 55(October):883.
Lewy, A.J., et al. 1998. Morning vs evening light treatment of patients with winter depression. Archives of General Psychiatry 55(October):890.
Terman, M., et al. 1998. A controlled trial of timed bright light and negative air ionization for treatment of winter depression. Archives of General Psychiatry 55(October):875.
Wirz-Justice, A. 1998. Beginning to see the light. Archives of General psychiatry 55(October):861.
Further Readings:
Bower, B. 1992. Here comes the sun. Science News 142(July 25):62.
Sources:
Charmane I. Eastman
Rush-Presbyterian-St. Lukes Medical Center
Biological Rhythms Research Laboratory
1653 West Congress Parkway
Chicago, IL 60612Alfred J. Lewy
Oregon Health Sciences University
Department of Psychiatry, L-469
Sleep and Mood Disorders Laboratory
3181 SW Sam Jackson Park Road
Portland, OR 97201-3098Michael Terman
New York State Psychiatric Institute
1051 Riverside Drive
Unit 50
New York, NY 10032Anna Wirz-Justice
Psychiatric University Clinic
Chronobiology and Sleep Laboratory
CH-4025 Basel
Switzerland
copyright 1998 ScienceService