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Not Again This Year, SAD Sufferers Just Need to See the Light

by Dr. Robert N. Karman, Licensed Psychologist, Yucca Valley

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In mid-January 2013 I wrote an article on Seasonal Affective Disorder (SAD) for the Hi Desert Star here in Yucca Valley, CA. Several patients, friends, and acquaintances commented to me that they did not understand what SAD is until they read my article. Some people here benefitted from getting bright lights to help them cope with the reduced wintertime light Feedback indicated that the article was distributed by local readers to various friends and relatives as far north as eastern Washington state, where the condition is more severe than it is here.

Itís now almost time for the winter cycle to start again. I used my light meter to get additional readings about the time the sun is at maximum brightness to compare with the dead of winter. I have a pair of sunglasses I constantly wear outside to cut intensity and glare. It allows only 15% of the sunlight to pass through, great for the summer, not so good during winter for people with SAD. Here is a summary of the mid-day results from December 2012 and June 2013 at the summer solstice. A final measurement on September 2013 shows the light intensity starting to decrease again as we approach winter. Light intensity is expressed in lux. For your reference, the typical indoor light intensity ranges from 300-500 lux.

Date

Sky Condition

Light Intensity (lux)

With Sunglasses (lux)

12/22/12

 

Sunny

13,000

 

1,950

 

12/23/12

 

Cloudy

2,500

 

375

 

6/13/13

 

Sunny

131,500

 

19,725

 

9/22/13

 

Sunny

127,200

 

19,080

 

The brain needs a certain intensity of light to signal that it is daytime. But individuals vary in the intensity they need. Hopefully this chart helps you see the range of conditions we face in the Hi Desert.

Here is the article published in the Hi Desert Star:

Posted: Tuesday, January 15, 2013 6:30 pm

Not again this year, SAD sufferers just need to see the light By Dr. Robert Karman Licensed psychologist, Yucca Valley, CA

"Every winter itís the same thing. I feel awful from late fall until late February. Iím sleepy all day, canít sleep at night, depressed and grouchy. I really canít help it.

I crave all carbs, mostly chips. I gain weight, but lose it in the spring. Weird!"

I hear this yearly. Symptoms vary, the misery doesnít. People are relieved to find thereís help, even to know it has a name: Seasonal Affective Disorder or SAD. It affects around 5 percent of the population. Maybe not you, but likely someone you know has it. Hereís why it happens and what helps.

Seasons and our biology interact. Light controls the pineal gland which in daytime produces serotonin, a mood regulator. At night time, it produces melatonin, which puts us to sleep. In spring and summer, when thereís a sharp difference between daytime and night, the pineal readily switches production.

Two things change in late fall and winter. Days get shorter and the sun isnít as bright as it is in spring and summer. The pineal of individuals with SAD doesnít switch off melatonin production when the weaker sun comes up but continues with melatonin. It still "thinks" itís night time.

The numbers tell us more.

Light intensity is measured in lux. In summer at noon sunlight exceeds 100,000 lux. In winter here at our latitude just before Christmas 2012, direct sunlight only provided 13,000 lux. Thatís intense enough for most people for proper pineal functioning.

Yet the next day was overcast and sunlight dropped to 2,500 lux, when SAD sufferers didnít get enough daylight for their brains to shut off their melatonin production. They remained sleepy during the day, maybe seeking coffee to stay awake. Since they didnít make enough serotonin, they also craved the ingredients in carbs to make more.

One cloudy day is bad for SAD but a straight week or two of them is intolerable.

Simple, right? If you lack light, then get more. The first choice is free: More direct sunlight. Sitting in the sun or taking a walk can both work, but without sunglasses, which can cut light up to 85 percent.

If that doesnít work, there are special light boxes that simulate extra sunlight, available for under $75 on the Internet that provide 10,000 lux. Exposure can be as little as 15-minutes once in the morning or a couple of times spaced through the day depending on need. Light boxes come with instructions, and the bulbs in these boxes last for years.

It takes a few days before improvement and consistent use throughout the winter season, especially on overcast days, to obtain optimal results.

However, be cautious if you have eye problems, are bipolar, or take medicines that make you photosensitive. Check with your doctor before proceeding with light therapy. Side effects can occur, which small changes in distance from the light or duration of exposure usually correct. Side effects can include headaches, insomnia, or dry eyes, and in rare instances, a manic episode.

 

Light might not be the only issue. Vitamin D can decrease in winter, an issue easily measured with a blood test and corrected with a supplement. In some cases, an antidepressant is necessary, but usually the place to start is with natural light and, if necessary, adding artificial light.   If the extra light works, adjust your routine to start using it every year just before you normally get the symptoms to avoid even starting another year like those from your past.


For more information on Seasonal Affective Disorder this book is excellent:

Winter Blues, Fourth Edition: Everything You Need to Know to Beat Seasonal Affective Disorder,  by Norman E. Rosenthal MD (Sep 4, 2012)

All 14 amazon.com reviewers agreed with me and gave it a 5 out of 5 rating.

An article for physicians that provides alternative treatments as well as guidance on how to manage the SAD disorder and use of lights is found at http://www.aafp.org/afp/1998/0315/p1340.htm

 


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