What can be done to help SAD ?
You should get a check up from your medical practitioner first. Chat through your symptoms to get a proper evaluation.
Several treatments for SAD exist:
Artificial light
Natural light
Medication
Psychotherapy
Exercise
Ionized air therapy.
Artificial light therapy
We know that there is a relationship between exposure of an individual to light and the incidence of both winter blues and SAD.
Scientists have confirmed that light can elevate mood and re-set the body clock. How this happens is still be investigated.
Melatonin is the chemical in the brain which makes us sleepy. It is known that somehow light reduces the amount of melatonin produced but not exactly how.
There is certainly a link between the retina which is at the back of the eye and the area of the brain that releases melatonin but it has also been shown that shining a bright light onto the back of the knee will re-set the body's biological clock which also involves melatonin.
It is also thought that light may stimulate the release of Serotonin in the brain which is a chemical
which makes us feel good but this has not been proven.
The most convenient way of using light therapy especially in the winter months is by using artificial light generated using a light-box or light-visor.
It is recommended that you should check with your medical practitioner and optometrist before purchasing one of these to make sure that they are safe and suitable for you.
Using a bright light source in a light-box is the treatment of choice and has a success rate of around 85%.
A light-box or light-visor has a bright light much stronger than office or home lighting.
Recently it has been discovered that this therapy will work without the harmful effects of uv rays so these light frequencies have been removed.
It is rated at a dose of 10,000 lux and is used for up to an hour each day. The amount of light and therefore the amount of time spent exposed to it will vary from person to person .The time taken to have an effect will also vary from person to person.
Most will notice an improvement in about a week but often many months of regular treatment is necessary. The therapy can be used at any convenient time but it has been shown that using it at night causes restlessness and even sleeplessness so morning is best.
It is important to keep the distance between the face and a light-box the same for each session. The light must shine into the eyes but does not have to enter the eyes directly and if the patient accidentally looks directly at the light briefly then they will come to no harm.
Obviously it is necessary to keep reasonably still during the therapy and for those who cannot, the light-visor may be a better choice.
Once the light levels outside improve as Spring approaches, patients should be encouraged to use natural light therapy.
Artificial light therapy has very few side effects associated with it but some users have reported mild headache, eyestrain and "feeling wired". We do not know about the long term effects of prolonged exposure of light on the retina. There is no evidence of any harm but as a precaution it is advisable to check with your optometrist before and during use.
Natural light therapy
Natural light outside is often many times brighter than light-visors or light-boxes and is therefore preferable in the Spring/Summer. One hour exposure to outside light each day is regarded as enough to help SAD but as with artificial light therapy it works best if the exposure is regular so if the weather is poor and you do not feel like walking you are not going to get the most out of this strategy. If possible, try being without your glasses or contact lenses because these block out some of the light spectrum
Medication
SSRI drugs (selective serotonin reuptake inhibitors) have been shown to be effective in SAD, for example citalopram, escitalopram, fluoxetine, paroxetine, fluvoxamine and sertraline.
Psychotherapy
It has been shown that psychotherapy may be of benefit in SAD by exposing possible underlying depression.
Exercise
Regular exercise promotes the production of the "feel-good" hormones for example serotonin.
If the exercise is done outside then there is the additional benefit of exposure to natural light. Exercise itself is known therefore to elevate mood and using goal setting and celebrating success improves self esteem which again elevates mood.
Walking the dog has been shown to be ineffective as dogs have a tendency to stop and start which means the walker stops and starts. The key requirements are that whatever exercise is performed, it must firstly be sustained activity for at least half an hour per day and should leave you slightly out of breath with the heart rate raised.
Ionised air therapy
This is rather cutting edge and not proven but there is evidence that using negatively charged air or negative ions can help with SAD. Air- ionizers are commercially available either as stand alone or more often in conjunction with air purifiers. It's interesting that it is felt by many that a walk along a beach net to the Ocean or by a waterfall raises the spirits and elevated the mood. Both crashing waves and waterfalls generate vast amounts of negatively charged air molecules or ions. Some air-conditioners include a negative ion generation facility. Photocopiers, tvs and computers generate positively charged particles which make us feel bad.
Diet and the winter blues
Your diet is very important too. While you might be craving a stodgy plate of cheesy pasta, you should choose foods rich in the ‘feel-good’ hormone serotonin, such as fish, chicken, cottage cheese, avocado and bananas. A glass of wine (or two) might lift your spirits in the short term, but alcohol is a depressant in the longer term.
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