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Light
Therapy, SAD and the Winter Blues
by Neil Wagner
| A light
box can be like a window of sunshine! |
The cycle of sunlight and darkness has always set the rhythm of
human life. The flow of light and dark serves to keep our bodies'
internal circadian clock synchronized so that we are alert and awake
during the day, and ready to sleep at night.
Our health, mood, and behavior are affected when the quality and
quantity of sunlight is lessened. Today's modern, urban lifestyles
often keep us indoors, away from daylight. In addition, shorter winter
days, cloudy skies, shift work and jet travel can affect our circadian
rhythms adversely.
Seasonal Affective Disorder (SAD) is a form of seasonal clinical
depression. It generally starts each year between September and
January, and disappears during the longer days of April or May.
During the winter, people with SAD are likely to experience
fatigue, sadness, difficulty concentrating, increased sleep (though
without feeling rested), carbohydrate craving and weight gain,
feelings of being overwhelmed, loss of libido and irritability. People
suffering from SAD may experience these and other symptoms to such a
degree that they are unable to function normally, and often feel
chronically depressed. SAD affects about 11 million North Americans.
The Winter Blues or (SubSAD) is a milder form of seasonal
depression but can still cause distress and severely limit one's
day-to-day activities. Winter Blues may affect an additional two to
three times as many people as SAD does, or up to 25% of the population
in northern latitudes.
Bright light therapy has been researched and implemented in the
United States and abroad since 1981. It involves exposure to intense
levels of light that replace the light normally found in sunlight.
As light enters the eye, it hits the retina and is transmitted by
nerve impulses to the pineal gland. The pineal gland controls
melatonin and serotonin secretions. These set the body's internal
clock or circadian rhythm.
Light therapy can raise the level of serotonin in the day and
melatonin at night. Serotonin keeps us alert and full of energy during
the day while melatonin helps us rest and recuperate at night. Both
promote optimum health. Light therapy helps to adjust the body's
melatonin timing so that it receives the same amount that it produces
during the winter as in summer.
Melatonin has been shown to counteract stress, boost the immune
system to help fight off viruses and bacteria, improve the quality of
sleep, minimize jet lag, reduce the risk of heart disease and regulate
biological rhythms. Melatonin may also protect against cancer and play
a role in determining how long we live.
Bright light therapy consists of sitting close to a light box with
eyes open so that the light shines on the user's face. Looking
directly at the light is not necessary. One is free to read, write or
eat a meal while staying oriented towards the light. This can also be
a pleasant time to meditate or listen to music.
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Additional
notes on light therapy:
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Controlled
clinical trials have recently established bright light
therapy as a first-line intervention for SAD. Dawn
simulation and negative ion treatments both show promise,
but are still are in investigation stages. Trials of two
drugs that act on the brain's serotonin system have
demonstrated moderate benefit relative to placebo pills,
but the average results appear not to match bright light
therapy in achieving a complete remission of winter
symptoms.
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Studies
of light therapy for depression have not been limited to
SAD. There is promising evidence that it may be effective
in nonseasonal depression as well. Recently, Dr. Daniel
Kripke of the University of California at San Diego
compared a set of placebo-controlled trials of bright
light with antidepressant drug trials and found
improvement rates to be similar. One major difference is
that light appears to work within one week, while
medications may take up to eight weeks to match the
efficacy of light. Interestingly, light used in
conjunction with medication appears to be superior to
either one alone. Several European hospitals have already
begun to administer light therapy alongside drug
treatment. |
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Sitting within the 10,000-lux range of a light box for a 30-minute
session soon after awakening is a typical treatment. This equals
sitting in the 2,500-lux range (about double the distance, but 1/4th
the light intensity of the 10,000 lux range) for a 2-hour session.
Moving towards or away from the light changes intensity levels.
Light box brightness levels can vary between manufacturers, so
check to find the particular 10,000 lux range of your light box. The
10,000 lux range is about 2 feet for the North Star 10,000. As a
measure of comparison, note that 100 lux is the amount of light
entering one's eyes from a 100-watt bulb five feet away.
Once adjusted to light therapy, an individual gets a fairly good
intuitive feel for the results and soon learns to adjust the session
length to achieve optimum results. Treatment time can range from
between 15 minutes to three hours in the 10,000 lux range.
A positive response usually begins within two to four days after
beginning light therapy, but it could take up to several weeks to get
the full beneficial effect. After the first week of accustoming
oneself to light therapy, it is fine to spend more time with it. This
is especially helpful on cloudy days, or for those who have an office
without a window. A light box can be like a window of sunshine!
Some people can skip treatments for one to three days, occasionally
longer, without ill effects, but most have symptoms returning quickly
when treatment is interrupted. Bright light therapy helps with SAD,
SubSAD, sleep disorders, PMS, jet lag, and shift work adjustment. Many
insurance companies will reimburse the purchase of a light box when a
doctor or therapist prescribes light therapy.
This information is intended to provide readers with general
information about the current use of light therapies. No medical
instructions or advice is intended. It is suggested that all
interested persons seek the advice of a skilled clinician.
Neil Wagner of Homer
owns Alaska Northern Lights. His company has shipped light boxes
across the world since 1995. For more information see www.alaskanorthernlights.com;
e-mail nlights@xyz.net; or
call (800) 880-6953 or (907) 235-6953.
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Beating
the Wintertime Blues
by Kaycie Rosen
…depression
occurs when a person is not doing what he or she
is meant to do in life. |
Seasonal Affective Disorder, or SAD,
is something many people experience during the winter months here in
Alaska. Cold temperatures, snow, and limited daylight can make it
challenging to maintain emotional balance. One of my mentors once told
me that depression occurs when a person is not doing what he or she is
meant to do in life. While this may pertain to larger questions such
as friends, family, career, etc., it may also be relevant to any
barrier a person encounters that prevents him or her from living a
life of joy and ease. There are many variable and often layered
factors that can contribute to SAD or depression. Some are physical,
some are related to past or current trauma, and some are related to
lack of clarity about what one wants or how to get it, or feeling
stuck in a situation. This imbalance can manifest in many ways, for
many reasons, and is often multifaceted.
One of the foundational principals of Naturopathic medicine is to
treat the whole person; this inherently recognizes that there are
multiple systems that may be involved in any single disease process.
This applies not only to the physical body, but also to the less
tangible aspects of ourselves, including the emotional and spiritual.
Many of us are familiar with the concept that our mind or emotions can
influence the progression or development of disease. Similarly, it is
also important to remember that dysfunction on the physical plane can
significantly affect our mental stability. Coping with the knowledge
of illness can in itself lead to a depressed mood. Chronic disease or
injury can also be both exhausting and disheartening, and depression
can accompany that process. Additionally, imbalances in the physical
body such as blood sugar imbalance, chronic fatigue, or thyroid
dysfunction can in themselves cause a decreased ability to regulate
our emotions.
In addition to the mixture of physical, mental, and emotional
causes of depression, the added stress of cold weather and lack of
sunlight can also play a major role. When this is the primary trigger
for a depressed mood and happens only during the winter months, it can
be labeled SAD. However, it does not mean that sunlight is the only
factor. If you are feeling persistently down, it is important to
obtain proper evaluation of both the physical body and the emotional
planes in order to fully understand the root cause (or causes) of
depression. It is important to get adequate evaluation to develop
understanding of an issue that may be comprised of multiple layers.
A Naturopathic doctor (ND) can act as the keystone when searching
for the cause of depression. As a primary care doctor, an ND can
perform a medical assessment, including lab testing and clinical
diagnosis to rule out organic dysfunction in the physical body. If the
underlying physiological aspects of depression are addressed, mood
regulation can be much more easily achieved. Concurrently, our focus
as holistic practitioners allows us to expand our assessment beyond
the physical. Naturopathic medicine is unique in its ability to assess
and treat disease on many levels. We are interested in treating and
understanding the whole person, which includes physiology,
biochemistry, mental, emotional, and spiritual issues.
Another integral principle of Naturopathic medicine is that there
is a healing force in nature that, when given the proper nourishment
and freed of obstacles, will bring a living being to a state of
health. There are many factors necessary to maintain a healthy mind,
body, and spirit. Because the state of one will necessarily affect the
health of the others, it is important to maintain balance in all of
these areas. It is important to start with the basics when treating
any disease, as those activities are fundamental to mental well-being.
These include adequate sleep, proper nutrition, adequate water intake,
stress management, and a balanced interpersonal and inner life. If all
of these are in balance, a person will be well on their way toward
mental health.
In addition to offering assistance for these physiological aspects,
an ND can also offer treatments that may target the emotional and
mental planes as well. Some of these other options for prevention or
treatment of SAD or depression include specific nutritional therapies,
botanicals, homeopathic remedies, or hands-on therapies such as
craniosacral therapy. If antidepressant medication is necessary, these
treatments can also be used concurrently, and in collaboration with
your other medical providers.
As we move through the winter season, it is more important than
ever to stay connected with the people around us. Reaching out and
asking for assistance is the best way to maintain balance; don’t be
afraid to consult someone for support or advice through a period that
seems rough. May your new year be one of health and vitality!
Kaycie Rosen is a
Naturopathic doctor, specializing in holistic primary care family
medicine. She works at Avante medical center, and can be reached at
907-770-6700
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How
To Be
Happy In The Dark
Jackie
Kosednar
The long, dark winters of Alaska
can put even the best of us in a funk. Gloomy days can intensify
depression or make our bodies sluggish. Alcoholism, drug addiction and
family violence often increase from the pressure of the dark. Thoughts
& attitudes can become negative. Even our bodies change as the
summer tan fades and we begin to look pale. Some of us gain weight in
the winter, and our mood can go down hill as we stay indoors more often.
There are ways to remedy these winter blues, however, and counter the
influence of the dark. It is
possible to stay happy, healthy and energetic all winter long!
Lack of natural light affects
different people in different ways. The dark has strong natural
energetic influence in all climates, especially the cold. This
natural force cause everything to slow down and “just be” in the
dark months -- geese fly south; many animals hibernate; and most plants
enter a rest period, waiting for spring. The natural signal of light
gets dimmer and dimmer, influencing us human animals as well as the rest
of nature.
As our bodies begin to
‘hibernate,’ our glandular system responds by slowing down. Fatigue,
or lack of energy, can set in. Unfortunately, this energy shortage
affects our immune system, causing it to slow down and thus not do its
job as effectively. This is why the cold and flu season always happens
in the winter, in the dark! The force of the dark is a subtle influence
on all of us. But like any
influence, it doesn’t have to dominate our lives.
We can easily overcome the
influence of the dark, even capitalize on it. Two basic remedies that
balance out the dark are light and exercise. The addition of these two
simple habits can make a dramatic shift in our lives.
Investing in a good light
designed especially for Seasonal Affective Disorder (SAD) is a great
thing to shift your glandular system into high gear and wake up the
immune system. Providing artificial light for the brain can be mentally
uplifting since it stimulates the production of positive brain
chemicals.
Basically, a SAD light is a very
bright light created for the treatment of seasonal depression. These
lights are available through medical prescription or for sale at stores.
Studies prove that the influence of this artificial light stimulates the
pineal gland (one of the master glands of the body) and keeps the body
running efficiently. In fact, all light helps. For example, it is also
useful to place plant lights to bring brightness to dark corners and
encourage the growth of green plants. These influences tell your body to
wake up and produce energy.
Regular workouts (as little as 20
minutes a day) also help to keep the body in a higher gear. As darkness
influences your body to slow down and vegetate, you can give it a
stronger signal: to exercise and get moving. The two influences create a
polarity – a balance. And, a body in balance is a healthy, happy,
body.
There are plenty of ways to
exercise 20 minutes once a day, or 40 minutes three times a week. You
might walk, ski or ice-skating; you could exercise in your home or at
the gym; you might join in classes or exercise along with a videos. Find
what form of exercise works for you, and decide to do it the rest of
your life.
When you add lots of light to
this recipe for health, it is easier to exercise because you feel more
like doing it. If you sit a lot during the day, get up and move around
every 50 minutes for 10 minutes. Your productiveness – as well as your
happiness – will increase.
Our minds have an incredibly
strong influence on our bodies. The mind has a powerful capacity to heal
the body and create health simply because the inner mind doesn’t know
the difference between fantasy and reality. Thus, you can use your
imagination to easily influence your glands, just as the SAD light
would. In a relaxed state, imagine a ray of brilliant bright light
striking you in the middle of your forehead and streaming through your
head. Meditate on this image for awhile, every day, until the light
returns in the spring. With a little persistence, it will keep you
uplifted!
Many people also become color
deficient in the Alaskan winter. As the bright light leaves, the scenery
around us changes to grays, browns and, finally, the monotonous white of
winter. This process also influences us to slow down and stay put. To
balance this, add a little color to your daily meditation. Imagine any
color of the rainbow and allow it to surround you like a fog. Then,
imagine your body absorbing all of the color. Do this with every color
that occurs to you until you feel color satisfied. This practice will
cure a winter color deficiency and make you feel happier and more alive.
As thoughts go dim and negative
with the lack of light and color, the decision to implement a positive
attitude can cancel out the irritability that often accompanies negative
winter attitudes. Happy thoughts produce brain chemicals that make you
happy, for emotions are side effects of thoughts. Keeping your thought
positive is a very good thing to do for your health – not only in the
winter by all year long.
It is important to realize that
the dark is not negative, but a natural energy that is necessary and
beneficial to us. We close our eyes every night and go into the dark to
sleep and rejuvenate; we work out psychological issues in our dreams.
This is good and necessary to both mental and physical health.
In the yin and yang of Oriental
Medicine, the dark is likened to the feminine, and it is easy to see how
the dark winter is very feminine in influence. When we are troubled, we
naturally become introspective and often wish time alone to balance the
outward thrust of our male energies. In the winter, we can benefit by
using this natural feminine influence to go within and flow with our
innate creativity.
As the dark brings up our issues,
we can release, clear and transform them, instead of fighting them.
Allow yourself to take that anger management class or being that
counseling you have been considering. The winter is a perfect time to
get lots of bodywork. A good massage gets the body moving by getting the
blood and lymph moving. The winter is also the ideal time to work on
health issues: stop smoking, get strict about your diet and improve the
quality of your life. Flowing with the positive influence of the dark
can help you stay in balance.
If you want to make it through
the winter and emerge strong, healthy and happy in the spring, start by
implementing these three simple practices into your life: light,
exercise and meditation. It’s a great way to balance the body, mind
and spirit.
Jackie Kosednar is a hypnotherapist,
Energy medicine practitioner, spiritual counselor, personal growth
trainer, and the publisher of Alaska Wellness Magazine. She teaches
Energy Medicine techniques in all of her workshops. Call 272-2469 for
more information.
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Natural Ways
to Wake Up and Stay Alert in the Alaskan Winter Darkness
by Jessica J. Allen
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Many
people are dependent on chemicals to become awake in the morning
and to stay awake during the day. |
It can be a challenge for some
of us to wake up naturally--especially during the long, dark months of
the year. Melatonin is produced in the body in response to darkness.
Light disrupts the production of this "sleep hormone",
thereby leading to the "summer insomnia" many people in
northern climates enjoy.
The sunrise, allowed into our
windows, will awaken us naturally. However in the winter months of our
northern climate, many of us need to arise earlier than the sun does.
The use of a dawn simulating lamp (which can be separate from or be
plugged into an existing lamp) will gradually lighten the room and is
useful to naturally decrease the melatonin levels. These lamps can
also be programmed to be at full brightness at a certain time,
allowing you to arise refreshed with or without an alarm clock.
Many people are dependent on
chemicals to become awake in the morning and to stay awake during the
day. However, chemicals such as caffeine can be detrimental to the
human system. New research shows that the caffeine equivalent of three
or more cups of coffee per day increases the risk of heart
malformations and cleft palates in the fetus. As little as 300 mg of
caffeine per day (the equivalent of two average cups of percolated
coffee) can actually decrease the odds of becoming pregnant by half,
and miscarriages are more frequent in women who consume at least 200
mg per day. Some studies show that habitual caffeine use may
contribute to migraines, chronic headaches, and chronic fatigue due to
disturbance of the sleep cycle. It also contributes to cystic breast
changes, heartburn, adrenal stress, ulcers and muscle twitches.
In low amounts, caffeine may
actually be useful. It can help the body burn fat instead of
carbohydrate if small amounts (250 mg) are taken immediately before
aerobic or anaerobic exertion. However, using the natural forms (such
as those found in guarana or green tea) are generally considered safer
than synthetic sources. Using much larger amounts (such as the 1,500
to 3,000 mg used in weight loss programs) is not worth the potential
adrenal fatigue and thyroid burnout, which may occur as a result of
the body's attempt to balance the effects of caffeine with an enhanced
output of thyroxin hormone to regulate the body's metabolism.
Small, consistent doses of
caffeine over time have also been hypothesized to contribute to weight
gain by causing a steady release of the hormone cortisol from the
adrenal glands. Cortisol is a hormone that is normally released during
times of stress. Elevated levels of cortisol over long periods produce
a constant stress that compromises the body's ability to heal and
adapt. This translates into the production of a number of undesirable
effects in the body, such as muscle catabolism and increased visceral
fat storage. Less muscle and more fat around the organs is not only a
health risk factor in many chronic diseases, but also will create
lethargy, reduced focus and concentration and increased levels of
inflammation in the body in the short term. Needless to say, all of
these things can affect a person's overall quality of life
significantly.
Furthermore, with additional
caffeine comes the effect of diuresis (increased water loss)
which will impair organ function, concentration, and
fatigue even more, and create a tolerance effect. As the
body adapts to current levels of caffeine, a tolerance to the
stimulant is created. This requires more and more caffeine over the
long term to have the same desired effect as the initial exposure (a
"quad shot" versus "one shot" of espresso, for
example). This is indeed a negative consequence that calls into
question the addiction that caffeine can create. This is most
noticeable when people try to limit their consumption and begin to
experience signs of caffeine withdrawal, most commonly throbbing
headaches that seem to originate without any specific cause.
Some people complain that
drinking a lot of coffee will put them to sleep. Most of the time this
is because they have exhausted their bodies from chronic overuse of
caffeine or other stimulants. Therefore, taking a break from all
caffeine may be required, with re-introduction of smaller doses to
feel the effects of increased alertness and concentration. In some
cases, however, re-introduction is not recommended due to the strain
it puts on the adrenal glands.
As with everything, use caffeine
wisely, in moderation. If you have heart problems, caffeine is not
recommended--instead, consult with a healthcare provider who
specializes in nutrition and exercise physiology. Extremely small
doses of caffeine (20 mg) can contribute to an increased feeling of
well-being, but should be limited in frequency and used sparingly. It
is important to note that moderation is key; anything over 200 mg of
caffeine use creates anxiety, nervousness, upset stomach and
jitteriness.
Although inconclusive, studies
show that there may be a link with caffeine to an increased risk of
hypertension, heart disease, kidney cancer, pancreatic cancer,
osteoporosis, premenstrual syndrome, and slowed childhood growth and
development. In addition, although it helps with short-term exercise
performance, it does not help with weight loss. This is because
long-term metabolic effects weaken as the body develops a tolerance to
caffeine.
Although most people associate
caffeine with coffee (it accounts for 75% of consumption), caffeine is
also found in the following substances: chocolate, guarana, cola nuts,
tea, mate, soft drinks and supplements. The FDA currently doesn’t
require companies to list caffeine on their labels or menus. It comes
as no surprise that most products made with coffee--mocha ice cream,
soft drinks and "instant energy" drinks--contain caffeine.
You may be surprised to know, however, that caffeine is also added to
some brands of hot cereal, candy bars, chewing gum, mints, jelly
beans, chips, mints, sunflower seeds (Sumseeds), beer (Bud Extra) and
even hot chocolate (Swiss Miss Chocolate "Pick-Me-Up").
Caffeine is classified as a drug and is used as a diuretic as well as
a cardiac and respiratory stimulant. For these reasons, it should be
used only when necessary, from natural food sources only, and with
caution--especially in children, pregnant and lactating mothers.
Natural ways of staying awake
include daily exercise, adequate water intake, breaks during the
workday to stretch and move, and utilization of certain food
combinations (such as eating lightly during the day so that your body
is not focusing its energy on digestion but instead on the daily tasks
at hand). Taking a B-vitamin complex with lunch can also help minimize
post-prandial fatigue.
These guidelines serve as a
baseline for healthier choices but, as always, it is up to each of us
to educate ourselves as to what is going into our body and to take
responsibility for our own health. Seeking out health care
practitioners who can supply proper, up-to-date information can be
extremely beneficial in this process.
Dr. Jessica is a
family chiropractor practicing what she preaches in Anchorage at
Kremer Chiropractic Clinic. To subscribe to her health e-newsletter,
please visit her website at www.wholefamilychiropractic.com.
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