Guest guest Posted October 22, 2006 Report Share Posted October 22, 2006 Have you ever been diagnosed with SAD (Seasonal Affective Disorder) ??? It becomes worse in the winter months in the northern states due to the lack of sunshine... I sent an article for you to look at... We have a couple of others on here that suffer with this maybe they will be helpful to you... ((( Lighted Hugs )))Helen Does anyone else have a problem with energy when it is dreary and rainy out. Living in Michigan especially in the Fall and Winter season's we have a lot of those crummy days. I notice that when the weather is like that I turn into a zombie and have no energy and find myself falling asleep in my wheelchair. I take a multi-vitamin and drink a small amount of caffeine a day but was wondering if anyone else have days like this and what do they do to overcome the loss of energy? I know I have a lot on my plate but I miss myself being the energizer bunny.Any input will be appreciatedSharon "When life's problems seem overwhelming, look around and see what other people are coping with. You may consider yourself fortunate." Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 24, 2006 Report Share Posted October 24, 2006 In a message dated 10/24/2006 9:45:20 P.M. Eastern Daylight Time, writewillow@... writes: Someone (don't know who and it doesn't matter)suggested fluorescent light boxes as a treatment forSAD. It's not fluorescent light that helps, it'sfull-spectrum light which is like sunlight - havingall the different colors of light. http://www.mentalhealth.com/book/p40-sad.html#Head_5 Is light therapy an effective treatment for SAD?More than 60 controlled studies of light therapy have been conducted by researchers around the world. Although there are general limitations to each study (e.g., small sample size, brief treatment periods), several qualitative reviews have concluded that light therapy is an effective treatment for SAD, with response rates of 60% to 90% in controlled studies. Two meta-analyses also confirm the efficacy of light therapy against plausible placebo controls. In large series, the clinical response rate for light therapy is approximately 65%. The most studied light device is the fluorescent light box. The fact that the light box has proven effective in almost every study, regardless of sample size, has placed the light box as the "gold standard" light device. Other light devices include head mounted units, or incandescent light visors. Studies of the head mounter units have shown good clinical response rates (comparable to those of light box studies) but the bright light conditions were no better than dim light, putting into question whether visors are superior to placebo. Dawn simulators are devices that slowly increase the room illumination while subjects are sleeping, to simulate a "summer dawn" during the winter. Early results suggest a beneficial effect of dawn simulators in SAD, but other studies show superiority of light boxes over dawn simulators. Although efficacy has not been established for head mounter units and dawn simulators, these devices may be helpful for some patients when light boxes are not available or not convenient. What are the relevant parameters of light therapy?Parameters for light therapy generally include intensity, wavelength, duration of daily exposure and timing of light exposure during the day. Intensity is usually expressed in "lux", a photometric unit of illuminance that corrects for the visual spectral responsiveness of the eye. As reference, indoor lighting is usually less than 500 lux, outdoor light on a cloudy day ranges from 1,000 lux to 5,000 lux, and midday summer sunlight can reach 50,000 lux or higher. The antidepressant effects of light therapy are thought to be mediated through the eyes, not through skin exposure. The usual "dose" of light therapy used in studies was 2,500 lux for at least one to two hours per day, but recent studies showed similar efficacy for 30 minutes of 10,000 lux exposure. Because of the convenience of briefer daily treatments, the 10,000 fluorescent light box has become the clinical standard. Although there as been controversy about the importance of timing of light exposure, new studies have confirmed that, on average, morning light therapy is superior to evening light exposure. The wavelength or type of light (incandescent, fluorescent) is not as important as intensity, but white light may be superior to narrow band wavelengths. Ultraviolet wavelengths are not necessary for the antidepressant response, and should be avoided because of long term toxicity. What is an adequate length of time for a trial of light therapy?Response to light therapy generally occurs within two to four days, and measurable improvement is often seen in one week. Most patients (but not all) experience rapid recurrence of symptoms after discontinuing light therapy. Longer trials have shown increasing response after two weeks, and incremental improvement response at three or four weeks. The atypical depressive symptoms (hypersomnia, increased appetite, carbohydrate craving, and weight gain) are associated with favorable response to light therapy, while the presence of melancholic symptoms or a personality disorder is associated with poor response. What practical tips are there for using light therapy?Commercial light devices are now widely available in medical supply stores or via mail order. A light device should meet government electrical safety standards, have a filter for the ultraviolet wavelengths and have been tested in reputable clinical trials. Patients must maintain proper distance and positioning to ensure the correct dose of light exposure. Because of the rapid response and relapse with light therapy, patients can become involved as active participants in determining their optimal dosing of light. For example, if patients respond to early morning light exposure, but the time is inconvenient for them, they can try shifting the exposure time to afternoon or early evening. Alternatively, they can try to reduce the duration of exposure to 15 minutes for maintenance. What are the side effects of light therapy?The common side effects of light therapy reported by patients in clinical trials include eye strain or visual disturbances (19%-27%), headache (13%-21%), agitation or feeling "wired" (6%-13%), nausea (7%), sweating (7%) and sedation (6%-7%). These side effects are generally mild and subside with time or by reducing the dose of light. Hypomania and mania have also been reported as uncommon but serious side effects of light therapy. Fluorescent light therapy using 2,500 lux to l0,000 lux is considered relatively safe on the eyes. Two follow-up studies did not show any eye or retinal damage after five years of light therapy. Ophthalmologic monitoring is not considered necessary unless there are risk factors for light toxicity (Table 3). Can light therapy be used in other populations and conditions?Some studies have shown benefit of light therapy in children and adolescents with SAD, in adults who have "subsyndromal" symptoms of SAD and in adults with nonseasonal depression. There are also studies of light therapy in other psychiatric disorders, including bulimia nervosa and premenstrual dysphoric disorder. The circadian effects of bright light have been exploited to treat jet lag, shift work, circadian sleep disorders and behavioural disorders in dementia. These results are considered preliminary and beyond the scope of this summary. Recommendations: Light Therapy(see description of the levels) Light therapy is an effective first line treatment for seasonal disorder (Level 1 evidence). The fluorescent light box, with light intensities of greater than 2,500 lux, is the preferred device for light therapy (Level 1 evidence). Some patients may respond to other light devices, such as lhead mounter units and dawn simulators (Level 5 evidence). The starting "dose" for light therapy using a fluorescent light box is l0,000 lux for 30 minutes per day (Level 1 evidence).Alternatively, light boxes emitting 2,500 lux require two hours of exposure per day (Level 1 evidence).Correct positioning is important (e.g., sitting close enough to the light box) to obtain the correct illumination (Level 3 evidence).Light boxes should use white, fluorescent light with the ultraviolet wavelengths filtered out (Level 3 evidence, Level 2 evidence).Light therapy should be started in the early morning, upon awakening, to maximize treatment response, but exposure at other times of the day may be helpful for some patients (Level 1 evidence).Response to light therapy often occurs within one week, but some patients require two to four weeks to show a response (Level 2 evidence).Patients can be encouraged to become active participants in establishing an optimal light protocol (Level 5 evidence).Common side effects of light therapy include headache, eyestrain, nausea and agitation, but these effects are generally mild and transient, or resolve with reducing the dose of light (Level 2 evidence).There are no absolute contraindictions to light therapy and no evidence that light therapy is associated with ocular or retinal damage (Level 3 evidence).Patients with ocular risk factors should have a baseline ophthalmologic consultation prior to starting light therapy, and periodic monitoring (Level 5 evidence) Recommendations For Opthalmologic ConsultationOphthalmologic consultation recommended for patients with the following risk factors for retinal toxicity to bright light exposure: & Mac183; Pre-existing retinal or eye disease (e.g., retinal detachments, retinitis pigmentosa, glaucoma). & Mac183; Systemic illnesses that affect the retina (e.g., diabetes mellitus). & Mac183; Previous cataract surgery and lens removal. & Mac183; Taking medications that have photosensitizing effects in humans.*lithium phenothiazines, such as thioridazine (antipsychotics, antiemetics), chloroquine (antimalarial), hematoporphyrins (used in photodynamic therapy for cancer),8-methoxypsoralens (used in ultraviolet treatment for psoriasis), melatonin, hypericum (St. 's Wort) & Mac183; Older age, because of greater risk of age-related degeneration.*Animal studies show retinal changes with drugs including beta blockers, tricyclic antidepressants, and tryptophan. The panel consensus opinion was that ophthalmological monitoring for patients on these drugs is not required unless patients have other risk factors. http://www.mentalhealth.com/book/p40-sad.html#Head_5 Treatment studies of light therapy have shown increasingly rigorous methodology with larger sample sizes, less diagnostic heterogeneity, longer treatment periods, and parallel instead of crossover designs. Wavelength of light used in light therapy was examined in two studies. In one study, the ultraviolet (UV) spectrum did not add to the therapeutic efficacy of light therapy [14*]. Because of the potential harmful effects of long-term W exposure, light therapy devices should have W filters that block wavelengths below 400 nm. In a comparison light box study, cool-white fluorescent lights were as effective as full-spectrum fluorescent lights [15], adding evidence to other studies showing that various light sources (including incandescent lights) are effective for treating SAD. Devices other than light boxes were also studied for light therapy. Two recent studies, with the largest sample sizes in light therapy studies to date, used a light visor [16*,17*]. In both studies, there was no relationship between the intensity of light and various measures of response to treatment, despite the fact that very low intensity light (60 lux) was used. This contrasts to most light box studies where a dear intensity-response relationship is found. Several explanations may explain this discrepancy. The proximity of the visor light source to the eye may increase the amount of light that reaches the retina, as compared to a light box. Lux, a unit of illumination, may also not be the best measure of the biologic or therapeutic effect of light. There is increasing evidence that even low illumination can affect biologic parameters [18], so that for some patients, light as low as 100 lux may be therapeutically effective. Finally, although the response rate was high in both studies (over 60% by strictly defined criteria), a non-specific (placebo) effect of light therapy must also be considered. In this regard, a light box study by Eastman and associates [19**] using a non-light control condition (a negative ion generator that, unknown to subjects, was turned off), found no differences between the control condition and bright light treatment (7000 lux for 1 hour in the morning). However, the response rate for the bright light condition (29%) was unusually low compared to other treatment studies. The selection criteria and unusually sunny weather during the course of their study may have excluded more light-responsive patients. Thus, the issue of placebo effects in light therapy remains unresolved. http://www.webmd.com/hw/depression/hw169586.asp Light therapy Research has shown that light therapy is an effective treatment for SAD.4, 5 There are two types of light therapy: bright light treatment, in which you sit in front of a "light box" for a certain amount of time (usually in the morning); and dawn simulation, which is done while you sleep. For dawn simulation, a low-intensity light is timed to go on at a certain time in the morning before you wake up and gradually gets brighter. Light boxes are available commercially and use fluorescent lights that are brighter than indoor lights but not as bright as sunlight. Ultraviolet light, full-spectrum light, tanning lamps, and heat lamps should not be used. You place the light box at a specified distance from you on a desk or in front of a chair and use it while you read, eat breakfast, or work at a computer. Light therapy is usually prescribed for 30 minutes to 2 hours, depending on the intensity of the light used.2 Some people find dawn simulation light therapy more convenient because it works as they sleep. Light box therapy, which some studies have shown to be most effective if done in the morning, may be less convenient for people who have busy schedules.6 Yet some studies have found that dawn simulation therapy is not as effective as bright light (light box) therapy.2 It may take as little as 3 to 5 days or up to 2 weeks before you respond to light therapy. Stopping light therapy will likely cause you to relapse back into depression.2 Light therapy may work by resetting your "biological clock" (circadian rhythms), which controls sleeping and waking. If you have eye problems or you take medications that make you light-sensitive, ask your health professional about whether light therapy is safe for you. Tell your health professional about any conditions you have and medications you are taking before you start treatment. Light therapy will need to be continued for the entire time you are depressed. People who discontinue treatment usually lapse back into depression.1 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 24, 2006 Report Share Posted October 24, 2006 Someone (don't know who and it doesn't matter) suggested fluorescent light boxes as a treatment for SAD. It's not fluorescent light that helps, it's full-spectrum light which is like sunlight - having all the different colors of light. The light boxes are professionally available, it may take up to 8 hrs exposure a day, you don't even have to be awake. It works even if your eyes are closed. Recent info has revealed that blue light may be just as effective and it may help people with regular 'depression.' Web MD has a lot of info on this. ; ) Willow --- angelbear1129@... wrote: > > > Have you ever been diagnosed with SAD (Seasonal > Affective Disorder) ??? It > becomes worse in the winter months in the northern > states due to the lack of > sunshine... I sent an article for you to look > at... We have a couple of > others on here that suffer with this maybe they > will be helpful to you... > ((( Lighted Hugs ))) > Helen > > Does anyone else have a problem with energy when it > is dreary and > rainy out. Living in Michigan especially in the > Fall and Winter > season's we have a lot of those crummy days. I > notice that when the > weather is like that I turn into a zombie and have > no energy and find > myself falling asleep in my wheelchair. I take a > multi-vitamin and > drink a small amount of caffeine a day but was > wondering if anyone > else have days like this and what do they do to > overcome the loss of > energy? I know I have a lot on my plate but I miss > myself being the > energizer bunny. > > Any input will be appreciated > > Sharon > > > > > > > " When life's problems seem overwhelming, > look around and see what other people are coping > with. > You may consider yourself fortunate. " > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2006 Report Share Posted October 27, 2006 Great info everyone thanks. Going handicapped equipment shop and see what I have to do to get one of these lights. Winter is coming fast and I don't want to be a hermit this winter. Thanks Sharon > > > > > > > Have you ever been diagnosed with SAD (Seasonal > > Affective Disorder) ??? It > > becomes worse in the winter months in the northern > > states due to the lack of > > sunshine... I sent an article for you to look > > at... We have a couple of > > others on here that suffer with this maybe they > > will be helpful to you... > > ((( Lighted Hugs ))) > > Helen > > > > Does anyone else have a problem with energy when it > > is dreary and > > rainy out. Living in Michigan especially in the > > Fall and Winter > > season's we have a lot of those crummy days. I > > notice that when the > > weather is like that I turn into a zombie and have > > no energy and find > > myself falling asleep in my wheelchair. I take a > > multi-vitamin and > > drink a small amount of caffeine a day but was > > wondering if anyone > > else have days like this and what do they do to > > overcome the loss of > > energy? I know I have a lot on my plate but I miss > > myself being the > > energizer bunny. > > > > Any input will be appreciated > > > > Sharon > > > > > > > > > > > > > > " When life's problems seem overwhelming, > > look around and see what other people are coping > > with. > > You may consider yourself fortunate. " > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2006 Report Share Posted November 3, 2006 The lights in the lightbox are a type of fluorescent, but the key is that they are full-spectrum, not fluorescent. I forgot to mention that the tests show it might take less time exposure with the blue light therapy. Willow --- AStep17427@... wrote: > > In a message dated 10/24/2006 9:45:20 P.M. Eastern > Daylight Time, > writewillow@... writes: > > Someone (don't know who and it doesn't matter) > suggested fluorescent light boxes as a treatment > for > SAD. It's not fluorescent light that helps, it's > full-spectrum light which is like sunlight - having > all the different colors of light. > > > > > _http://www.mentalhealth.com/book/p40-sad.html#Head_5_ > > (http://www.mentalhealth.com/book/p40-sad.html#Head_5) > > Is light therapy an effective treatment for SAD? > More than 60 controlled studies of light therapy > have been conducted by > researchers around the world. Although there are > general limitations to each > study (e.g., small sample size, brief treatment > periods), several qualitative > reviews have concluded that light therapy is an > effective treatment for SAD, > with response rates of 60% to 90% in controlled > studies. Two meta-analyses also > confirm the efficacy of light therapy against > plausible placebo controls. In > large series, the clinical response rate for light > therapy is approximately > 65%. > The most studied light device is the fluorescent > light box. The fact that > the light box has proven effective in almost every > study, regardless of sample > size, has placed the light box as the " gold > standard " light device. Other > light devices include head mounted units, or > incandescent light visors. Studies > of the head mounter units have shown good clinical > response rates (comparable > to those of light box studies) but the bright light > conditions were no > better than dim light, putting into question > whether visors are superior to > placebo. Dawn simulators are devices that slowly > increase the room illumination > while subjects are sleeping, to simulate a " summer > dawn " during the winter. > Early results suggest a beneficial effect of dawn > simulators in SAD, but other > studies show superiority of light boxes over dawn > simulators. Although efficacy > has not been established for head mounter units and > dawn simulators, these > devices may be helpful for some patients when light > boxes are not available or > not convenient. > What are the relevant parameters of light therapy? > Parameters for light therapy generally include > intensity, wavelength, > duration of daily exposure and timing of light > exposure during the day. Intensity > is usually expressed in " lux " , a photometric unit > of illuminance that corrects > for the visual spectral responsiveness of the eye. > As reference, indoor > lighting is usually less than 500 lux, outdoor > light on a cloudy day ranges from > 1,000 lux to 5,000 lux, and midday summer sunlight > can reach 50,000 lux or > higher. The antidepressant effects of light therapy > are thought to be mediated > through the eyes, not through skin exposure. > The usual " dose " of light therapy used in studies > was 2,500 lux for at least > one to two hours per day, but recent studies showed > similar efficacy for 30 > minutes of 10,000 lux exposure. Because of the > convenience of briefer daily > treatments, the 10,000 fluorescent light box has > become the clinical standard. > Although there as been controversy about the > importance of timing of light > exposure, new studies have confirmed that, on > average, morning light therapy > is superior to evening light exposure. The > wavelength or type of light > (incandescent, fluorescent) is not as important as > intensity, but white light may be > superior to narrow band wavelengths. Ultraviolet > wavelengths are not > necessary for the antidepressant response, and > should be avoided because of long > term toxicity. > What is an adequate length of time for a trial of > light therapy? > Response to light therapy generally occurs within > two to four days, and > measurable improvement is often seen in one week. > Most patients (but not all) > experience rapid recurrence of symptoms after > discontinuing light therapy. > Longer trials have shown increasing response after > two weeks, and incremental > improvement response at three or four weeks. The > atypical depressive symptoms > (hypersomnia, increased appetite, carbohydrate > craving, and weight gain) are > associated with favorable response to light > therapy, while the presence of > melancholic symptoms or a personality disorder is > associated with poor response. > What practical tips are there for using light > therapy? > Commercial light devices are now widely available in > medical supply stores > or via mail order. A light device should meet > government electrical safety > standards, have a filter for the ultraviolet > wavelengths and have been tested in > reputable clinical trials. Patients must maintain > proper distance and > positioning to ensure the correct dose of light > exposure. Because of the rapid > response and relapse with light therapy, patients > can become involved as active pa > rticipants in determining their optimal dosing of > light. For example, if > patients respond to early morning light exposure, > but the time is inconvenient > for them, they can try shifting the exposure time to > afternoon or early > evening. Alternatively, they can try to reduce the > duration of exposure to 15 > minutes for maintenance. > What are the side effects of light therapy? > The common side effects of light therapy reported > by patients in clinical > trials include eye strain or visual disturbances > (19%-27%), headache (13%-21%), > agitation or feeling " wired " (6%-13%), nausea (7%), > sweating (7%) and > sedation (6%-7%). These side effects are generally > mild and subside with time or by > reducing the dose of light. Hypomania and mania > have also been reported as > uncommon but serious side effects of light therapy. > > Fluorescent light therapy using 2,500 lux to l0,000 > lux is considered > relatively safe on the eyes. Two follow-up studies > did not show any eye or retinal > damage after five years of light therapy. > Ophthalmologic monitoring is not > considered necessary unless there are risk factors > for light toxicity (Table > 3). > Can light therapy be used in other populations and > conditions? > Some studies have shown benefit of light therapy in > children and adolescents > with SAD, in adults who have " subsyndromal " symptoms > of SAD and in adults > with nonseasonal depression. There are also studies > of light therapy in other > psychiatric disorders, including bulimia nervosa and > premenstrual dysphoric > disorder. The circadian effects of bright light have > been exploited to treat > jet lag, shift work, circadian sleep disorders and > behavioural disorders in > dementia. These results are considered preliminary > and beyond the scope of this > summary. > Recommendations: Light Therapy > (see description of the levels) > Light therapy is an effective first line treatment > for seasonal disorder > (Level 1 evidence). > The fluorescent light box, with light intensities > of greater than 2,500 lux, > is the preferred device for light therapy (Level 1 > evidence). > Some patients may respond to other light devices, > such as lhead mounter > units and dawn simulators (Level 5 evidence). > The starting " dose " for light therapy using a > fluorescent light box is > l0,000 lux for 30 minutes per day (Level 1 > evidence). > > Alternatively, light boxes emitting 2,500 lux > require two hours of exposure > per day (Level 1 evidence). > > Correct positioning is important (e.g., sitting > close === message truncated === Quote Link to comment Share on other sites More sharing options...
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