Depression affects 20 percent of women and 12 percent of men in the United States; more than likely you know someone who is affected by depression whether he or she has the disorder or knows someone else with the disorder. Depression is characterized by a sad mood, loss of interest, feeling of guilt, low energy, abnormal sleep and appetite, loss of concentration and an increased risk of suicide. These symptoms must be present for at least two weeks before someone is diagnosed with depression. Potential causes of depression include genetics as well as personal stressors such as the loss of a relationship, a job or a loved one.
To date, the majority of depression treatments have focused on pharmacological therapies, such as selective serotonin re-uptake inhibitors (SSRIs) and other antidepressant medications. These medications work by increasing levels of serotonin and dopamine in the brain. Unfortunately, they take about four to six weeks to have any effect and, like all medications, unwanted side effects can occur. An alternative therapy that has been used in the past and is currently being tested is light therapy. Light therapy has been shown to be effective in seasonal affective disorder, also known as SAD. Currently light therapy is being explored as a treatment for non-seasonal depression.
Plenty of past studies
There have been multiple studies over the years using light therapy as treatment for depression. One such study appeared in a 1999 Psychiatric Times article about the work of Daniel F. Kripke, M.D., and his colleague Richard Loving, Ph.D., from the University of California, San Diego. “Loving has been studying unipolar nonseasonally depressed outpatients who are being treated with antidepressants along with a half-night of sleep deprivation followed by administration of bright light therapy,” reported Psychiatric Times.
“There is now plenty of evidence that adding light will help the patient at least in the first week or two of treatment when the antidepressant drugs don’t actually do that much,” Kripke said in an interview with Psychiatric Times.
Spending the day outdoors can do wonders for the mind, body and soul. In fact, people who are outdoors for at least one hour a day tend to be less depressed and have less sleep complaints than those who spend their time indoors. According to Kripke, “a sunny day outdoors, illumination might be about 10,000 lux looking towards the horizon. However, people spend most of their time indoors in environments with lighting between 50 and 500 lux. In the evening, the average living room might be lit at about 15 lux, but some people watch television in rooms as dim as 1 lux, which is about the same as the light of the full moon.” Fifteen to 30 minutes of bright light (10,000 lux) is the average light therapy given to people to treat depression.
Another current study
A 2015 study by Raymond W. Lam, M.D., from the University of British Columbia, Vancouver, and colleagues compared the effectiveness of light therapy with antidepressant therapy alone. “The trial lasted 8 weeks and included 122 psychiatric outpatients, aged 19 to 60 years, who had a diagnosis of MDD of at least moderate severity as assessed by board-certified psychiatrists and confirmed via the Mini International Neuropsychiatric Interview and the Hamilton Depression Rating Scale. Of this total intent-to-treat population, 32 patients were allocated to receive light monotherapy, 31 to fluoxetine monotherapy, 29 to combination therapy, and 30 to placebo,” reported a 2015 Psychiatric Times article.
Results demonstrated that there was no difference between fluoxetine monotherapy and the placebo, indicating that SSRIs may not actually be the best treatment for depression. Other results demonstrated that light therapy, when used alone or in combination with fluoxetine, is well-tolerated and effective in patients with depression.
A call for more outdoor living
This year the popular outdoor store REI, closed its doors on Black Friday and led the campaign #OptOutside based on the theory that the general public should spend their day exploring nature and the outdoors instead of shopping in a mall for the best sale item. It may be more productive for mental health if more companies adopted this idea.
With all of the concrete evidence showing that light therapy can treat and prevent depression, and the best form of light therapy is being outside, time outside would benefit employees and students alike. The option of working outside on a patio can enhance mood and potentially make for a better work environment.
Spending more time exercising outdoors can save money on a gym pass and get people outside in the fresh air where there’s optimal lighting. Kids used to play outside until it got dark; now kids stay indoors, play video games and watch television. Are mental health problems with today’s youth a byproduct from lack of outdoor time? If everyone spent an hour a day outdoors, would depression in the United States decrease?
The Sovereign Health Group treats behavioral health disorders, including depression and other mental illnesses, substance addiction and co-occurring conditions. For more information, contact our 24/7 helpline.
Written by Kristen Fuller, M.D., Sovereign Health Group writer