Light boxes

For an estimated 35 million Americans -- those who suffer from seasonal affective disorder (SAD) and those who have the lower grade "winter blues" -- autumn brings declining spirits along with falling leaves. The incidence of SAD rises with geographic latitude, affecting 1.4% of Floridians but almost 10% of the population of New Hampshire.

Although several neurotransmitters, or chemical messengers in the brain-- including melatonin, serotonin, and dopamine--- have been implicated in the origin of SAD, light deprivation seems to be the underlying culprit. It is also the easiest to remedy. To supplement winter's stingy supply of rays, photo-therapy -- the controlled exposure to bright light--has become the favored remedy for SAD. Although researchers haven't determined exactly how it works, they believe that light, reaching the brain through the retina of the eye, corrects the abnormalities in brain chemistry that result from light deprivation.

During phototherapy, the patient sits from 1-3 feet away from the light box --a set of non-UV fluorescent lights attached to a metal reflector and protected with a plastic screen. The patient is instructed to glance occasionally at the apparatus, which looks like a miniature version of the devices that illuminate baseball parks. Treatment usually begins with 10-15 minutes of exposure to a 10,000 lux box, which emits light 20 times brighter than ordinary indoor light. If symptoms become more severe, the duration of light exposure is usually increased, to a maximum of 90 minutes a day. Nearly all patients notice an improvement after 14 days of treatment; some feel better after only a few days.

The Food and Drug Administration (FDA) classties light boxes as experimental, which means that they cannot be marketed as a treatment for SAD. However, light boxes are low on the FDA's list of devices to investigate, so they aren't heavily policed. Therefore some may be sold with instructions for therapeutic use.

The cost of a light box ranges from $250 to $500 and is covered by a steadily increasing number of health plans. Many are portable, weighing as little as 13 pounds; light visors are also available.

If you think you have SAD, you should discuss the problem with your dinidan before buying a light box.

For more information about light therapy call the Winter Blues Information Network at 1-800-FIX-BLUEs or the National Institute of Mental Health at 301-443-4536.

One of the telephone numbers listed in our October article on seasonal affective disorder (SAD) was incorrect. To obtain an information packet on SAD or on light box manufacturers, call 301-496-0500. For information on other mental disorders, call 301-443-4513.

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