Treatment
Below is a
list of current treatment methodologies. Please note that not all of
these treatments have been proven to relieve SAD symptoms. Consult you
physician prior to undertaking any form of treatment.
Light Therapy is the most widely
accepted treatment method for SAD. As mentioned previously, SAD is believed
to be caused by reduced exposure to sunlight (which may naturally occur
during the winter months). Light therapy involves sitting in front of a
specially designed light box for 30-60 minutes a day to simulate sunlight
that is not being received naturally. A light box is simply a box with
specialized bulbs (approx. 10,000 lux) behind a screen to block UV light.
Your doctor may offer this service in his office or specialized light boxes
may be purchased from vendors ranging in price from $200-$500 (USD). There
are far too many products on the market to mention in this forum. The old
adage of “buyer beware” is certainly applicable – there are outrageous
claims about some of these products that are simply too good to be true.
Consult your physician and insurance company prior to purchasing any medical
product from a private vendor. The user simply sits next to the light
box for the specified time allowing the light to enter the eyes indirectly.
Do not stare into the light. Tanning beds cannot be used in place of a light
box due to the ultraviolet light emitted. Tanning beds are harmful to the
eyes and the skin. Positive results may be noted in little as 2 to 4 days.
Side effects of light therapy may include: light sensitivity, headaches,
fatigue, irritability, and insomnia if used late in the day
Dawn Simulation involves a specialized
light set to a timer that slowly increases in intensity at a specified time
each day to simulate dawn. This may be useful for individuals who have
difficulty waking in the mornings. This method has not proven anymore
effective than light therapy.
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Psychotherapy, if used, is usually
prescribed in conjunction with light therapy and is conducted by a certified
health professional. Psychotherapy alone is not recommended for SAD.
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Medication is usually prescribed if light
therapy alone has been insufficient or if symptoms are severe. This requires
diagnosis and follow up with a certified health professional. Currently,
antidepressants from the selective serotonin reuptake inhibitor (SSRI)
family are recommended. This includes medications such as citalopram (Celexa),
fluoxetine (Prozac), and paroxetine (Paxil). These medications function by
blocking the chemical serotonin from neurons in the brain. This creates a
higher level of serotonin detected by neuroreceptors which is thought to act
as a stimulant to counter depression.
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Cognitive-Behavioral Therapy (CBT) is a
combination of cognitive therapy (which focuses on one’s own thought
processes that may be self-defeating) and behavioral therapy (which examines
and modifies one’s reactions to given situations). The two combined can
alter perception and behavior in a positive manner which may assist in
overcoming depressive symptoms and compliance with treatments.
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Negative Ion Therapy involves using a
special electronic device to produce negative ions, a molecule that contains
an extra electron. These negatively charged particles are created naturally
by the sun, wind, and moving water. The effectiveness of this therapy has
not been scientifically proven and would not necessarily be recognized by
your physician as a treatment. This technology is also used in high-tech air
fresheners.
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Supplemental Melatonin, to shift the sleep
cycle, seems like a logical
treatment for SAD but its effects on other body systems, possible drug
interactions, and long term effects are not completely understood. Melatonin
does not require a prescription and is available at health and nutrition
stores. It is NOT regulated by the FDA and can pose a threat due to
impurities and dosing inconsistencies. Natural melatonin poses a safety risk
because it is acquired from the pineal gland of animals and may contain
viruses. Consult your physician before starting this form of treatment and
ask your pharmacist for synthetic melatonin. No thorough study has been
completed to determine the efficacy of this treatment.
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Electroconvulsive Therapy (ECT) has been
used in severe cases of SAD but only in situations where other treatments
had no effect. ECT requires direct supervision by a doctor and is conducted
in a medical facility. The treatment involves placing electrodes on the
patient’s head and passing a prescribed dose of electric current through the
brain. The patient requires sedation and constant monitoring due to the risk
of seizures. This treatment is generally used for chronic depression that
does not respond to other forms of treatment.
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