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Old 10-24-2003, 11:01 AM   #7
Leenie
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Default Therapy Articles (Light, etc.)

Here's an article I found.... don't know if its true b/c I haven't researched it enough...but I think the general idea is here:

What is Light Therapy?
Light therapy involves the use of a light source designed to affect the body as the sun would affect it if there were sunlight available. Light Therapy (or phototherapy) is a non-evasive, non-medication therapy recognized by the National Institutes of Mental Health and American Psychiatric Association as a viable therapy using light as the primary tool to treat conditions such as seasonal affective disorder (SAD), depression, dysthymia, manic depression, lethargy, obsessive compulsive disorder (OCD), bulimia nervosa, and secondary symptoms (e.g., Sundowner's Syndrome) associated with Alzheimer's disease.

Light therapy is called alternative but it has been used for years. Putting newborn babies under intense light is a routinely prescribed way to treat jaundice. Exposing people to carefully timed bright lights can reset the biological clock, helping people overcome jet lag or cope with the stresses of shift work.

Today, even conventional doctors are accepting these and other therapeutic uses of light therapy .

What is Seasonal Affective Disorder (SAD)? Everyone gets "the winter blues." So, what's different about SAD?

Many people complain about feeling down, having less energy, putting on a few pounds, and having difficulty getting up in the morning throughout the dark short days of winter. People suffering from SAD experience these and other symptoms to such a degree that they feel unable to function normally. They often feel chronically depressed and fatigued, and want to withdraw from the world and to avoid social contacts. They may increase their sleep by as much as four hours or more per day; have greatly increased appetite, often accompanied by irresistible cravings for sweet and starchy food, and gain a substantial amount of weight. Women frequently report worsening of premenstrual symptoms. People with SAD suffer in the extreme the kinds of changes which others may suffer to a much lesser degree in wintertime. An individual SAD sufferer, however, need not show all the symptoms described above. Sleep duration, for example, may be normal, while carbohydrate craving may be extreme, or vice versa. Sometimes a symptom in the cluster is actually opposite the norm, such as insomnia as opposed to excessive sleep. Recent studies indicate that about five times as many people may suffer from "winter doldrums," a subclinical level of SAD, as suffer at the level of clinical severity. These people notice the return of SAD-like symptoms each winter, and are bothered by them, but remain fully functional. As many as 25% of the population at the middle-to-northern latitudes of the United States experience "winter doldrums."

How does light therapy work?

Exposure to bright light effects changes in a person's circadian rhythms. Thousands of people find relief through bright light therapy, although the physiological mechanism is still uncertain. Such exposures suppress the secretion of melatonin (which makes us sleepy), and increase the secretion of seratonin (which keeps us alert and full of energy), but which of these influences are the primary mechanism is not yet known.

What intensity and duration is most effective?

Light therapy involves exposure to intense levels of light under controlled conditions. Our technologically advanced lightbox is set up on a table or desktop at which one can sit comfortably for the treatment session. Treatment consists simply of sitting close to this light. Looking at the light is not necessary or recommended; rather people are free to engage in such activities as reading, writing, relaxing, using the computer, watching television, or eating meals. What is important is to orient your head and body toward the light, concentrating on activities illuminated by the lights, and not on the lights themselves. Treatment sessions can last from fifteen minutes to three hours, once or twice a day, depending on individual needs. The time of day for light therapy is an important factor. Many people with winter depression respond best to treatment early in the morning. However, people who wish to stay up later will want to use the lightbox early in the evening. Two standard intensities are indicated: 5,000 lux for an average of one to two hours, or 10,000 lux for an average of 30 minutes to one hour. Intensity can be changed simply by moving closer or further away from the light. Regular use and experimentation will determine the optimum time of day for each individual.

What has research shown?

Researchers at medical centers and clinics in the USA, Canada, and other countries around the world have had much success with light therapy in many hundreds of patients with clear histories of SAD for at least several years. Marked improvement is usually observed within four of five days, if not sooner. Symptoms usually return in about the same amount of time when the lights are withdrawn. Most users maintain a consistent daily schedule beginning, as needed, in fall or winter and usually continuing until spring, when outdoor light becomes sufficient to maintain good mood and high energy. Some people can skip treatment for between one to three days, but most notice the effects almost immediately if treatment is interrupted.

Are there any side-effects?

Side effects have been minimal. People occasionally report eye irritation and redness which can be alleviated by sitting further away from the light. Using a humidifier to counteract the dryness of winter air indoors may also help. The most dramatic side effect, and one which occurs infrequently, is a switch from a lethargic state to a state of over-activity. In such instances, cutting back the amount of daily timed exposure to the light usually helps. If not, getting the guidance of a physician skilled in the use of light therapy is advised.

When are the lights contra-indicated?

People with a history or family history of Bipolar Disorder should exercise caution. Bright light therapy has been known to serve as a trigger for manic eposides. Research studies exclude patients with ocular or retinal pathology (for example, glaucoma, cataracts, retinal detachment, retinopathy) and those who might be at risk (for example, predisposing factors of diabetes). No adverse effects of light therapy has been found in eye examinations of SAD patients to date.

Can the lights be combined with antidepressant medication?

People who have received partial benefit from antidepressants often begin light therapy without changing drug dose. If there is a quick improvement, it is then sometimes possible to reduce the dosage or withdraw the drugs under clinical supervision, while maintaining improved mood and energy. Some patients find a combination of light and drug treatment to be most effective (particularly with Prozac & Zoloft). Some antidepressant drugs and antibiotics, however, are known or suspected to be photosensitizers which may interact with the effect of light in the retina of the eyes. Users of these drugs should therefore check with their medical practitioner or pharmacist before commencing light treatment.

Do lightboxes work for people with major clinical depression, too?

Statistics show that approximately 5-9% of the population suffer from depression. Of those, over half go undiagnosed, and of the remaining half, less than 15% will receive adequate treatment. In an article written by Jeff Kelsey, M.D. recently published in Healthline Magazine, major depression costs the U.S. economy over 40 billion dollars per year, of which only 28% represents the expense of treatment. Females are twice as likely as males to develop depression during their lives, and experience has found that in general, being able to explain a reason for depression is rarely an effective treatment. In the past, antidepressants have been the treatment of choice, often in conjunction with psychotherapy. Where one antidepressant was not enough, two different varieties were often prescribribed to be taken together. Results were not typically seen until the 4th week. Today, however, research is questioning the efficacy of antidepressants altogether after a study by Irving Kirsch, Ph.D., published in Prevention and Treatment, the journal of the American Psychological Association, showed that the beneficial effects of antidepressants only outweighed placebos by 25%. In other words, 75% of the patients responded as well to the placebos as the control group did to the actual antidepressant. Additionally, a growing number of patients are becoming discontent with the results of their antidepressants. It is thus timely that new research shows light therapy to be a viable alternative to antidepressants, thus providing patients with many new options.

According to Daniel Kripke, MD, director of the Circadian Pacemaker Laboratory at the University of California, San Diego, "Light may produce antidepressant benefits within 1 week, in contrast to psychopharmacological treatments, which typically take several weeks." In a review of clinical trials, Kripke determined that bright light therapy for nonseasonal major depression produced statistically significant net reductions in mood symptoms of about 12-35% on the Hamilton Depression Rating Scale. He noted those results were comparable with those obtained in major trials of antidepressant medications.
Many doctors now recommend patients use light therapy (lightboxes) in conjunction with their antidepressant (notably Prozac and Zoloft) regimen, and they are getting excellent results. "Light and medications appear to work best in combination," Kripke said, adding that combined treatment should also equal lower costs due to faster improvement and less disability.
Light therapy has a strong advocate in Anna Wirz-Justice, PhD, professor of psychiatry at the University of Basel in Switzerland, who is quoted in an article from The Journal of the American Medical Association (JAMA) as saying, "Light is as effective as antidepressant medications are, perhaps more so." Indeed, several European hospitals have already begun to administer light therapy for depression.
A controlled study on nonseasonal depression is currently underway at Columbia-Presbyterian Medical Center in New York City. The study will once again investigate the efficacy of bright light treatment for nonseasonal depression.
Can light therapy help people who have Chronic Fatigue Syndrome (CFS)?

Depression, joint pain, and fatigue are the 3 most debilitating symptoms of CFS. In one case study, Dr. Raymond Lam of Vancouver, discovered light therapy alleviated a patient's depression as well as her joint pain; in other cases, improvement has focused mainly on mood and sleep. Clinical trials of light therapy for CFS patients have now become a priority, particularly in light of the fact that to date, successful treatment interventions remain elusive.

Will insurance cover the cost?

Many insurance companies have reimbursed the purchase price of Ott bioLightboxes for the treatment of SAD, PMS, Major Clinical Depression, sleep disorders and circadian imbalances relating to shift work. Eligibility will depend on your individual contract and the current policy of your medical insurer. You are advised to check it out and ask your medical practitioner for a prescription.
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