Millions dread the coming of winter, not because it’s cold but because the darkness of the night lasts too long. Daytime also carries a somber cloak. Many respond with moodiness, and some with frank mental depression that needs treatment. The treatment: sitting in front of bright, artificial light radiating from a box.
It may sound like quackery, like something out of science fiction or ancient myths, but, in fact, it does work. By shining intense light on the eyes of people suffering from deep depression in the winter season, psychiatrists have lifted the spirits of uncounted patients.
This light treatment, called phototherapy, has real effects on the minds of human beings. It has opened up a new way to treat the depression that affects millions of Americans from September, when days begin to shorten, through the winter and into March, when they begin to lengthen again.
A team of scientists at the National Institute of Mental Health in Bethesda, Maryland, began to focus on the link between mood and illumination. Dr. Norman E. Rosenthal, a chief psychiatric researcher at the institute, was one of them.
“There is not only winter depression – people get depressed in summer, too,” says Dr. Rosenthal. “We think for summer it’s the intolerance to heat. But we’re not sure.”
In the United States, Dr. Rosenthal estimates, 10 million people get clinically or dangerously depressed with the coming of winter. A smaller number become depressed with the advent of summer. All are suffering from what doctors now call seasonal affective disorder, or SAD.
Helen Smith, a housewife from New York City, says she finally realized she was starved for light. “Since puberty,” she recalls, “depression was constant. I had no focus or goals. It took me 7 years to finish college. You can’t just pick yourself up and make it better. Depression robs you of everything.”
The families of people like Helen Smith often believe that the patient can simply overcome the depression by an act of will. But the person no more can eject the depression from the mind than you can cure cancer by thinking about it. Mrs. Smith’s doctor sent her to Dr. Michael Terman, director of the Winter Depression Program at the New York State Psychiatric Institute in Manhattan.
“I’ve kept journals since the age of 9 or 10,” says Mrs. Smith. “September 15 was always the day in my journals when I would crash. But I did not see the pattern until I met Dr. Terman.” He took her off depression drugs and had her sit in front of a light box with six fluorescent tubes for 3 to 4 hours each morning and for 2 hours before bedtime. As she sat, she read, did needlepoint, or wrote in her journal. Within 3 weeks, she was feeling really good, she reports.
“I’ve had three winters depression-free,” Mrs. Smith exults. “I have a future. I have a family now. I belong to the human race.” Since being treated by Dr. Terman, she has married and has a baby girl. As do most SAD patients, she says she still hungers for light. “But now,” she adds, “half an hour in the morning is all I need.”
In less than 10 years, scientists have recognized that SAD is a mental disorder and that light plays a big part in its origin and treatment. The progress began when Dr. Rosenthal, then a young physician from South Africa, went to work in 1979 with Dr. Thomas A. Wehr, who was studying biological clocks in animals at the National Institute in Bethesda. The biological clock triggers many daily activities, each at about the same time every day – hunger, going to sleep and getting up, among others. Generally, your biological clock lags behind real time. With no cues from daylight, traffic noises, or temperature changes, you would feel sleepy later and later each day. Eventually, you could end up 12 hours out of step with real time.
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GENERAL HEALTH
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