IT is the season to be jolly, but about 18.5 percent (1 in 5) or 43.8 million adults in the United States experience some type of mental illness during this time of the year or in a given year. 10 million (4.2 percent) have the serious form of an illness, which adversely affects their life. One in five (21.4 percent) of those between 13 and 18 battles with severe depression at some point in their life. Those between 8 and 15, the prevalence is about 13 percent. Bipolar disorder is seen in 2.16 percent and 1.1 percent live with schizophrenia, while 18.1 percent have an anxiety disorder like PTSD (post-traumatic stress disorder), phobias, and obsessive-compulsive disorder (OCD).
Increased risk for suicide
41 percent of adults in the U.S. with a mental health condition barely received mental health services in the past year because many elected not to seek medical care for various reasons. Depression is more common among women and those between 40 and 59, and those under the poverty level are about two and a half times more prone to have the illness. The condition is serious, with physical symptoms affecting cognitive function and mood. It is associated with increased rates of chronic diseases, medical utilization and impaired overall performance. Depression costs the United States about $193.2 billion in lost earnings per year. It is estimated that on average 20 veterans commit suicide a day, according to the US Department of Veterans Affairs, and more than 90 percent of children who committed suicide had a mental health condition.
All of us have had some degree of depression at one time or the other because of the stressors we face in life. But that type of depression is a mild, transient and natural mental reaction to usual challenges we encounter and not the clinical disease we call a mental disorder. When the condition persists, becomes worse and negatively impacts our daily activities, we label it serious depression.
Let there be light
Light therapy has been found to be effective in the treatment of seasonal affective disorder (SAD), which happens at a certain time of the year — mainly in the fall or winter, during the week of Thanksgiving, Christmas, and the first part of the new year. These are the periods when people have very little exposure to the sun’s natural light because they stay indoors to avoid the cold and wintery season. It is also a time of the year when loneliness could be overpowering, especially for parents with empty nest syndrome and seniors who live alone.
In combination with a drug regimen, light or phototherapy has also been shown to benefit those with moderate to severe depression. Other conditions where light therapy is useful include, jet lag, in transit to a nighttime work schedule, sleep disorders and dementia. Some of the reasons why phototherapy is used are: its effectiveness in SAD; to complement antidepressant medications, or lessen drug dosage; for non-seasonal depression with insomnia; avoidance of antidepressants during pregnancy or while breastfeeding. Light therapy has been proven to be safe and effective, and has few side-effects.
Light treatment for skin diseases, like psoriasis, uses a different lamp — one with UV light, which has greater potential risk and complications, like skin and eye damage. Your physician can recommend the particular proven and safe light box to use.
Application
A light therapy box emits bright light that mimics natural outdoor sunlight. The person works, watches TV, does computing, reading, or simply sits by this box at a duration and intensity prescribed by your physician. This exposure affects brain chemicals associated with our mood much like exposure to the sunlight, easing SAD symptoms or depression. Going outdoor to do chores, to be with friends and family, or simply to walk, taking advantage of Mother Nature’s good old sun, which costs no money, is a great way to prevent SAD or improve our mental health throughout the year. This is different from sunbathing or using artificial sun-tanning, which are unhealthy and dangerous for our skin and bodies, and increases the risk of skin cancer.
Risks and side-effects
While light therapy (where the harmful UV light is filtered out) is generally safe, there are possible side effects, albeit mild and short lasting. They include headaches, eye strain, nausea, agitation, irritability. Those with bipolar disorder (manic-depressive) might “push” the situation to the other extreme and experience mania, hyperactivity, euphoria, and agitation — the opposite symptoms of depression. This is why medical consultation is strongly recommended before anyone starts with light therapy or any other form of treatment. Tanning beds, which are unsafe and could be life-threatening, are not substitutes for the light therapy we are discussing here.
The side effects are usually transient and dose-related (time of exposure and distance from the light box), disappearing within a few days. Each person reacts differently, others more sensitive than some, so the physician can tailor the treatment for each individual. The skin is more sensitive when one has lupus, taking certain antibiotics, anti-inflammatory drugs or herbal St. John’s Wort, or has an eye condition or a personal or family history of skin cancer. It is harmful to the eyes to look at the light box directly just like looking at the sun directly, but the eyes must be open when getting light therapy.
Key elements
For best results, the Mayo clinic posted these three key elements for effective photo-therapy:
Duration – When you first start light therapy, your doctor may recommend treatment for shorter blocks of time, such as 15 minutes. You gradually work up to longer periods. Eventually, light therapy typically involves daily sessions ranging from 30 minutes to two hours, depending on your light box’s intensity.
Timing – For most people, light therapy is most effective when it’s done early in the morning, after you first wake up. Your doctor can help you find the light therapy schedule that works best.
Intensity – The intensity of the light box is recorded in lux, which is a measure of the amount of light you receive at a specific distance from a light source. Light therapy boxes usually produce between 2,500 lux and 10,000 lux. The intensity of your light box affects how far you sit from it and the length of time you need to use it. A 10,000-lux light box usually requires 30-minute sessions, while a 2,500-lux light box may require two-hour sessions.
While light therapy is not for everyone, those on it could maximize the benefits by getting the right light box recommended by the physician, being consistent, proper timing of the treatment, continuing other prescribed treatments, and regularly consulting with the attending healthcare giver.
Photo-therapy may not cure SAD and depression, but it has been effective in easing symptoms, improving energy level, and helping people feel better about themselves, positively impacting their mood and attitude in life.
In many aspects of health and diseases, I cannot help but marvel at, and be endlessly grateful for, the many wonderful natural gifts Planet Earth blesses us with every day. In return, perhaps, we should show our appreciation by protecting it.
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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Visit philipSchua.com, Email: [email protected]
