Effective treatments for SAD?

October 6, 2009 1:05 AM

Effective treatments for SAD that work for you? (Please let's avoid a general discussion/opinion exchange about SAD.)

I live in the UK.

posted by humblepigeon to Health & Fitness (34 answers total)

Apologies if this sounds flippant, but a holiday somewhere warm in the middle of winter works wonders for me (the few times I've done it).
posted by MuffinMan at 1:08 AM on October 6, 2009

Light box for 20 minutes in the morning.
posted by doncoyote at 1:38 AM on October 6, 2009

Response by poster: Light box for 20 minutes in the morning.

Any particular light box? What technique do you use? How close do you sit? Do you do anything while you use it? Do you stare into the light, or just do something within its glow, like reading? How soon after you wake up?
posted by humblepigeon at 1:45 AM on October 6, 2009

I have two of these at my desk - similar to a light box but in a more traditional desk-lamp form.

I turn them both on first thing and leave them on for an hour or so. I'm probably 3' from one and 4' from the other, and usually looking at a computer screen off to one side. If I feel like I need more I sit right between them, 2' away from each, and read a book. I wouldn't stare into the light, it's a bit intense.

The actual sun works even better, but of course that's not always available.
posted by mmoncur at 2:15 AM on October 6, 2009

Daily doses of Vitamin D.
posted by Blazecock Pileon at 2:18 AM on October 6, 2009 [3 favorites]

Best answer: Seconding Vitamin D. I don't have SAD, but my mother does. Growing up she would pretty much hibernate in the winter, but last year she finally started to actually listen to her doctor when she said to take Vitamin D and I can't BELIEVE the difference it made for her. She's more energetic and active than I've ever seen in my whole life.
posted by Caravantea at 2:46 AM on October 6, 2009

I built my own light box out of "daylight" fluorescent lamps. Its on a timer and I set it to go on roughly 12 hours before sunrise. I turn it off when the sun actually rises. Makes waking up much less painful.
posted by gjc at 3:26 AM on October 6, 2009

I was in exactly the same position and got one of these . It's too early to give any empirical evidence but it is definitely cheering me up every morning. Good luck.
posted by jhighmore at 3:28 AM on October 6, 2009

Not for me but for my wife: Vitamin D and a walk outside in the middle of the day worked. A lightbox did not: I suspect because devoting the recommended amount of time to sit in front of it each day was a bit onerous. Having a daily routine which does not require getting up before sunrise during the middle of winter is a great plus too.
posted by rongorongo at 3:48 AM on October 6, 2009

Response by poster: Doses of Vit D that work? There's a lot of conflicting advice out there. Also methods of ingestion? Tablets?
posted by humblepigeon at 4:06 AM on October 6, 2009

Seconding gjc. I didn't build a box but replaced ALL my light bulbs with "daylight" bulbs. Is Home Depot in UK? This worked much better for me than Vitamin D.
posted by jara1953 at 4:06 AM on October 6, 2009

Save the cash, just buy full-spectrum CFLs (anything rated with 6500K) and replace every light in your house with them, it'll give you much more flexibility than a lightbox as well. If your most-inhabited (living?) room doesn't light up enough that you sense a warm glowy feeling, then it's time for more lamps! That's what I've done, and it's helped me (a New Englander presumably hard-wired for SAD) and my partner who has similar troubles.
posted by tybeet at 4:25 AM on October 6, 2009 [2 favorites]

Going outside into the sun if there is any is the best medicine. I once had to go something like four or five months without a sunny day. Let's just say violence and depression was up in town. I put every light I could on, but a dedicated light box is much better and worth every penny.
posted by caddis at 4:36 AM on October 6, 2009

I realize this comes with its own health risks, but last winter I used a tanning both for about 4-6 minutes every week and my mood was amazingly improved.
posted by tastybrains at 4:57 AM on October 6, 2009

Staying healthy - I have just started a new exercise programme that gets me outside (running), vitamins, eating well.

I also have one of those Philips wake-up alarm clocks that has a light that steadily turns on over 30 minutes. I moved from a country where it is rarely dark to Europe and this thing is fantastic for me.
posted by wingless_angel at 5:17 AM on October 6, 2009 [1 favorite]

I have an old lightbox (don't know make or model, sorry) and using it for 20 minutes in the morning helps.

Another thing that helped - swimming at the local gym. If you have access to a pool and like water, I recommend it. I think it's that the pool room is very well heated and very brightly lit, and of course I have found vigorous exercise helps.
posted by pointystick at 5:21 AM on October 6, 2009

Vitamin D plus light box here. The one thing that really really helped this past winter was going to Cuba for a week. One week of soaking up sun (not tanning, just being outside with sunblock etc.) was enough to keep me going for a month at least. Generally I hibernate in the winter, but I'm going to try and go away twice for a week this winter. I asked my therapist if there was any way I could get an Rx for it so my health plan could send me to Mexico for the winter ;) but I'm still waiting on that one.
posted by variella at 5:32 AM on October 6, 2009

I take Vitamin D along with omega-3 fish oil. I use this, between 1 and 4 tsp a day yields 400 to 1600 IU. It seems to make a difference.

I also rigged my workspace with extra lighting to make it nice and bright.
posted by DarkForest at 5:32 AM on October 6, 2009

Best answer: So, I'm from the Southern US, but I attended college for 4 years in the northern extremes of the country. This hit me rather badly the first year (and then every year after that).

What helped me:

1 - Light Box. I'd use it in the evenings, especially when I was trying to get work done. My main issue was that I'd go into a building for classes while the sun was coming up, and usually leave while the sun was already down, so I needed that bit of light in the evenings.

2 - Eating healthy. I tended to eat healthier in the winter - less fried foods, less grease in general. I kept to soups and salads, as well as lots of fresh fruit.

3 - Getting outside during sunlight. My schedule didn't always allow for this, but if I could go walk around the block for 20 minutes, then that did a ton of good. The cold also fought this (hard to enjoy a leisurely walk in -20F weather).

4 - Being social. This was surprisingly the most important thing, and tended to be the first thing to go. I needed to be around my friends, and make sure I got out of my room to do other things. Whether it was just dinner, or going into town to run to WalMart, or even just out for a drink, escaping and reminding myself that I wasn't the only person out there always helped.

Good luck with this - I know exactly how this feels, and I hope you get through this. There's been some great advice in this thread.
posted by SNWidget at 5:34 AM on October 6, 2009 [1 favorite]

Neither of us were ever diagnosed with SAD, but my wife and I have both dealt with depression and we both noticed a real benefit from using a light box during out first long and rainy winter in Portland years ago. I am sure it was the cheapest one available--we just kept it in the bathroom and we would both get about 20 minutes in front of it after we got out of the shower, etc.
posted by Ignatius J. Reilly at 5:54 AM on October 6, 2009

I started using a sunrise alarm clock a few years ago, and haven't suffered any seasonal problems since then.
posted by grouse at 6:26 AM on October 6, 2009

I get pretty low-level SAD but the thing that worked for me was twofold

1. turn on the bright overhead lights in the morning as soon as I had to wake up. Like literally roll over, flip on light switch and lie there squinting while I woke up further.

2. on any cloudy day [these were many when I lived in Seattle, less so now that I live in Vermont] make sure to have very bright non-flourescent lights on (full spectrum seems fine, but I personally don't have a problem with just regular old bright lights) in whatever room I'm working on.

And then, yeah the usual, don't self-medicate with too much coffee or too much food and try to get out and get some exercise even if it's walking around the block somewhat.
posted by jessamyn at 7:22 AM on October 6, 2009

Seconding @tastybrains: tanning booth. Weekly or twice a week, 10 minutes each time. No more SAD.
posted by seawallrunner at 8:11 AM on October 6, 2009

Best answer: Doses of Vit D that work? There's a lot of conflicting advice out there. Also methods of ingestion? Tablets?

When my doctor told me to take vitamin D (a blood test showed I was deficient) she specified that I should take vitamin D3, not plain vitamin D. It comes in gel capsules, like fish oil.
posted by The corpse in the library at 8:19 AM on October 6, 2009 [1 favorite]

The following specific actions work for me, and I have long-term documented SAD (and not just mild blues --- real "what's the point of anything" & "can't face dressing myself" type stuff):

1. Light box. My current box is a portable blue LED box from Apollo. I believe it's called a goLite Blu. I bought it specifically so I could take it with me to use as a sunrise clock when traveling.

How I use it: I find a sunrise/dawn alarm really pretty vital to getting myself out of bed (at all) in the winter. I set the alarm to wake me with a slow brightening starting 15 minutes before I need to start getting up. It slowly wakes me up, and when I am awake and it reaches its brightest point, I lie in bed for 5-10 minutes facing the light, but not looking into it. I've positioned it so that the light is just above my eye level, as if the light would be coming from above me if I were standing. Like the sun. This is pretty much guaranteed to shift me from groggy to pretty awake and ready to rise. The first few days of lightbox each season actually tend to get me a little agitated, but it settles down. You can read while using it, no problem. Deep into the winter, I'll often take it out w/me to the living room and set it next to me while I do my morning email check for a little extra light time.

2. Vitamin D: I take three 400-mg pills per day, with my regular vitamins. Adding this step to my little mental health regimen made an ASTONISHING difference.

3. Omega 3s: I take Omega 3 (or a combo Omega oil, like GNC's Multi-Oil) capsules daily, the standard dose recommended on the label. I'm not that particular about trying to reach a specific Omega target daily.

4. Exercise. It's the last thing I want to do, but it makes a big difference in my mental state. AM workouts work the best, even just 15-20 minutes, particularly if it's fairly rigorous.

5. Get outside whenever I can, even if it's just a brisk 20 minute walk during which I am cursing the weather the whole time. The winter where I ended up taking a lot of blustery lunchtime walks through the park was one of my most cheerful yet. I nearly froze my face off, but I would always return to the office practically bouncing with hearty windblown glee, regardless of how cloudy or snowy it was outside.

6. And yes, whenever possible, I definitely try to get away for a week's sunny vacation around late January. It gives you something to look forward to & makes those last 2-3 months before Spring starts to peek in bearable.

Good luck. These things combined have turned winter from a guaranteed descent into depression for me into a mild dip that I mostly notice when I hit the excitableness of Spring and shed it like a dirty coat.
posted by tigerbelly at 8:30 AM on October 6, 2009 [3 favorites]

Vigorous daily exercise. Like, drenched with sweat, beet red, gasping for breath. It makes a huge difference for me. I've done the whole "moderate activity every day" sort of thing, and it is just not the same. Even just 20 minutes of hard cardio does the trick.

Also, one winter I took a boot camp, and we met for outdoor workouts nightly for a month. For some reason, just being out in the dark did a little bit to change my attitude about the gloominess of winter's long, dark nights. Now I try to get out more in the winter, rather than hibernating.
posted by peep at 8:49 AM on October 6, 2009

Nthing exercise and good nutrition. Turning on as many lights as possible at home when it's dark out helps too. I tried the lightbox but was unable to turn it into a habit.

Also... I did Paxil one winter. Although I decided not to do it in subsequent winters (it was too hard to wean off of it; I had to get an rx for the liquid an go off it literally a drop at a time because I got such bad vertigo), it seemed to get me "over the hump" and none of my winters have been as bad since that Paxil winter.
posted by rabbitrabbit at 10:14 AM on October 6, 2009

I have an earlier version of the Litebook. It's small, you can drop it on a concrete floor without breaking it, it's portable, doesn't use much energy, the bulbs last a very long time, and 20 minutes in the morning while waking up works for me. Plus Vit D and the odd winter flowering indoor plant. I like colour, so add bits of my favourite happy colours to the house, like a big red mug for morning coffee or a colourful poster. Here in Canada where winter means months of gray skies and slush, every bit helps.
posted by x46 at 10:33 AM on October 6, 2009

Vitamin D works if you're deficient. You don't need extra, just to be brought back up to normal (this is backed up by research, I don't have time to find references now but can do so in a few days if you're interested). A really high proportion of people living in places with short days in the winter do get mildly deficient, so it's definitely possible that extra vitamin D will help. The best way to do it is get a blood test from your GP, should be pretty straightforward, then supplement at the appropriate level for any deficiences found. They can give you advice about the best type to take and make sure you're not wasting your money taking vitamins you don't need.
posted by shelleycat at 1:42 PM on October 6, 2009

I'll second everything tigerbelly said. Especially the Vit D + the amount. 100% RDA is not enough.
posted by Dmenet at 6:05 PM on October 6, 2009

All above are good suggestions, but there's one more thing that could really improve your life: get up early. Rise with the sun and open up your blinds. This will maximize the numbers of hours that you are getting sunlight. Go to bed early too.
posted by Sara Anne at 11:08 AM on October 7, 2009

One other thing I thought of this morning, and I don't know if it's really SAD-related, but when I started turning the heat up to a comfortable temperature rather than trying to save money/energy and therefore being constantly cold, I started being MUCH happier in the winter.
posted by rabbitrabbit at 9:20 PM on October 7, 2009

Best answer: Nthing light box. I have one of these, which has been very helpful.

Morning routine: roughly half an hour of gentle exercise (Egoscue Method postural alignment exercises, which I can't recommend highly enough — depression makes you hurt physically, and these will help). Then 15 minutes in front of the light box (10 minutes of zazen with my eyes half-open, then 5 minutes petting the cat or reading).

Other things that have been helpful (read: lifesaving) for me:

The Depression Book: Depression as an Opportunity for Spiritual Growth by Cheri Huber. When I first came across this, I thought the idea was ludicrous. "I don't want to grow spiritually from this, I just want it gone!" But her point is that with depression, as with every other experience in life, one can either have the experience and learn something from it, or one can have the experience and not learn something from it, but not having the experience is not an option.

An iron supplement — I take Floradix. (It would probably be prudent to get your iron level tested before supplementing. I didn't bother.) I find that when I'm not taking the iron, I experience a bone-deep fatigue that my back brain interprets as depression-induced lethargy and hopelessness. From there the slide into the Pit of Despair is a short one.

Fish oil — after proving and re-proving it to myself repeatedly by running out and not restocking for a while (I'm thick that way sometimes) I finally realized that the fish oil is essential. Earlier this summer my doctor and I reduced my antidepressant dose by half (down from the maximum dosage), and I've found that half the dose with iron and fish oil works better than the maximum dose without the iron or fish oil.

Vitamin D (gel capsules — I've been getting them at Trader Joe's). I recently got tested and found that my level was half of the lower limit of normal. Since then I've been taking 5,000 IU a day, and the difference is quite noticeable.

Walking, lots. Moving forward through the world with my head up, looking at the surroundings. As useful as the exercise is on so many levels healthwise, I do think it's the moving forward under my own power that's most important as far as dealing with depression goes.

Staying warm, as rabbitrabbit says. If heating your living space isn't practical, explore warm but non-restrictive clothing. It's important that it not keep you from moving.

This is a topic that's been on my mind as the days have been getting shorter. I've been dealing with major unipolar depression for most of my life, which generally gets worse in the winter. Last winter was the best, least difficult I've had that I can remember, ever, based largely on the things I've figured out about how to care for myself. I hope some of them might be helpful to you too. Best wishes. Hang in there.
posted by Lexica at 9:44 PM on October 8, 2009 [4 favorites]

I'm researching all this stuff, myself, but just wanted to point out a NYT article reporting problems with the vitamin D blood tests.
posted by The Dutchman at 11:17 AM on October 18, 2009