Would a SAD light box help my medication resistant depression?

February 17, 2015 2:42 PM

Would a SAD light box help my medication resistant depression? (details within)

I've been fighting depression for a very long time. I've tried seven or eight anti-depressants and had half a dozen therapists. I believe my depression is classified as medication resistant and atypical because I sleep and eat rather than having a loss of appetite and sleeplessness.

I live in sunny part of the country (California) without snow, although I don't always get outside to experience the sun.

Would a SAD light box help me? Or would my time/money/energy be better spent exploring other treatment options?

As an indication of how I'll try anything: it's gotten so bad I'm also considering ECT (electro convulsive therapy) too.

posted by bluecore to Health & Fitness (15 answers total)

Rather than spending the money on a box, it might be more effective to just open the blinds during the day, or get outside--don't have to do anything! Eat your lunch outside, for example.

ECT isn't what it used to be. When I was hospitalized a couple of years ago one of the other people on the ward was receiving ECT for the same reason, and the difference between the first day I met them and three weeks later was night and day. Consult with your healthcare team.
posted by feckless fecal fear mongering at 2:52 PM on February 17, 2015

I live in California too (though in the Bay Area) and I notice that I have significantly less energy on cloudy/foggy days here, so I do think light can be a factor even in a climate like this (I did have more noticeable seasonal affective disorder in another climate, and haven't used a light box here, but I believe that it can help). But, have you tried a regular serious exercise routine (35+ minutes of cardio per time)? I think that can be even more effective for a lot of people.
posted by three_red_balloons at 2:52 PM on February 17, 2015

Also, this new wearable device that uses neurosignaling to shift moods (on demand, at home) seems like it might be worth checking out if you get your doctor's blessing.
posted by three_red_balloons at 2:56 PM on February 17, 2015

I have treatment resistant depression too. Have any of these doctors tried putting you on an antipsychotic medication? Getting put on lamictal made super huge improvements for me.

I did just order a light but do not have it yet.
posted by fluffy battle kitten at 2:57 PM on February 17, 2015

I believe my depression is classified as medication resistant and atypical because I sleep and eat rather than having a loss of appetite and sleeplessness.

Have you actually told a doctor that? I would venture to say the majority of depressed people sleep and eat a lot, or at least a large minority do.

I don't think the lamp will help much, unfortunately, but try it. I'd ask around and borrow or buy used one someone's not using - there are plenty collecting dust.
posted by michaelh at 2:58 PM on February 17, 2015

I have a very dear friend who had severe depression that after trying everything, finally became manageable with ECT. The treatments were pretty hard on her, but she's now off medication and she just gave birth, so to her, they enabled her to become a parent.

Pretty good stuff I'd say.
posted by Ruthless Bunny at 3:01 PM on February 17, 2015

I know four people who have had some lifting of depression symptoms with a bright light but we live in a dark region and the depressions here were more seasonal. There are studies successfully using bright light therapies for non seasonal depression so it seems worth a shot! Be sure to buy a 10k lux light, otherwise it is not really what's being studied in most studies. http://www.ncbi.nlm.nih.gov/m/pubmed/24397276/?i=18&from=bright%20light%20therapy%20depression
posted by feets at 3:18 PM on February 17, 2015

Ps if you search "bright light therapy" plus "depression" on pubmed there are 43 pages of results; many quite current and encouraging, and that info is probably more evidence-based than most of the responses you're going to get here. Chronobiology and light therapy are still becoming known and still just at the infancy of being studied, perhaps because they are not as patentable as pharmaceuticals and thus there is less money available to research them.
posted by feets at 3:23 PM on February 17, 2015

I had a depression that felt more like a physical illness, but with it were anxiety, intrusive thoughts,lack of energy, and lack of interest in things I liked. The symptoms included night sweats and a perpetual post-nasal drip as well as the emotional stuff. There was no reason in my life at this time to be depressed, unlike previous episodes of depression. I had all the usual medical tests at the time, thyroid, lyme, full blood screening and all was normal.

I went back on anti-depressants, several were tried, but they really did not do much. Then I read here that someone suggested probiotics so I tried it, cheap and harmless and I was getting fed up with feeling lousy. After about a month of taking the probiotic daily, the depression was gone and I felt normal again. I am now weaning off of the last anti-depressant and continue to feel good.

I am not the kind of person who is into nutritional supplements or new-age cures, so I am as surprised as anyone that this worked. For depressed people it is worth a try, can't hurt, might help.
posted by mermayd at 3:23 PM on February 17, 2015

I tried a light box years ago when I moved to Seattle. Light therapy takes more discipline than you'd think. You have to sit within a certain (close) distance away and you have to look pretty much directly at the light all the time -- you can't DO anything else while you're sitting there, except for listening to podcasts or music. Also, it's apparently more beneficial first thing in the morning than it is other times of day, so I had to set my alarm to get up half an hour earlier than usual to do my light therapy before leaving for work. Eventually I gave up because I didn't see that much benefit and I preferred getting a few more z's. I will say, though, that exercise did help me WAY MUCH MORE than light therapy ever did. Half an hour a day of cardio seemed to give me a huge benefit, where half an hour of light therapy didn't.
posted by rabbitrabbit at 3:31 PM on February 17, 2015

Lightbox helps me a lot, but I'm in the dark northern Midwest. Before investing in a box, try getting outside for 30 minutes as early as you can. My experience is the lightbox brings very quick results: if the sun isn't helping in two weeks, I'd move along to another option.

Regular exercise makes a huge difference. I was able to manage bipolar disorder without meds by exercising 90 minutes a day. There's detailed info and interactive tests at cet.org, the Center for Environmental Therapeutics. Although the name doesn't make it clear, these folks are scientists, very low woo. The tests help you schedule the onset and duration of light for optimal effectiveness.

Best wishes!
posted by Jesse the K at 7:16 PM on February 17, 2015 [1 favorite]

I tried the lightbox thing but only managed a week. As rabbitrabbit said, it does take more discipline to use it everyday. I've had a lot of luck with high IU vitamin D (5000 IU). I've read that your body expels what it doesn't need so there's no reason not to try to saturate your body. That combined with some mindfulness exercises did it for me.

If you're near Oakland, I'm selling my Verilux Happylight Deluxe. It's been used for a total of 4 hours so it's got lots of life left. $50, if you're interested.

Good luck and I hope you find what you need.
posted by just.good.enough at 7:52 PM on February 17, 2015

It seems that your diagnosis is severe, medication-resistant depression, not SAD. It's unclear from your post what your doctors are actually recommending. If the ECT suggestion is indeed theirs, I suggest you strongly consider it. Its efficacy rate is something like 30% higher than any medication, according to research I did last year in Medline when considering it for my mother (recommended by her neuropsych and PA; we did not do it due to the sedation factor which would likely worsen her dementia). The improvement also tends to be long lasting.

I wish you well.
posted by Riverine at 8:37 AM on February 18, 2015 [1 favorite]

It's impossible to know until you try, but considering that a SAD lightbox costs less than a therapy session, it may be worth a try. It doesn't take much time to use one. You can leave it on during your morning routine and it just becomes part of the routine after a while.
posted by wye naught at 2:46 PM on February 19, 2015

You may want to learn more about transcranial magnetic stimulation.
My sister's life has changed dramatically for the better after this treatment.
posted by Kitty Cornered at 7:17 PM on February 20, 2015 [1 favorite]