Now is the time of year, when many people experience Seasonal Affective Disorder (SAD), a type of depression that comes on during the darker months of the year. Doctors often treat SAD with “light box” therapy. During light therapy sessions, you sit or work near a light box and the light enters your eyes indirectly.
Some researchers are finally “thinking outside the box” and have found light therapy also helps treat other types of depression not brought on by seasonal light deprivation.
In a recent study supported by the Canadian Institutes for Health Research, researchers randomly assigned 122 adults with major depression not related to SAD to one of four treatment groups.
The first group received 30 minutes of light treatment per day and a placebo pill. The second group used a “placebo” device that didn’t provide actual light therapy and took Prozac. The third group took used the placebo device and a placebo pill. And the fourth group received both actual light therapy and Prozac.
After eight weeks, researchers used a widely recognized depression scale to evaluate the participants’ mental and emotional state.
Placebo outperforms antidepressant
First and foremost, Prozac showed no benefit over placebo.
No surprise there. Other studies consistently show the same thing (particularly when patients also receive a lot of attention from a health professional).
Among those who used a placebo device and took a placebo pill, about 30 percent of participants still showed improvement. Again, this finding demonstrates the benefits of a health professional paying any kind of attention to these patients.
By contrast, among those patients who used the placebo device and took Prozac, only 20 percent showed improvement.
So — the drug + placebo device performed worse than the placebo pill + placebo device. In other words, it appears the drug actually counter-acted or negated any potential beneficial placebo effect!
And what about the group who got the real light therapy and the placebo pill? They fared even better yet — about 40 percent of them went into remission in just eight weeks.
Of course, the researchers still recommended giving Prozac together with light therapy because that combination saw a small bump in benefits. But as you know, antidepressants carry many harmful and dangerous side effects. In fact, a recent investigation shows antidepressants cause 15 times as many suicides as the FDA reports.
Back to the study at hand, I came away with two major impressions.
First, placebo continues to offer greater benefits than drugs for this major mental health condition. Secondly, light therapy performs even better than placebo alone.
Overall, patients tolerated the light treatment well. Researchers don’t fully understand why it works. For seasonal affective disorder, it may help correct disturbances in the body’s internal biological clock, or circadian rhythm. For non-SAD depression, it may work through the same “mechanism of action.” But we just don’t know at this point.
Isn’t it enough — for now — to know it DOES work?
You can buy light boxes at drugstores and other retail outlets for less than $100. And some insurance even plans cover them. Treatment involves sitting in front of the light box for 30 minutes as soon as possible after waking. You can do it while eating breakfast or just working at your desk or on the computer.
Remember, this is also the time of year when vitamin D levels decline, if you don’t take regular vitamin D supplements. Research I reported from the U.K. a couple years ago demonstrated those with low mood during winter had lower vitamin D levels, which explains a lot.
So make sure to take 10,000 IU daily of vitamin D. You can find it in liquid form, which may be easier to swallow with juice or water.
- “Efficacy of Bright Light Treatment, Fluoxetine, and the Combination in Patients With Nonseasonal Major Depressive Disorder,” JAMA Psychiatry 2016;73(1):56-63