Do SAD Light Boxes Really Work?


We often feel sad when we see leaves fall during autumn or experience a longing feeling when the first snow comes. But to some, these times can make them feel extremely depressed. And it’s not just “winter blues” or a “seasonal funk.” People diagnosed with SAD or Seasonal Affective Disorder struggle with depressive mood, low energy, and inability to perform their social roles when the season changes. Along with medications and psychotherapy, one of the treatments for SAD is light therapy.

So, do SAD light boxes really work? Light therapy boxes are actually very effective. It won’t cure SAD or other depressive symptoms completely, but it may ease the symptoms accompanying it. People who exhibit extreme depressive symptoms are still recommended to see a professional for treatment. Therefore, you shouldn’t buy a SAD light box just because a friend told you to do so.

Open Sourced Workplace promotes ways in which companies can make their workplaces conducive for productivity and health awareness. With that, it supports various methods in giving the workers pro-mental health spaces. We have written a detailed article, “How Do You Promote Wellness In The Workplace? (Why Employee Wellness Matters)” which explains the importance of prioritizing employees’ well-being in the workplace.

If you experience extreme mood changes once the season shifts, then it’s time to take action. Brushing off the symptoms that you have will only lead to prolonged suffering and unproductivity. It can lead to missed opportunities, less work done, and prohibiting yourself from doing the things you enjoy. In this article, we explore the effectiveness of SAD light boxes, provide information about Seasonal Affective Disorder, and examine if light boxes are best for your condition.

What Is a SAD Light Box?

To understand the effectiveness of SAD light boxes, it is essential that we first discuss what a light box, also called a light therapy box, is and its correlation with SAD.

Light Therapy Box

Light therapy is a way to manage SAD and certain other conditions through exposure to artificial light. SAD is a type of depression that transpires at a specific time each year, usually in the fall or winter. (Check out the latest selection on AmazonOpens in a new tab.)

Seasonal changes in day length may trigger mood problems. For example, winter provides less natural light due to its shorter days and longer nights. It may lead to people experiencing symptoms of depression due to the changes in their environment. They start their day without natural light, or sunrise, and ending their work facing darkness, or sunset.

One of the causes of Seasonal Affective Disorder is lack of sunlightOpens in a new tab.. Light boxes, therefore, provide people with SAD with more light. Cells in the retina are connected to the hypothalamus, a part of the brain that helps control circadian rhythms. Your circadian rhythm, also known as the sleep/wake cycle, is a 24-hour internal clock that cycles between sleepiness and alertness at fixed intervals. Light therapy boxes banish seasonal symptoms and restore normal circadian rhythms by activating the hypothalamus at a particular time every day.

Light therapy involves being near a special light box for 30 minutes a day. This method is usually done as soon as you wake up. Light boxes give off 10,000 lux (a unit measure of light intensity). You can absorb 50,000 lux of light or more on a sunny day, and 10,000 lux is 100 times brighter than usual indoor lighting.

Many people use the 30 minutes by catching up on their work or reading their favorite books since you need to have your eyes open. However, it would be best if you don’t look at the light directly.

Light boxes come in a variety of designs, including desk lamps and wall-mounted installations. It contains filters to obstruct harmful UV rays and has multiple shapes, sizes, light types, and price points.

Why Use a Light Therapy Box?

Light therapy boxes can help people not only in the treatment of SAD but also for several other reasons. These include the following:

  To enhance the efficiency of antidepressant medication or mental health counseling (psychotherapy)

 To withdraw from antidepressant medications due to pregnancy or breastfeedingOpens in a new tab.

  To support people in taking a lower dose of antidepressant medication

  To experiment with a treatment that is considered safe or has a few side effects

Light therapy is also utilized as a treatment for several conditions, including:  

 jet lag,

  sleep complications,

  adapting to night-time work schedule,

 dementia, and

 other non-seasonal types of depression.

Light therapy boxes are also used for skin disorders. It uses a lamp that exudes ultraviolet (UV) light, unlike lamps used for SAD. This type of light is strained out in SAD light therapy boxes and other conditions because it can damage the eyes and skin. For example, skin conditions like psoriasis can be treated by this. It is different from the type of light therapy used for the conditions listed above.

Risks of Light Therapy Box

Light therapy isn’t appropriate for everyone. Some demand more light or brighter light, while some can’t endure bright light. For people with bipolar disorder, for example, bright lights can trigger hypomania or mania. People with a history of skin cancer, diabetes, or pre-existing eye disease should check with a doctor before trying light therapy. Even if the risk of eye damage is low in light therapy, mild and temporary side effects can occur during this treatment. These effects may involve

 eyestrain;
 headache;
 sunburn;
 nausea;
 irritation or agitation;
 mania, euphoria, hyperactivity, or anxiety associated with bipolar disorder; and
 dryness of the skin.

When side effects do occur, problems may go away on their own within a few days of starting light therapy. To manage the issues, you can reduce treatment time, increasing the distance from the light box, taking rests during long sessions, or adjusting the time when you use light therapy. You may also use eye drops, nasal drops, and sunscreen.

Consult your doctor for advice if side effects are a continuing problem, especially if you have the following conditions:

1. You have sensitive skin or a health condition like systemic lupus erythematosus. If so, you have a skin that is extremely sensitive to light.

2. You are taking medications such as antibiotics, anti-swelling, or the herbal supplement St. John’s Wort. These medications increase your sensitivity to sunlight.

3. If you have an eye condition, you are more vulnerable to light damage.

4. Consult your doctor first if you have a record of skin cancer.

Light therapy boxes are devised to separate harmful ultraviolet (UV) lightOpens in a new tab.. However, some may not filter it all out. Ultraviolet light can induce skin and eye damage. Look for a light therapy box that transmits as little UV light as possible. If you have issues about light therapy and your skin, it is better to talk to your dermatologist.

What Is Seasonal Affective Disorder (SAD)?

As stated above, SAD is caused by a mismatch of your body’s connection to its environment. It involves your body’s circadian rhythms and the timing of sunrise and sunset.

According to Alfred LewyOpens in a new tab., a doctor at Oregon Health & Science University, SAD is akin to having jet lag for five months. Believed to affect 1.4 to 9.7% of the US population, it’s now a well-established disorder that once was doubted by scientists.

How Seasonal Affective Disorder Happens?

SAD was first identified in the 1980s. It was initially thought to be a result of insufficient sunlight exposure during the short days of winter. Over the past years, researchers have supported a more complex theory called the phase-shift hypothesisOpens in a new tab..

Here’s how the phase-shift hypothesis goes. The sunlight received by your eyes every morning stifles your melatonin production, indicating to your body that it’s time to wake up. Melatonin is a hormone that monitors the sleep-wake cycle. This process is responsible for your body’s innate clock, located in an area of your brain called the suprachiasmatic nucleus.

As dawn gets delayed during winter, your circadian rhythm naturally changes later. It puts the circadian rhythm out of state with your body’s sleep-wake cycle. Bodies don’t get sunlight at the accurate time to calibrate people’s circadian rhythms every morning due to some waking up before dawn during winter.

Most researchers believe that this mismatch is the cause of depression, overeating, lethargy, and other symptoms many people experience. They have found out that people who are most prone to SAD are those whose melatonin production begins too early or too late before sleeping.

If you are struggling with the disorder, your symptoms can be treated by solving the root of the problem: light exposure. Recently, the use of light therapy boxes helps most sufferers by providing exposure to artificial light that reflects the spectrum of light emitted by the sun. With that, we can conclude that three following factors cause SAD:

  •  Biological clock or circadian rhythm. The low exposure of sunlight during fall and winter may cause the start of winter SAD. This reduced level of sunlight may disturb your body’s internal clock, which leads to emotions of depression.
  •   Serotonin levels. A low amount of sunlight can cause a reduction in serotonin levels that triggers the onset of depression. A decline in serotonin, a brain chemical or neurotransmitter, can result in mood swings that play a role in SAD.
  •   Melatonin levels. Season changes can disturb the equilibrium of the body’s level of melatonin. Therefore, it plays a role in sleep disturbances and mood.

Symptoms of SAD

SAD symptoms often appear throughout the late fall or early winter. Then it goes away during the sunnier days of spring and summer. Some people also experience SAD in reverse. In both cases, symptoms may start moderate and become more severe as the season advances. Signs and symptoms of SADOpens in a new tab. may include the following:

• Feeling depressed every day
• Low self-esteem
• Losing interest and pleasure in activities you used to enjoy
• Inhibiting low energy and reduced sex drive
• Unexplained aches and pains
• Sleep problems
• Changes in your appetite or weight (this may include overeating or eating less)
• Feeling stressed, angry, irritable, or disturbed
• Difficulty in concentrating
• Feeling hopeless, worthless, and guilty
• Recurrent dark thoughts such as death or suicide

Symptoms of fall and winter SAD include the following:

• Oversleeping
• Enormous appetite, especially a craving for foods high in carbohydrates
• Weight gain
• Lethargy
• Wanting to be alone often
• Struggling to concentrate

Symptoms of spring and summer SAD include the following:

• Trouble sleeping (insomnia)
• Less appetite which leads to weight loss
• Weight loss
• Agitation or anxiety
• Feeling of uneasiness
• Presenting violent behaviors

Spring and summer can bring on indications of mania to some people diagnosed with bipolar disorder. During the fall and winter periods, they may feel a state of depression.

When to Visit a Doctor

People with SAD feel down for days and are unmotivated to do activities they usually love. It’s different from some people who feel down only on some days. SAD symptoms are more destructive and can influence the lives of people who suffer from it.

• You can consult with your doctor when:
• your sleep patterns change,
• your eating habits become imbalanced,
• you utilize alcohol for comfort or relaxation
• you feel hopelessness often, or
• you start to think about death or suicide.

We have written a detailed article, “Workplace Depression Effect on Productivity (Symptoms, Effects and How to Help),” which explains the impact of depression on the level of productivity in the workplace.

Risk Factors of SAD

Women are twice as likely as men to seek treatment for SAD. And it occurs more commonly in younger adults than in older adults. Factors that may increase your risk of Seasonal Affective Disorder include the following:

      • People living far from the equator appear to be susceptible to SAD due to the decreased sunlight they receive during the winter and longer days during the months of summer.

      • If you have blood relatives who are diagnosed with SAD or other forms of depression, you can be more susceptible to SAD.

   • If you have major depression or bipolar disorder, the symptoms of your condition can get worse.

Complications Of SAD

You should treat SAD as you do other types of depression. It can get worse and lead to problems if not taken seriously. Complications of SAD may include the following:

• Social alienation
• Substance abuse, such as alcohol and drugs
• Problems in school or work
• Anxiety, eating disorders, and other mental health complications
• Behavior and thoughts on suicide and death

If SAD is diagnosed and treated before the symptoms get worse, it can help prevent further complications. We have written a detailed article, “15 Emotional Signs Of Stress In The Workplace,” which explains the emotional indicators that workers are struggling with stress and mental health.

Effectiveness of SAD Light Boxes

Approximately half to three-quarters of people with Seasonal Affective Disorder reportOpens in a new tab. that their symptoms decrease when using light box therapy. At the same time, about half of people who are also using antidepressants report a decline in symptoms. Light box therapy lightens symptoms of SAD within a week but returns if a person stops using the box regularly.

Along with light box therapy, doctors might also prescribe medication or use cognitive behavioral therapy designed for SAD. Cognitive behavioral therapy aims to transform a person’s thought patterns to cope better with the changes of seasons.

Researchers are finding various ways to improve the effectiveness of light therapy. One approach is making light boxes that simulate dawn and sunrise. It will slowly increase the intensity from darkness to 300 lux. Another method is the usage of lower-intensity blue light. It has a more powerful effect on the retina than white light.

Three Essential Factors for Effectiveness

There are many factors to the effectiveness of SAD light boxes. It’s most efficient when you have the proper combination of light intensity, duration, and schedule.

1. Intensity. A 10,000-lux light box at a range of about 16 to 24 inches (41 to 61 centimeters) from your face is the usual recommendation for SAD. Lux is the unit of measure of the intensity of the light box and the amount of light you receive.

2. Duration. Light therapy usually involves daily sessions of about 20 to 30 minutes with a 10,000-lux light box. However, a lower-intensity light box may require longer sessions, such as with 2,500-lux light boxOpens in a new tab.. Others require 60 minutes, which is the highest exposure someone should receive. Your doctor may give you particular instructions, such as suggestions for you to start with shorter sessions that will slowly increase through time.

3. Schedule. When you use the light box matters. Light therapy is most efficient when used early in the morning for most people. Consult with your doctor to decide the light therapy schedule that works best for you.

Preparing For Light Therapy Box

It’s best to ask your doctor or other health professionals about whether you need to take any special precautions during light box therapy. Even though you don’t need a prescription to purchase a light therapy box, it’s better to discuss it with a professional first to get the most benefit and minimize possible side effects. Research the variety of features and options for light boxes to guarantee that you’re buying quality and safe products.

Beginning Light Therapy

Most people begin light box treatment in the early fall when it starts to become cloudy in the United States. It then ends in spring since the sunlight is sufficient enough to sustain a good mood and higher levels of energy.

Along with your doctor’s guidance, adjust your light based on the timing and continuance of your symptoms. Consult with a professional if you want to try light therapy for nonseasonal depression or other conditions.

During Light Therapy

  •  You can rest or work near a light box during the therapy. Your eyes must be open, but the light must not enter your eyes directly. The bright light can damage your eyes.
  •  Exposing only your skin to the light won’t give you the same effect. You can place your light box on a table or desk in your home or office. That way, you can do things that you enjoy.
  • Light therapy requires time and consistency. Follow your therapy schedule, and make sure not to overdo it.

Results

Light therapy can ease symptoms, increase your energy levels, and help you feel better about yourself and your life. Your condition can start to improve within just a few days. In some cases, it can take two or more weeks.

Getting the Full Benefits of Light Therapy Box

It’s normal to seek ways on how to get the most out of your purchase. You can take steps to make sure you’re getting the right light therapy box. Follow the instructions below:

  Get a proper light box. Be sure that your light box is safe, has adequate brightness, and is easy to use. Do some research and consult with your doctor before buying a light therapy box.

  Use it regularly. Stick to a daily schedule to help ensure that you maintain improvements over time. If you can’t do it every day, take a day or two off, but monitor your condition very carefully.

  Jot down your schedule. Your symptoms can return if you stop too soon and interrupt light therapy. Keep track of when you start in the fall and when you stop in the spring so that you know when to begin and end your light therapy next year.

 Involve other treatments. You may need additional treatment if your symptoms don’t improve with light therapy. Discuss other treatment options with your doctor, such as antidepressants or psychotherapy.

Choosing a Light Therapy Box

Every light therapy box for SAD treatment is made to ease the symptoms that it brings to your mental health and body. However, one may work better for you than another. FeaturesOpens in a new tab. such as light intensity, safety, cost, and style are important factors to consider.

1. Consult with your doctor first before purchasing a light box.

You must take into consideration your health condition when buying a light box. If you’re experiencing SAD and bipolar disorder concurrently, the usage of the light box must be critically reviewed by a professional.

Light exposure for an extended period or taking higher intensity may trigger manic symptoms for people who have bipolar disorder. Also, if you have eye conditions such as glaucoma, or cataracts, you have to go to your eye doctor before buying and using a light box to avoid further harm.

2. Understand and research how a light box works.

A light box simulates light outdoors, and the light produced by this device generates a chemical change in the brain that elevates your mood and eases other symptoms of SAD. In general, the light box should

• provide an exposure to 10,000 lux of light (if this is the recommended intensity for your condition, as there are light boxes that emit less heat) and

• transmit as limited ultraviolet light as possible (for SAD treatment).

Standard recommendations incorporate in using the light box are as follows:

1. Use the light box in the initial hour of waking up.

2. Use it for about 20 to 30 minutes.

3. Use it at a gap of about 16 to 24 inches (41 to 61 centimeters) from your face.

4. Use it with your eyes open, but do not look directly at the light.

5. Position your light box 45 degrees to the left or right from your midline or eyes.

Light boxes are not regulated by the Food and Drug Administration (FDA) for SAD treatment, so you must understand and research your options. You should also talk with a professional before using it.

You can also buy a light box without a prescription. However, don’t go around buying a light box on your own. Your doctor might recommend a specific light box for your condition.

Things to Consider When Buying a Light Box 

Here are some things to think about when buying a light boxOpens in a new tab. for Seasonal Affective Disorder:

Make sure the light box is made explicitly for SAD treatment. Buy a light box that will help your SAD symptoms or your depression. As stated above, certain lights are created for skin disorders. There are differences in the amount of UV light being transmitted; for example, light boxes for SAD filter out most or all UV light. Those for skin disorders emit UV light that can damage your eyes when misused.

Consider the amount of brightness you will be getting. Light boxes produce different light intensities. Dimmer boxes require more time to use each day compared to brighter boxes that need less time to get the same effect. The recommended intensity of light is 10,000 lux.

Search for the style of a light box that is convenient for you. There are many styles and shapes of light boxes available. Some come in small and rectangular, while some look like elevated lamps. Buy one that is convenient for you and will not lessen the effectiveness of the light box to your condition.

In connection with that, buy a light box that you can put in your desired location. First, think about where you want to place your light box and the activities you might do while using it. Check the manufacturer’s instructions for information about the proper distance you need to get the right amount of light. Also, position your lamp in a way that it gives you a downward light so that it won’t go directly into your eyes. Make sure that it’s not located directly in front of you.

One way to make sure that the product you’re buying is suited for your purpose is to see if reputable hospitals, clinics, or research facilities also use it.

It’s better to consult healthcare professionals in purchasing light boxes so that you will get one that is well-suited for your needs.

Related Questions

How much light does a person get every day? The answer to this can differ based on your location, the current season you’re experiencing, and how many times you go outdoors. You also get light indoors; however, the amount of lighting entering your eyeball from interior lighting is far less than the amount of light you get outside. Therefore, it’s essential to go and get the natural light your body craves, such as the sunlight. Unless you are outside most of the day, you are relying on photons to get your light energy. In summer, there’s much sun that you can get enough even by staying indoors. The table below shows you how much less light you receive indoors to the light you can get outdoors.

Bright moonlight

1 lux

Candlelight at 20 cm

10-15 lux

Street light

10-20 lux

Normal living room lighting

100 lux

Office fluorescent light

300-500 lux

Sunlight, 1 hour before sunset

1000 lux

Daylight, cloudy sky

5000 lux

Daylight, clear sky

10,000-20,000 lux

Bright, sunlight

>20,000-100,000 lux

Source: repairfaq.cis.upenn.eduOpens in a new tab.

Is it important to position the light box above my eyes? Yes, it would be best if you position your light box above your eyes to get the most impact. An interesting experiment by the team that first developed the blue light box shows the importance of the positioning of your light box. They put a helmet on patients undergoing light therapy. This process allowed the light to hit only the top of their eyeball or the bottom part. It turns out the light must hit the bottom of the retina to get the most benefit rather than hitting only the top of the eyeballs, as per the patients’ responses. You can think about it like this: the light above in the sky produces the light that you need and not from the ground.

What are sunrise alarm clocks? Sunrise alarm clocks simulate the sunrise. Essentially, they are similar to light boxes and have the same function as well. They do not radiate ultraviolet rays. The sunrise alarm clock can take care of your light therapy before leaving your bed. Your eyes absorb the light through your eyelids, helping you to wake up slowly. Setting your clock resembling a sunrise in June or July is recommended for maximum benefit.

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