Living well in Myanmar SAD? Escape the monsoon doldrums with light therapy

Living well in Myanmar SAD? Escape the monsoon doldrums with light therapy

By Christoph Gelsdorf MD'   |   Sunday, 01 September 2013

In a meeting with my editor at The Myanmar Times last week, we discussed the feeling of – to use a non-medical term –"blah" that can sometimes arise as the rainy season drags onward.

That got me thinking about Seasonal Affective Disorder (SAD), which is well known by doctors who practise in Western countries where winter season brings dreary weather and shorter periods of daylight. Although we don't have research for seasonal depression in monsoon countries specifically, a correlation between the disease in northern latitudes and in the tropics seems likely.

SAD is defined as recurring feelings of being "down" that come on during a particular season and resolve when the season ends. While the biological cause of SAD has not been proven, the prevailing theory is that decreased daylight can cause alterations in two hormones called melatonin and serotonin which regulate energy and mood. Changes in regular light patterns can even negatively affect your body's internal 24-hour clock, called the circadian rhythm.

For Western wintertime sufferers, SAD brings on a number of depressive symptoms: sleeping more than usual; heavy, tired feelings in the arms and legs; increased appetite, especially for sweet or starchy food; weight gain; feelings of crankiness or irritability; and interpersonal difficulties such as increased sensitivity to rejection.

Interestingly, some of these symptoms differ from or even oppose those typically seen during non-SAD forms of depression, such as weight loss, decreased sleep and poor appetite. These differences lend support for the medical belief that SAD should be considered diagnostically unique.

Another distinctive feature – and good news for SAD sufferers – is the therapeutic value of light therapy. Up to 80 per cent of patients diagnosed with SAD by a doctor respond well to timed exposure to artificial light. Some psychiatrists and family physicians use light therapy to prevent SAD from recurring in people who have had it in previous seasons.

If you feel these long overcast months are causing you to struggle, a home version of phototherapy may help. Exposure to bright light for 15-30 minutes a day, particularly early in the morning, might re-establish your circadian rhythm and fine-tune your melatonin and serotonin levels.

For therapy purposes, bright light means a source measuring 10,000 lux. While watts measure how much power a bulb uses, lux is a measure of how much light a source produces. There is no easy equivalency between the two measurements, but basically you're looking for a light source equivalent to what your eyes would sense in full daylight. Fluorescent light is best.

Don't stare directly at the light – you don't want to hurt your eyes – but simply sit under the light while reading, working, listening to music or doing anything else you like. As long as the light is in your field of view, you may find the treatment makes you feel better after just four or five days, and the benefit usually lasts as long as you continue the treatment.

Possible negative side effects of light therapy are headache, fatigue, irritability and excessive sensitivity to light. If you experience any of the symptoms above, even to a moderate degree, it is best to stop treatment at once and meet with a doctor prior to attempting any further treatment on your own. Remember as well that several other factors can impact mental illness and treatment approaches – which can also include medication and behavioral therapy – so be sure any treatment is tailored to your needs.

If you are suspicious of the benefits of light therapy, however, it may interest you to know that I sometimes worked 24-hour shifts delivering babies while training to become a doctor, during which my colleagues and I never saw natural light. In our meeting room we had a light box whichwe switched on in the morning with the intent of re-establishing our circadian rhythm. I can't say for sure whether light therapy really made us happier to be in the hospital, but it may reassure you to know that even doctors are willing to try it.

Christoph Gelsdorf is an American Board of Family Medicine physician who sees patients in Yangon and California. He is an honorary member of the Myanmar Medical Association. Reader thoughts and questions are welcomed.

http://www.information.myanmaronlinecentre.com/living-well-in-myanmar-sad-escape-the-monsoon-doldrums-with-light-therapy/