AT THE INSTITUTE OF NEUROSCIENCES TREATMENT FOR DEPRESSION WITH LIGHT THERAPY
For man, almost all physiological functions and behaviors have a rhythmic tendency. The length of the cycles is variable for different functions: from very short (ultradian rhythms), to daily (circadian rhythms), to rhythms with longer cycles (weekly, monthly, seasonal, or even longer.)
Mood disorders, and in particular Seasonal Affective Disorder, appear to be tied to alterations in circadian rhtyms. [Monteleone et al, Progress in Neuro-Psychopharmavology & Biological Psychiatry, August 2010]
A meta-analysis of 20 controlled studies shows that treatment with bright light is effective in mood disorders, seasonal in nature or not, with effects equivalent to those of antidepressants. [Golden et al, The American Journal of Psychiatry, April 2005]
Light, through the optic nerve, balances levels of melatonin, serotonin, and regulates circadian rhythms, sleep-wake patterns, improving mood, appetite, and the quality of sleep.
The eyes are the most external part of the brain: it is important that they be exposed to a particular light frequency.
Our organism, and in particular our nervous and endocrine systems, receives through light precious stimuli which regulate their proper functioning. Light stimuli reach determined regions such as the hypothalamus, which regulates the production of serotonin and cortisol, as well as the epiphysis which regulates the production of melatonin. In this way, the neuro-endocrine system maintains that cyclical nature which makes us feel well.
If this cyclicality becomes lost, disorders occur that can cause suffering and a decline in the quality of life. These disorders, if opportunely evaluated and recognized, can be treated and even prevented, simply through light therapy.
GUIDELINES FOR THE USE OF LIGHT THERAPY
The following guidelines for light therapy are obtained from scientific studies, in published scientific literature, which have shown a therapeutic efficacy.
- Seasonal Affective Disorder (SAD)
- Non-seasonal Depression
- Augmentation or acceleration in pharmaceutical treatment of Depression
- Depression in pregnancy
- Bulimia e Night binge-eating syndrome
- Sleep and circadian rhythm disorders
- Child ADHD
- Adult ADHD associated with SAD
- Dementia e alteration in sleep-wake patterns
- Obsessive-Compulsive Disorder
- Non migraine headaches e Cluster headaches
- Premenstrual Syndrome (PMS)
- Chronic Fatigue Syndrome
- Alteration of the sleep-wake pattern from jobs with night-day shifts
- Jet lag
MODE OF ADMINISTRATION
It is necessary to sit at a distance of about 50-70cm (20-28in) from the light source, with eyes open. Even if there is no risk in looking at the light source directly, to do so is not indispensable for the efficiency of the treatment. During exposure it is possible to perform normal work activities at the office, to read, or to watch TV. The treatment is daily and its duration is variable based on the type of disorder and on individual response, from 2 days to 2 months, even if on average, 2-4 weeks are sufficient. The daily schedules indicated for the treatment, the duration of each single exposure session, the type of lamp and the intensity of the light are determined from the individual clinical evaluation, which beyond specific diagnostic tests can avail an accurate evaluation of the quality sleep and sleep-wake patterns through the use of an actigraphy.
CONTRAINDICATIONS AND SIDE-EFFECTS
Light therapy presents, even if in a reduced way in respect to pharmaceutical drug treatment some contraindications and side effects, even if minor in general. It is thus appropriate to evaluate together at the clinic the possible presence of contraindications and the appearance of undesired side effects after the first exposure sessions.
The therapeutic results are amply documented on a scientific level by many studies present in the world literature and can be surprising. The effects have not been measured only in terms of subjective improvement in the tone of the mood, but also through the measurement of biological parameters such as levels of cortisol, melatonin, and of certain functions of the serotonergic system.
Like the majority of most natural treatments, light therapy also requires commitment and motivation on part of the subject. The patient is thus advised to respect the protocol of the treatment and the hours of exposure and to modify some life behaviors that could influence the results, such as, for example, to improve the hygiene of sleep, to respect the prescribed meal times, as well as the amount of time designated for physical activity and rest. Light therapy is a treatment which can also accompany a traditional pharmaceutical course of treatment or even alternative therapeutic strategies such as vitamin supplements, melatonin, magnesium, or ademetionina. For every single case, the best course of treatment will be evaluated for the needs of the patient and the pertinent clinical conditions.