Therapies for treating for seasonal affective disorder
From the Harvard Health Letter
About half a million Americans – women more often than men – suffer from seasonal affective disorder, while many others experience milder symptoms.
Symptoms may include loss of pleasure and energy, feelings of worthlessness, inability to concentrate, and an uncontrollable urge to eat sugar and high-carbohydrate foods. The most common form of seasonal affective disorder arrives in the fall, tends to worsen in January and February, and then subsides in the spring.
Although bright white light remains a mainstay of treatment, in the past few years researchers have investigated ways to improve and refine light therapy.
• Traditional light therapy – Fluorescent light boxes are most often used to deliver traditional bright light therapy. Patients usually expose themselves to 30 minutes of light. Bright white light acts on cells in the retina that connect to the hypothalamus, a part of the brain that helps control circadian rhythms, which are somehow disrupted in seasonal affective disorder.
Two reviews of multiple studies on light therapy, which included only randomized controlled trials, concluded that bright light therapy was as effective at treating seasonal affective disorder as antidepressant therapy, and in some cases more effective.
But investigators have sought to improve on traditional light therapy for three reasons. First, it doesn’t work for everyone. Different studies have reported that 50 percent to 80 percent of patients achieve complete relief from depressive symptoms after bright light therapy – and remission may depend upon carefully individualized timing of light.|
Second, dosing remains a major question. Dose depends on the strength of the light source, the patient’s distance from the light box, light wavelength, and duration of exposure. The recommendation for 30 minutes of daily exposure is based on average response to white light; some patients may not need that much exposure to benefit, or may experience adverse side effects from that amount. Others – such as parents of toddlers – may not be able to sit in front of a device for 30 minutes each morning.
Finally, side effects of bright light therapy, while mild for many patients, may be more of a concern for others. For example, bright light therapy may trigger hypomania or mania in patients with bipolar disorder, which is why mood-stabilizing medications are often recommended at the same time. And while the risk of retinal damage from light therapy is small over all, some medications and medical conditions increase the risk for some patients.
• Retina risk – The following medications or conditions raise the risk of retinal damage from bright light therapy:
First-generation antipsychotics
Lithium
Melatonin
St. John’s wort
Diabetes
Retinopathies
Enhancing light therapy
Investigations are under way to see if changing the timing of light therapy, or using particular wavelengths of light, might improve response or reduce risk of side effects like mania or retinal damage.
• Better timing – Researchers from Columbia University reported that remission from seasonal affective disorder was twice as likely if light therapy was precisely calibrated to melatonin rhythms. They found that 80 percent of patients achieved remission if light therapy began 7.5 to 9.5 hours after an evening melatonin surge, compared with 38 percent of patients whose light therapy began 9.5 to 11 hours afterward. Individual melatonin shifts may vary by five to six hours.
• Dawn simulation – In this variation of light therapy, a preset light device turns on before a patient awakens. Light intensity increases gradually over a period of 90 minutes. Although the studies so far have been small, they have also been promising.
• Blue light – Traditional devices use white light, a mixture of all the colors (such as blue, green, and red) in the visible light spectrum. The use of light-emitting diode (LED) technology has made it possible to create smaller and more portable devices and test specific wavelengths of light.
Studies have found that ganglion cells in the retina are particularly sensitive to blue light, suggesting that this wavelength may powerfully affect circadian rhythms. Researchers are investigating whether blue light might provide the same benefit as white light but with less exposure time – which might reduce risk of side effects in vulnerable patients.
• Current guidance – Experts recommend that patients with seasonal affective disorder first try traditional bright white light therapy after awakening. If it does not help or creates bothersome side effects, it may be worth trying antidepressants or one of the alternatives under investigation.
The FDA does not test, approve, or regulate light box devices, so patients considering buying any device should ask about the wavelengths it emits and check to see if it has been used in any reputable research facilities.
For more information on seasonal affective disorder and other forms of depression, order our Special Health Report, Understanding Depression at www.health.harvard.edu/UD.
Exercise is the secret
to better health
From the Harvard Health Letter
Whether you’re 9 or 90, abundant evidence shows exercise can enhance your health and well-being. But for many people, sedentary pastimes, such as watching TV, surfing the Internet, or playing computer and video games, have replaced more active pursuits.
What exercise can do for you – Millions of Americans simply aren’t moving enough to meet the minimum threshold for good health — that is, burning at least 700 to 1,000 calories a week through physical pursuits. The benefits of exercise may sound too good to be true, but decades of solid science confirm that exercise improves health and can extend your life. Adding as little as half an hour of moderately intense physical activity to your day can help you avoid a host of serious ailments, including heart disease, diabetes, depression, and several types of cancer, particularly breast and colon cancers. Regular exercise can also help you sleep better, reduce stress, control your weight, brighten your mood, sharpen your mental functioning, and improve your sex life.
A well-rounded exercise program has four components: aerobic activity, strength training, flexibility training, and balance exercises. Each benefits your body in a different way.
Fighting disease with aerobic activity – Aerobic exercise is the centerpiece of any fitness program. Nearly all of the research regarding the disease-fighting benefits of exercise revolves around cardiovascular activity, which includes walking, jogging, swimming, and cycling. Experts recommend working out at moderate intensity when you perform aerobic exercise—brisk walking that quickens your breathing is one example. This level of activity is safe for almost everyone and provides the desired health benefits. Additional health benefits may flow from increased intensity.
Protecting bone with strength training – Strength or resistance training, such as elastic-band workouts and the use of weight machines or free weights, are important for building muscle and protecting bone.
Bones lose calcium and weaken with age, but strength training can help slow or sometimes even reverse this trend. Not only can strength training make you look and feel better, but it can also result in better performance of everyday activities, such as climbing stairs and carrying bundles. Stronger muscles also mean better mobility and balance, and thus a lower risk of falling and injuring yourself. In addition, more lean body mass aids in weight control because each pound of muscle burns more calories than its equivalent in fat.
Ease back pain with flexibility exercises – Stretching or flexibility training is the third prong of a balanced exercise program. Muscles tend to shorten and weaken with age. Shorter, stiffer muscle fibers make you vulnerable to injuries, back pain, and stress. But regularly performing exercises that isolate and stretch the elastic fibers surrounding your muscles and tendons can counteract this process. And stretching improves your posture and balance.
Preventing falls with balance exercises – Balance tends to erode over time, and regularly performing balance exercises is one of the best ways to protect against falls that lead to temporary or permanent disability. Balance exercises take only a few minutes and often fit easily into the warm-up portion of a workout. Many strength-training exercises also serve as balance exercises. Or balance-enhancing movements may simply be woven into other forms of exercise, such as tai chi, yoga, and Pilates.
© 2010, The Harvard Medical School. Used with permission.
YMCA kicks off 2010
fundraising campaign
The Youngstown YMCA was set to begin its 2010 fundraising campaign with a party at Immaculate Heart of Mary Parish Center on Saturday, Jan. 30. The campaign runs through March 5.
The evening was set to feature live entertainment, auctions, raffles and gourmet food all to benefit the YMCA’s “Strong Kids Campaign.” The campaign provides financial assistance to underprivileged youth and families for membership and/or program fees, assistance to special needs populations and agencies with usage of the YMCA’s pools and gyms.
In 2008, the YMCA provided $870,000 in assistance to the community. The need is expected to rise this year to include an estimated 3,380 youth, more than 553 families, 1,200 adults and 800 special needs children. In addition to the campaign party, helping to jumpstart the fund-raising campaign is the annual Spin-A-Thon on Saturday, Feb. 6. Spinners will raise money for the campaign by securing donations for each hour they ride, with some riders even committing to the entire seven hours. For more information, contact Greg Kleeh, director of Financial Development at 330-744-8411, ext. 130.
Howland salon raises
funds for Cancer Center
The Lanai Salon recently took a corporate gift and turned it into a fundraiser for the Ireland Cancer Center at Trumbull Memorial Hospital. The salon created a basket valued at nearly $500 and raffled it off to clients and the community. The basket included a pink limited edition Paul Mitchell flat iron, a professional blow dryer and an array of other salon and spa products. In just two months, the salon raised more than $900 for the Cancer Center through raffle ticket sales.
Fran Ruberto, one the salon’s owners, said due to the tremendous support they received, another raffle is in the works. “I think everyone has someone who’s been touched by cancer in their life, and this was a wonderful way for us to give something back,” Ruberto said. With the positive response from clients and staff, Ruberto contacted the Paul Mitchell offices in hopes that other salons would soon follow suit. The Lanai Salon is located at 165 Niles Cortland Road in the Galleria Suites in Howland. For more information, call 330-240-4838.
Diabetes program
sets February dates
Are you or someone you know at risk for diabetes? Risk factors include family history, age, being overweight and race. The Stepping Out Minority Diabetes Prevention Program is a free program that includes line dancing, salsa, aerobics, and other activities, as well as diabetes prevention; healthy eating and cooking classes; and regular health screenings for cholesterol, body fat, weight and blood pressure.
Plus, weekly prize drawings for regular participation. February registration dates are as follows: noon to 2 pm. on Feb. 13 at the McGuffey Center, 1649, Jacobs Road in Youngstown; 5-7 p.m. on Thursday, Feb. 18 at the United Methodist Community Center, 334 North Pearl St., Youngstown; and 5-7 p.m. on Wednesday, Feb. 24 st OCCHA, 3660 Shirley Road, Youngstown. This program is provided with support from Humility of Mary Health Partners, Associated Neighborhood Centers, OCCHA and United Methodist Community Center.
For more information, call the McGuffey Center, 330-744-4377; OCCHA, 330-781-1808; or United Methodist Community Center, 330-743-5149, ext. 226.
Compiled from local reports.
