Heliotherapy Am I BLUE? No, Just SAD by Michael Braunstein

	"This little light of mine..." In 1980, a man came to see Dr. Lewy. He told of becoming depressed every November and staying that way until the days grew long in the summertime. He had been suffering that way for over fifteen years. Lewy sat the man down in front of a bank of fluorescent lights for a period of six hours a day, three before dawn and three after sundown. Within days the patient's mood lifted. He recovered fully and was soon taking only two hours of extra light a day. Light therapy became a sound, viable tool for treating the newly termed malady, SAD. Since then, light therapy has been endorsed by medical circles and therapists worldwide as an effective treatment for the depression associated with SAD. The range of specific application is vast and the research continues. In addition to treating SAD, light therapy -- also known as phototherapy -- has been found to be helpful to elderly patients with dementia or Alzheimer's syndrome. It is known that melatonin levels decrease as we age and there is a syndrome common in the elderly that is called "sundowner's syndrome." In winter months and summertime alike, when the sun goes down those with Alzheimer's or dementia can become sullen, depressed anxious or morose as darkness approaches. Research published in the Journal of Geriatric Psychiatry and Neurology in 1997 and the American Journal of Psychiatry in 1992 are only two of the studies showing that light therapy can ameliorate symptoms in the elderly. A spectrum of light appliances designed for use in treating SAD is available on the market today. Most experts recommend talking to someone who has worked with SAD in helping to find one suitable as treatment. Jeannie Curtis is a counselor in Omaha who works with SAD and phototherapy. She can be reached at 390-2342.
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SAD, or seasonal affective disorder, first came to public awareness shortly after research done in 1979 was published by the National Institute of Mental Health and the Archives of General Psychiatry Journal. That landmark reference coined the term and provided scientific basis for what songwriters, referring to "the sunny side of the street," had known for years. That is, sunlight has an effect on mood. Not exactly news to millions who live in Seattle, but hey, it's only science.

For 20 years in Los Angeles, seasonal affective disorder meant nothing to me. After all, how can you have SAD in a place where there are no seasons. I knew of it only as a plot device on Northern Exposure, my friend's quirky TV series filmed on location in Alaska. It seemed like everyone on that program had SAD. One episode had a character walking around with a hat with lights attached to the brim for therapy. For me, SAD became personal when So Cal went through a particularly lengthy rainy stretch in 1993. I started feeling moody and glum. I had never experienced such a mood before and I thought to myself, "This must be what people mean by depression. I must have a Prozac deficiency." The next day the sun came out, I got on my Harley for the first time in 11 days and felt exhilaration and knew exactly what SAD was all about. Hold the Prozac and start the Harley.

HICKORY, DICKORY DOCK, THE PROBLEM'S IN THE CLOCK
Millions of people are now diagnosed with SAD every year. Many more are improperly diagnosed and prescribed a drug for depression. Others self-medicate to fight a depression that has a real cause that can be remedied.

Doctors say symptoms can be mild to severe. Some sufferers become bed-ridden with the blues, sometimes sleeping twelve hours a day. Anxiety, irritability, withdrawal, overeating and sluggishness are some of the complaints.

In the case of SAD, science says it has to do with our circadian clock. For those who care, research locates the clock in the suprachiasmatic nucleii of the hypothalamus. It's common to all mammals and that is rather interesting since the hypothalamus is our primitive brain. That primitive part of our brain is very concerned with basic survival and knowing instinctively when darkness is coming, how long the days are, or when it may be time to seek shelter from predators; just the kinds of things that concerned primitive man. One plausible theory is that SAD began appearing when man learned to alter the natural patterns of day and night by lighting the interiors of buildings efficiently. When exactly does nighttime happen if we control the light? That in itself can become a problem and the internal clock is challenged by the artificial resetting of daylight savings time too.

In 1979, Dr. Norman Rosenthal and Dr. Al Lewy headed research at the NIMH investigating the connection between light and mood. They eventually focused on the hormone melatonin. Melatonin is produced in the pineal gland, located in the mid-brain. When research the early 1980's pointed to melatonin's role in promoting sound and restful sleep, as an anti-aging supplement and showing success in fighting cancer, the public started gobbling tons of the hormone, easily available in health food stores. Melatonin showed virtually no danger of side-effects. In fact, government researchers who set out to determine the "LD 50", -- the amount necessary to kill fifty percent of the animals tested -- couldn't produce a concentration strong enough to kill one mouse.

Other research found that taking melatonin helps airline employees deal with jet lag affecting their sleep. Melatonin in as small an amount as 5 milligrams helped them adjust.

Melatonin controls the function of many glands and Rosenthal and Lewy found that melatonin production is affected by exposure to light in excess of 2500 lux. (Lux is a measure of luminosity.) The link between sunlight and hormonal and mood function was made.

Rosenthal and others demonstrated in research later published in the Archives of General Psychiatry in 1998 that the mechanism of melatonin affecting SAD may have to do with internal core temperature as well. Melatonin and serotonin are two hormones that regulate temperature while we sleep. The relative temperatures associated with sleep and waking may be part of the mood equation.

HELIOTHERAPY -- LET THE SUN SHINE.
When the days grow short and the sun sinks lower in the sky throughout the winter months, many in sunlight-challenged geographical locations turn to artificial sources to lift their spirits. And recent research is showing that moderate tanning can provide health benefits.

One ironic study recently conducted showed that sunscreen lotions, considered by the public to protect the skin, can actually cause cancers. Dr. Marianne Berwick of the Sloan-Kettering Cancer Institute is not the only one who has come to that conclusion. In her study, Berwick supported the often-found conclusion that moderate tanning is a protection against skin cancer.

Days growing long? Dreary and blue? You can do a little light therapy or you can do it the totally all-natural way, the way the birds do it. Go south. Instead of trying to bring the sunlight to you, go to the sunlight! That's what I'm doing. Head south and you won't have to pay the higher light bill. Dry Tortugas here I come.

And just so you know? The only light you really need is the one inside you.

Be well.