Does Light Box Therapy Really Work for SAD?

Are you ready for sweater days or missing the sun rays? For many, the chill in the air is a reminder that days are getting shorter, and that lack of sunlight starts to wear down their mental health.

Seasonal Affectedness Disorder, or SAD, is the most well-known psychiatric condition associated with seasonality. One treatment popularized over the last decade is lightbox therapy to combat the symptoms of SAD. But is lightbox therapy evidence-based or a type of placebo? How does lightbox therapy work? Family Medicine Physician Dr. Rob Whittier has answers to these questions that may have you considering one.

What is Seasonal Affectedness Disorder (SAD)?

Seasonal affectedness disorder is a type of depression triggered by the change in season. It was first psychologically recognized in the 1980s. “The symptoms of SAD can be drastic,” says Dr. Whittier. Some of them include:

• Sleep disturbances, particularly sleeping 16+ hours daily
• Lack of interest in things that were once fulfilling
• Feelings of guilt or shame
• Energy changes (most often fatigue or less vigor for day-to-day life)
• Fidgeting or feeling foggy
• Feeling physically heavy
• Thoughts of self-harm or suicide

If you are living with thoughts of self-harm or suicide, help is available 24/7 by dialing 988 or by texting CONNECT to 741741. If two or more of these symptoms affect you, please reach out to your PCP for a medical evaluation or find one here.

What is Lightbox Therapy?

Lightbox therapy is an at-home therapy to mitigate the effects of SAD. The practice is simple: In the morning, you’ll sit in front of a specialized light for about 30 minutes. Health practitioners use lightbox therapy in conjunction with other treatments like behavioral therapy and pharmacotherapy (such as SSRIs).

Does Lightbox Therapy Really Work?

Warm light on our face tends to be a mood-booster, but is that all that’s happening? It’s much more than that, according to Dr. Whittier. “Lightbox therapy a well-studied treatment. In fact, researchers have found a link between the photoreceptors that pass through our retina (behind the eye) and turn to neural signals,” says Dr. Whittier.

He explains, “There’s new research on the melanopsin retinal cell in a subcategory of people. In some, this cell is not as receptive to light, so they need more bright light to activate it and turn on those neural signals. Having fewer daytime hours could be triggering the recurrent depression we know as SAD.” This brain pathway was only discovered in the year 2000 and continues to be studied, particularly the link between mood, cognition, and visually-absorbed light.

Choosing a Light Box

Therapy lights look a lot like tablets; you can get them online or through several retailers. Here are Dr. Whittier’s guidelines for selecting a light box.

• Ensure that the lightbox emits 10,000 lux (a measure of light intensity)—not to be confused with 10,000 lumens.
• Look for one with a diffusion screen that filters out UV rays.
• Beware of inaccurate branding: The most verified model is the Light Meter LM-3000.

Learn more about light box specifications in this article from Yale School of Medicine.

The Right Way to do Lightbox Therapy

Ideally, you want to sit in front of your light box before about 7:00 am, which mimics the summer sunrise. “Place the box in front of you or off to the side. There’s no need to look directly at it, but keep your eyes open while using it,” says Dr. Whittier. You can do something like eat, read, journal, or watch TV while the light is on you. The light should be positioned 12 to 18 inches from your face and you should sit in front of it for 30 minutes.

One Tool in a Treatment Plan

As with all mental health conditions, it’s crucial to come in for an evaluation and keep in touch with your health provider if you experience any psychological shift. If you’re living with SAD symptoms or a steep decline in your mental health, make an appointment with your primary care provider (or Dr. Whittier who is accepting new patients in Farmington, Utah). “Feelings of depression are not always SAD. I’ve seen patients whose work-up points to a thyroid condition or long COVID—that’s why proper evaluation is important.”

“Of course, the worst possible thing is if someone never comes in and progresses to thoughts or acts of self-harm. Please reach out for a complete evaluation. Help is possible and you’re not alone.”

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Dr. Rob Whittier is a Family Medicine (Primary Care) Doctor who practices at Ogden Clinic Farmington. His clinical interests include depression, anxiety, weight loss, and managing chronic issues such as fatty liver disease. He is also fluent in Spanish.

Schedule a visit with Dr. Whittier here.