Bright Light Therapy in Treatment of Seasonal Affective Disorder (Dissertation Sample)

Bright Light Therapy in Treatment of Seasonal Affective Disorder
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ABSTRACT
Treatment with regular light administration, or Bright Light Therapy (BLT), has been proved successful and is now accepted as a first-line clinical modality since the first description of Seasonal Affective Disorder (SAD) by Rosenthal et al. in the 1980s. Alterations in the circadian rhythm and changes in serotonin reuptake have recently been involved in studies addressing the efficiency of BLT on SAD patients. In nonseasonal unipolar and bipolar depression and other psychological conditions with real or suspected circadian system changes, BLT is increasingly being used as an experimental therapy. This paper determines the impact of BLT on SAD by analysing previously done studies.
Key Words: Seasonal Affective Disorder (SAD), Bright Light Therapy (BLT), research, studies.
Table of Contents TOC \o "1-3" \h \z \u ABSTRACT PAGEREF _Toc72611341 \h 21.0.Introduction PAGEREF _Toc72611342 \h 51.1.Seasonal Affective Disorder: Background Information PAGEREF _Toc72611343 \h 51.2.Bright Light Treatment PAGEREF _Toc72611344 \h 61.3.Problem Statement PAGEREF _Toc72611345 \h 72.0. Methods PAGEREF _Toc72611346 \h 92.1. Literature Search Strategy PAGEREF _Toc72611347 \h 92.1.1. Eligibility Criteria PAGEREF _Toc72611348 \h 92.1.2. Outcomes PAGEREF _Toc72611349 \h 102.2. Limitations of the literature search PAGEREF _Toc72611350 \h 103.0. Results PAGEREF _Toc72611351 \h 113.1. Analysis PAGEREF _Toc72611352 \h 124.0 Discussion PAGEREF _Toc72611353 \h 144.1. Mechanisms of the BLT Action PAGEREF _Toc72611354 \h 144.2. BLT Indicators Development PAGEREF _Toc72611355 \h 154.3. Bright Light Therapy compared with other treatments in SAD PAGEREF _Toc72611356 \h 164.4. Effects of Bright Lights Intensity and UV Radiation Type. PAGEREF _Toc72611357 \h 184.5. Difference in Duration Treatment PAGEREF _Toc72611358 \h 204.6. Side effects and Benefits of BLT on SAD PAGEREF _Toc72611359 \h 215.0. Conclusion PAGEREF _Toc72611360 \h 25References PAGEREF _Toc72611361 \h 26
TOC \h \z \c "Table" Table 1: Included studies and Characteristics PAGEREF _Toc72611329 \h 11
1 Introduction
2 Seasonal Affective Disorder: Background Information
Seasonal Affective Disorder (SAD) is a depressive disorder that occurs every winter and then goes away in the spring or summer. During the winter, patients also have an elevated appetite and sleep for more extended periods, in addition to a depressed mood. SAD is a fairly common disease that affects 1–3% of adults in temperate regions, with women being more affected when compared to men (McMahon, 2014). SAD is a recurrent primary depressive or bipolar disorder subtype characterized by a consistent temporal association (at least two years) between the onset and remission of adaptive episodes and a specific time of year. Seasonal affective episodes can outnumber nonseasonal affective episodes significantly throughout a person's existence. Fall-winter depression is the most common pattern, with depression onset in the fall or winter and spontaneous recovery or, optionally, hypomania/mania in the following spring. SAD is common among people in the18-30 year range but has also been observed in older people (Anglin, 2013). Because of these shifts in sunlight patterns, our "biological internal clocks" or circadian rhythms alter as the seasons change (Anglin, 2013). The human biological clocks become out of sync with individuals' daily schedules as a result of this. Melatonin, a sleep-related hormone produced by the brain's pineal gland, has also been linked to SAD. In the dark, this hormone, which may cause depressive symptoms, is released at higher levels. As a result, as the days grow shorter and darker, so does the development of this hormone.
Depressive symptoms and low energy are the significant symptoms of SAD. People with SAD can feel so sad, irritable, and cry frequently; they are exhausted and lethargic, have trouble focusing, sleep more than usual, lack motivation, reduce their activity levels, avoidance of social interactions, crave carbs and sweets, and appear to put on weight due to overeating, according to information for the general public (Anglin, 2013). In contrast to restlessness, symptoms of the less common summer seasonal trend disorder include poor appetite with accompanying weight loss, insomnia, frustration, disorientation, panic, and even aggressive behavior episodes. It is important to remember that the severity of seasonal pattern disorders varies. Subsyndromal S-SAD, also known as the "winter blues," is a milder type of SAD that affects certain people (Kerr et al., 2015). Others, on the other hand, can become seriously incapacitated and incapable of functioning. SAD symptoms may be as severe as those encountered by in-patients with nonseasonal depression in some cases. Suicide thoughts may be present, as they are in all depressive disorders. When working with individuals with or who may have SAD, health workers must always conduct suicide risk assessments.
3 Bright Light Treatment
Bright Light Therapy (BLT) has been a popular treatment for SAD since the first clinical trial in 1984 (Kerr et al., 2015). The decrease in light intensity an individual is exposed to during the winter months is thought to trigger SAD. The sleep/wake clock in the brain is affected by less light. Some brain chemicals like serotonin and melatonin are altered as a result of this. Changes in mood and signs of SAD may occur when these compounds are out of control. The light used in BLT is thought to migrate to the neurons in the back of the eye. These cells stimulate the brain, which causes the brain's chemical output to change (Kerr et al., 2015). Because of improvements in the equilibrium of neurotransmitters and improvements in the sleep/wake cycle, BLT improves low moods.
Knowing how importantly reduced daylight is in activating SAD and S-SAD, strategies that aim to replace it with bright artificial light, especially in the mornings, have consistently shown promise. Light therapy is also known as phototherapy or Bright Light Therapy (BLT). Lightboxes that emit broad-spectrum light with a composition identical to sunlight can be purchased. From early fall to early spring, symptoms of SAD and S-SAD can be alleviated by staying in front of a lightbox first thing every morning. Light rooms, with indirect and equally distributed light, are available in Scandinavian countries. Lightboxes typically screen out UV rays during the fall and winter and involve 20–60 minutes of regular exposure to 10,000 lux of cool-white fluorescents (McMahon, 2014). This is roughly 20 times more powerful than standard indoor lighting.
The harmful impacts of BLT usually are milder than those of antidepressants. Eye pressure, an elevated incidence of age-related macular degeneration, nausea, restlessness, and sleeping problems are among them (McMahon, 2014). Light therapy does not cause ocular changes or anomalies. Lithium, melatonin, phenothiazine antipsychotics, and some antibiotics are all photosensitizing drugs that should not be combined with light therapy (McMahon, 2014). Hypomania and suicide attempts can occur in some people, particularly in the first few months of exposure. A medical professional should supervise the use of light therapy.
4 Problem Statement
The affective and physical effects of depressive disorder and the timing and quality of sleep may be significantly influenced by exposing the eyes to the light of sufficient intensity and duration at the appropriate time of day. Winter depression, also known as a seasonal affective disorder, has been the most comprehensive clinical trial (SAD). We examine and discuss the use of light therapy for SAD and subsyndromal SAD in this article. Bright light therapy was used as an alternative to antidepressants, wake therapy (lack of sleep), or both in a novel series of procedures intended to accelerate and maintain the therapeutic response and avoid relapse in this article. The study goes through the essential aspects of light delivery systems' effectiveness and possible side effects.
2.0. Methods
The study is based on an analysis of selected studies that provide the most comprehensive image of the efficiency of BLT on SAD patients. This analysis is accomplished by choosing the most recent studies of the highest methodological standard applicable to the thesis's issue.
2.1. Literature Search Strategy
The approach included a systematic search for relevant literature in many databases, including PubMed, Google Scholar, and PsycINFO. The language was limited to English-language literature published between 2001 and 2020. The medical topic heading used for the quest included one phrase for BLT (phototherapy, BLT, and light treatment), a second phrase for the condition (psychiatry, depress, affective), and the third phrase for seasonal variation (season, SAD, winter and pattern).
2.1.1. Eligibility Criteria
Published random and placebo-controlled clinical trials were included. There are no generally accepted definitions of adequate brightness or therapy durations for BLT at the moment. A room's average light level is between 100 and 300 lx. BLT was required to have a minimum luminous flux of 1,000 lx, which contradicted Prejerk et al. (2020). The placebo condition was either nonphotic control (i.e., a low-density or sham negative ion generator) or 500 lx dim-light therapy, consistent with a previous meta-analysis by Prejerk et al. (2020) assumed to suppress plasma melatonin levels. Only the first-period data were included if a study used a crossover design to avoid potentia...