Welcome back, Dr. Elizabeth Saenger, who graced us last spring with her first post, The Opposite of Sex, Drugs, and Rock & Roll: Deborah’s Story, the start of a true family drama. Now fall is upon us, and the prevailing mood in this wonderful family is turning around. Jump back to Elizabeth’s first post to set the stage for what follows here. —Michael Terman
Ruth lives by the beach in Rock away in New York. In the summer, she strolls by the dunes, or basks in the sun, enjoying the waves and the people. However, when winter comes around, Ruth’s alter ego crawls out. And then she is, by her own admission, “slower than cold tar poured down a hill backwards.”
In the morning, she can’t get out of bed, much less make it to the kitchen at a reasonable hour. Instead of having breakfast at 8 AM, and giving herself a shot of insulin, as her doctor ordered, she sleeps. This throws off her schedule of meals and insulin shots, and often pushes her blood sugar level outside the normal range.
Further, because she has no energy, she doesn’t move around. Blood pools in her legs, causing edema. Her arthritis acts up, and her knees hurt.
Depending on the day of the week, her daughters, Deborah or Brenda, telephone Ruth in the morning to wake her up. However, sleep is an escape she does not want to give up, even though she realizes her hibernation leads to erratic insulin levels, and makes her daughters fear for her safety.
In March, the early morning sun scrubs the apathy off Ruth’s face. Her lethargy melts, and her energetic self jumps to the fore. She has survived the trials of SAD with stoicism, but she took a risk.
A Shortcut to Spring
If I had SAD, I wouldn’t be stoic. I wouldn’t risk the carbohydrate craving that could make my body look like a pumpkin.
Instead, I would head straight for the onlineAutomated Morningness-Eveningness Questionnaire(link is external)(AutoMEQ). This free, confidential self-assessment at the non-profit Center for Environmental Therapeutics(link is external) would take five to ten minutes to complete, and tell me what time light therapy would be most effective for me.
Light therapy often involves sitting in front of a light box for thirty minutes every morning, but without feedback from the AutoMEQ, I would not know what time would be best for me.
My AutoMEQ results would enable a professional, or perhaps a friend with SAD who swears by her light box, to get me started. And since I know about the criteria for selecting a light box to avoid the problems of Light Therapy on the Wild Side, I would avoid boxes with fields of light that are too small to do the trick—or, worse, boxes that emit ultraviolet light.
My light box would be a shortcut to spring.
Light Box, not Black Box!
To me it seems that the most natural way to treat a disorder associated with less light is to provide that light.
This is especially true given that the science of circadian rhythms shows how light activates a certain portion of our retina. Specifically, when the blue light within the spectrum of white light falls on receptors on the lower part of the retina, messages are transmitted to the suprachiasmatic nucleus in the hypothalamus. This process, which is separate from vision, energizes us.
What better way to improve my energy level than to supply an energizing antidote?
And what better tool to use than a light box? A light box is targeted to solve a specific problem, as opposed to medications. Medications affect multiple targets, often including targets that were fine before you took the medication. This sometimes causes side effects worse than the problem. Further, the way many medications work are often poorly understood. They are a black box.
Therefore, I would like the light box, not the black box!
Elizabeth Saenger, PhD, is a Harvard-educated psychologist who helps people help themselves live the way they want to, sometimes with style and originality.
She often teaches clients useful skills, from negotiation to how to cope with depression, individually, or in groups. These skills enable clients to solve problems later without her.
Thus her real job is to put herself out of business.