DETROIT – For about 20 minutes early each morning, while sipping tea, paying bills and reading, Louise Schneberger sits next to a small blue light to boost her mood and synchronize her sleep cycle.

“Without it, I’m crabby, depressed and horrible to be around,” says Schneberger, 42, a middle school teacher. “My daughter calls it my happy light. I tell everyone I know about it.”

As sunny days decline, particularly in northern climates, Seasonal Affective Disorder, or SAD, a type of seasonal depression, presents itself again as an issue for 14 million Americans like Schneberger.

The estimate comes from Dr. Norman Rosenthal, a leading SAD specialist and author of “Winter Blues, Everything You Need to Know to Beat Seasonal Affective Disorder” (Guilford Press; $15.95).

Finally, there is more help:

Better research on what works;

The nation’s first approved prescription drug for SAD, Wellbutrin XL;

Different drugs used by psychiatrists that appear to help; and

Cheaper prices for light boxes, growing in use as a treatment for the problem.

The lights help regulate the body’s internal circadian clock and control the production of the sleep hormone, melatonin, and the production of serotonin, a brain chemical, both of which contribute to improving mood, sleep and energy, research suggests.

Apollo Health’s goLite, as the company’s best-selling light is called, is a small, lightweight, portable unit that now sells for $159.99 at Costco. The same unit is $172 on www.amazon.com, and $249 on Apollo Health’s site, www.apollolight.com; 800-545-9667. Therapist Aldona Valivonis recommends the goLite, uses one herself and encourages people to fill out a mood tracker on Apollo Health’s Web site to check on their symptoms and adjust the amount of light they get.

She started using the light box a few weeks earlier than usual when she tracked her mood and confirmed she was not feeling as positive and energetic as she likes. Her morning ritual, she says, is “coffee, contacts, get dressed and out the door,” for an outdoor walk with her greyhound rescue dog.

She also watches her diet to be sure it includes the right mix of nutrients and complex carbohydrates to keep her mood balanced. Her patients, including Nancy VanDeGrift, 54, say the strategies all help.

VanDeGrift says the advice and blue light she uses offset feeling downright grumpy in the fall, among other symptoms. “I have a hard time getting up in the morning and I tend to put on weight in the fall,” says VanDeGrift, an adjunct math teacher.

She yearns some days to curl up on the couch in her pajamas. “All I want to do is read and sleep,” says VanDeGrift. This winter will be a particular challenge because VanDeGrift was laid off in January from the Ford Motor Co.

Dimming SAD’S impact

Using light units is just one of many ways of coping with seasonal affective disorder. Medical advances about the effects of light, exercise, food and drugs on mood offer strategies for dealing with SAD.

Light

There are many types of phototherapy lamps, from a bedside light attached to an alarm clock, to table, desk and floor models. They tilt forward to allow more light to enter the eyes. Sit 2-3 feet in front of the light, or beside it, but don’t stare into it.

The lights help regulate the body’s internal circadian clock and control the production of the sleep hormone, melatonin, and the brain chemical, serotonin, improving mood, sleep and energy, research suggests.

Try to use light therapy at sunrise or early morning for at least 20-30 minutes. The best time to begin is in the fall.

You should feel positive benefits, including more energy, fewer food cravings and a more rested feeling, in a few days, but it may take as much as two weeks, says Dr. Norman Rosenthal, a former National Institutes of Health researcher and author of “Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder” (Guilford Press, $15.95).

You have a choice between blue or white lights.

White full-spectrum light units should be 10,000 lux, the amount of light on a cloudless day at sunrise. By comparison, typical office overhead lighting is 500-700 lux. The best white-light boxes have a plastic diffusing screen that filters out ultraviolet rays that can cause eye damage. White has been favored for years and has the most research to support its effectiveness, say many doctors, including Rosenthal.

A growing body of research has found blue light is more effective in elevating mood, says Dan Adams, director of research at Apollo Health, a 20-year-old company leader in the blue light field. You want a unit that delivers 447-484 nanometers (nm) of blue light.

For more on phototherapy lights: SunBox Co. at www.sunbox.com or 800-548-3968. Prices begin at $200. Enviro-Med at www.bio-light.com or 800-222-3296. Prices begin at $299.

Exercise

When it comes to exercise and mood, the experts agree. An outdoor morning walk is one of the best strategies people can use to offset the gloomy feelings that accompany SAD.

Here’s the science behind it: When your bare skin is exposed to sunshine’s ultraviolet light, it makes a chemical called cholecalciferol that the body changes into vitamin D.

Sunlight exposure also helps regulate your production of two hormones, serotonin and melatonin, which play a role in wakefulness and mood.

A fair-skinned person can reach daily vitamin D needs by exposure to as little as 45 minutes a week of sunshine; a person with dark skin may need up to three hours of exposure to get the same benefit.

Can’t walk outside? A single bout of exercise, like 30 minutes on a treadmill, helps lift the moods of people with depression, studies show. But you’ll miss the chance to get vitamin D outdoors from exposure to UV sunlight. That’s why sitting indoors next to a window does not benefit you the same way an outdoor walk does.

Dr. Alan Rosenbaum, a Farmington Hills, Mich., psychiatrist who specializes in the drugs and supplements used to treat mental illness, including SAD, routinely gives his patients a blood test for vitamin D levels because so many are deficient. The hormone is key to a number of critical body systems, including bone formation and strength.

“Over 50 percent of people are vitamin D deficient because they don’t get enough sunlight,” Rosenbaum says. A person’s vitamin D level should be at least 30 nanograms per milliliter, “but we have people coming in with vitamin D levels in the single digits,” he says.

If you don’t get vitamin D outdoors, you can get it in food or supplements. But be careful, because too much can be harmful to your bones.

Food sources of vitamin D are found in salmon, fortified milk and fortified cereal.

The Institute of Medicine’s Food and Nutrition Board has set these daily requirements for vitamin D:

200 international units (IU) daily, ages 19-50

400 IU, ages 51-70

600 IU, 70 and older

Food

The fields of psychiatry and cardiology are looking at fish and fish oil supplements as ways to offset depression and heart disease. The answers aren’t in yet, but doctors who recommend the supplements say evidence is building that they work to protect your heart and improve your mood.

“Fish oil is good for many reasons including cardiovascular and cognitive preventive measures,” says Dr. Alireza Amirsadri, a Wayne State University School of Medicine psychiatrist who studies SAD. “It is a mood modulator and reduces anxiety and depression or even manic symptoms.”

Fish and fish oil supplements contain omega-3 fatty acids, substances that help nerve cells in the brain communicate with each other. They are derived from the oil of cold-water fish, such as mackerel, salmon, sardines, anchovies, and tuna, or as extracted oils from plants, such as flaxseed, canola (rapeseed) or soybean.

The federal Food and Drug Administration suggests a daily omega-3 fatty acid intake of 3 grams or less, and no more than 2 grams should be from supplements.

Taking excessive amounts of omega-3 fatty acids can cause bleeding, stomach pain, anemia or stroke. Also, avoid taking fish oil supplements with aspirin or ibuprofen and anti-clotting medications because the supplements act like blood thinners.

Protein – found in fish, shellfish, skinless poultry, lean beef, low-fat dairy products, dried peas and beans – also may boost mood, research suggests.

So, too, may chocolate, particularly dark chocolate.

Drugs

Wellbutrin XL was approved this summer by the federal Food and Drug Administration as the first official prescription medicine for SAD. It joins a list of anti depressants psychiatrists prescribe for the disorder.

An extended-release drug, Wellbutrin XL is a once-a-day antidepressant, to be taken in the fall. It is approved for adults 18 and older.

Three studies showed the drug prevented depression in patients with a history of SAD, compared to those getting sugar pills, according to the FDA, which reviewed the studies before granting approval for the drug for SAD in June.

Some doctors say Wellbutrin is no better than other anti depressant s in treating SAD. Others find it much better.

“I think it is superior,” says Rosenbaum. He typically prescribes a 300-milligram daily dose of Wellbutrin XL for SAD.

The drug carries a warning because it has been associated with an increased risk of suicidal thoughts and behavior in children and teens. Taking more than 450 milligrams daily can cause serious side effects, including seizures.

Wayne State’s Amirsadri says Wellbutrin XL should not be used by people who drink alcohol, who have eating disorders or who have had seizures because of the seizure risk. He says many antidepressants are as effective as the newly approved drug.

Doctors also use other prescription drugs and supplements to treat SAD. Rosenbaum, for example, also prescribes Provigil, a narcolepsy medicine; drugs known as MAO inhibitors and melatonin, a supplement often used to offset jet lag.

A study published this year in the Proceedings of the National Academy of Sciences, a respected journal, found that taking melatonin in the afternoon, combined with bright light exposure in the morning, helped to keep moods stable.

What is SAD?

Seasonal Affective Disorder, or SAD, is a form of depression that occurs at the same time each year after seasonal variations in light. The most common type occurs in the winter and ends in the spring. There is a less common summer form of SAD.

Symptoms include increased sleep, food cravings, weight gains, boredom, apathy, irritability and disinterest in activities and people.

For more information:

National Mental Health Association, www.nmha.org/infoctr/factsheets/27.cfm

Seasonal Affective Disorder Association, based in England, www.sada.org.uk

American Academy of Family Physicians, http://familydoctor.org/x1913.xml

The Society for Light Treatment and Biological Rhythms, www.sltbr.org


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