Bright Light vs. Prozac
Ten years ago, the American Psychiatric Association Council on Research convened a work group to “use the principles of evidence-based medicine to examine the efficacy of light therapy.” Their conclusion was published in the American Journal of Psychiatry the following year:
This analysis of randomized, controlled trials suggests that bright light treatment and dawn simulation for seasonal affective disorder and bright light for nonseasonal depression are efficacious, with effect sizes equivalent to those in most antidepressant pharmacotherapy trials. (1)
In simpler words, they found that bright light was as effective as antidepressant medication for both seasonal and non-seasonal depression.
In the decade that has followed, we cannot think of a single patient who has come to us seeking bright light treatment for their depression. They come asking for medication. They come seeking psychotherapy, which is also an effective treatment for depression. But they don’t come asking about bright light.
This winter, a patient left us a voice mail: “I just wanted to tell you that the light box has given me back my life!” Yet no one asks for it.
Just imagine if the American Psychiatric Association had published the same words about a new medicine. Think of the advertising campaign (and the cost of it) that would have quickly spread the word to doctors, patients and their relatives. Imagine the impact when the ads also emphasized that this new treatment was remarkably free from the troubling side effects of the old medicines. Those ads would create “awareness,” and that awareness would lead patients to show up in doctors’ offices asking about the new treatment.
Awareness of the therapeutic benefits of bright light is finally coming. It’s coming very slowly, for psychiatrists as well as patients, but it is coming. And research is continuing, confirming its value for depression and extending our understanding of its effectiveness in other illnesses and in “ordinary” health.
The more we learn, the more we discover about the biological power of cycles of day and night, light and darkness. Even diabetes is now being investigated as a “circadian rhythm disorder.”
The sun might not have a huge advertising budget, but it’s got staying power.
- Golden, Gaynes, Ekstrom, et al. The Efficacy of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-Analysis of the Evidence. Am J Psychiatry 2005; 162:656-662.