Winter depression
can be treated effectively, expert says

By Ryan Robbins
The Maine Campus

For most people, it's not unusual to feel somewhat depressed during the winter. But for some, wintertime can be a dark, dreadful nightmare.
According to Michael Terman, an associate professor of clinical psychology in psychiatry at Columbia University, suffering through long winter days with fatigue can be effectively treated.
Considered to be one of the leading researchers of Seasonal Affective Disorder by his peers, Terman addressed members of the University of Maine chapter of Psi Chi, a psychology honor society, March 28 at Donald P. Corbett Business Building.
Seasonal Affective Disorder, also known as SAD or winter depression, will affect an estimated 65.5 million Americans during their lifetime, Terman said.
While SAD and major depression -- another common mental illness involving mood -- share some symptoms, they can be distinguished from each other, Terman said.
For instance, depression can occur at any time of the year; SAD is more prevalent during the winter.
"Even in cases of SAD, in the clinically severe cases, some people get a double whammy," Terman said. "They feel terrible in July and August and they feel terrible in January and February, and they're much better during the transition periods. But by the strict definition of SAD and winter depression, you must feel well all summer. Otherwise, there's something else other than SAD."
Typical symptoms of SAD include difficulty waking up, chronic fatigue and increased consumption of carbohydrates. Major depression, on the other hand, involves more severe symptoms, like psychomotor agitation: wringing of the hands; difficulty sleeping; and either an increase or decrease in appetite.
Scientists believe the hormone melatonin plays an important role in SAD. Manufactured in the pineal gland, a small, pea-like structure in the brain, melatonin is released when the brain detects darkness. Studies have shown that on average, melatonin is released at about 9:30 p.m., Terman said.
Because melatonin causes the nervous system to slow down, Terman recommends light therapy to suppress the production of melatonin.
Patients receiving light therapy must sit in front of a special light box that emits 10,000 lux, the equivalent of the amount of sunlight a person receives 45 minutes after sunrise or 45 minutes before sunset, Terman said. Treatment is daily and lasts about a half hour.
"It's a highly effective method and it works for a large majority of people carefully diagnosed with seasonal depression," Terman said. Patients whose depression gets worse late in the day are good candidates for light treatment, he said. By contrast, people suffering from major depression tend to feel better later in the day.
One light box on the market, which Terman demonstrated, requires patients to set it up next to their beds. A computer gradually increases the intensity of the light in the morning to simulate dawn. The light can also be programmed to gradually decrease at night to simulate dusk.
Terman also believes the absence of negative ions in the atmosphere during the winter can also cause SAD.
"It is true negative ion availability tends to be much lower during the winter indoors in a dry and heated environment," Terman said. "It's affected by humidity levels tremendously."
To offset the absence of negatively charged ions, Terman recommends treating patients with industrial-strength negative ionizers that distribute negatively charged ions into the environment.
In one study, patients reported feeling better after 10 days of treatment and 20 days of treatment, Terman said. When the negative ionizer was taken away, patients reported feeling worse, he added.
However, not all researchers agree with Terman's findings.
Recently, the Wall Street Journal reported that researchers for the most part discount light therapy and negative ion treatment.
One of those researchers is Walter A. Brown, a clinical professor of psychiatry at Brown University School of Medicine.
"Psychiatrists aren't generally very impressed with the efficacy of light therapy," Brown told the Journal. "It's interesting theory, but so far the data haven't supported it."
The United States Food and Drug Administration has warned companies that manufacture light boxes not to make claims their products cure SAD.
As for negative ion therapy, some researchers are also skeptical.
In a 1992 study conducted by Charmane Eastman of Rush- Presbyterian-St. Luke's Medical Center in Chicago, patients were asked to sit in front of what they thought was an active negative ionizer. The patients reported feeling just as good after treatment as patients who had received light therapy, suggesting the patients' improved mood was caused by a placebo effect.
Terman downplayed Eastman's findings.
"Her results over the years have vexed the field because she's getting good placebo responses to the negative ionizer," he said. He didn't offer an explanation for Eastman's findings.
People who suspect they may suffer from SAD or major depression should see their doctor, Terman said.

This article originally appeared in the April 8, 1996, edition of The Maine Campus. Copyright 1996, Ryan R. Robbins.