Home Treatment

Home treatment is very important in the treatment of seasonal affective disorder (SAD). Home treatment for an episode of depression may include a combination of the following:

Light therapy

Light therapy is an effective treatment for SAD.¹

There are two types of light therapy: bright light treatment, in which you sit in front of a "light box" for a certain amount of time (usually in the morning), and dawn simulation, which is done while you sleep. For dawn simulation, a low-intensity light is timed to go on at a certain time in the morning before you wake up, and it gradually gets brighter.

Light boxes are available commercially and use fluorescent lights that are brighter than indoor lights but not as bright as sunlight. Ultraviolet light, full-spectrum light, tanning lamps, and heat lamps should not be used. You place the light box at a specified distance from you on a desk or in front of a chair and use it while you read, eat breakfast, or work at a computer. Light therapy is usually prescribed for 30 minutes to 2 hours, depending on the intensity of the light used and on whether you are starting out or are using it to maintain a response.

It may take as little as 3 to 5 days or up to 2 weeks before you respond to light therapy. Stopping light therapy will likely cause you to relapse back into depression.²

Light therapy may work by resetting your "biological clock" (circadian rhythms), which controls sleeping and waking.

If you have eye problems or you take medicines that make you light-sensitive, ask your doctor about whether light therapy is safe for you. Before you start treatment, tell your doctor about any other conditions you have and about the medicines you are taking .

Light therapy will need to be continued for the entire time you are depressed. People who discontinue treatment usually lapse back into depression.³

Seasonal Affective Disorder: Using Light Therapy

Physical activity

Being physically active during the daytime, especially first thing in the morning during winter, may help improve your energy level and relieve depression. Moderate exercises like walking, stationary cycling, and swimming are a good way to start an exercise routine.

Experts say to do either of these things to get and stay healthy:⁴

• Moderate activity for at least 2½ hours a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. Moderate activity means things like brisk walking, brisk cycling, or shooting baskets. But any activities—including daily chores—that raise your heart rate can be included. You notice your heart beating faster with this kind of activity.
• Vigorous activity for at least 1¼ hours a week. One way to do this is to be active 25 minutes a day, at least 3 days a week. Vigorous activity means things like jogging, cycling fast, or cross-country skiing. You breathe rapidly and your heart beats much faster with this kind of activity.

It's fine to be active in blocks of 10 minutes or more throughout your day and week. You can choose to do one or both types of activity.

Moderate activity is safe for most people, but it's always a good idea to talk to your doctor before you start an exercise program.

Also try to do exercises to strengthen muscles at least two times each week. Examples include weight training or stair climbing on two or more days that are not in a row. For best results, use a resistance (weight) that gives you muscle fatigue after 8 to 12 repetitions of each exercise.

Healthy diet

Eating a healthy, balanced diet is helpful for any type of depression and may help relieve some of the symptoms of SAD.

Complementary treatment

The following complementary treatments may be helpful in treating symptoms of SAD, although there currently is not enough scientific evidence to prove their usefulness.

• An herb called St. John's wort may help ease depression symptoms.
• Melatonin is a hormone that may help regulate your biological clock (circadian rhythms). But you need to take a very low dose at a specific time of the day.

Be sure to check with your doctor before you try these complementary therapies, because they may interact with other medicines you are taking.

You should not take St. John's wort if you are taking other antidepressants. Also, St. John's wort may cause light sensitivity. If you are using light therapy, you may want to discuss with your doctor whether St. John's wort is right for you in the treatment of SAD.

Research on the effectiveness of other SAD treatments is ongoing.

Advice for caregivers

Sometimes family members and friends are not sure how to help someone who has seasonal affective disorder. It may help to:

• Spend time with your loved one even though he or she may be withdrawn or quiet.
• Offer to help with daily tasks that temporarily may be too difficult to do alone. But it is important that you do not enable the person to remain depressed by taking over all of his or her daily responsibilities.
• Take a walk or do some other type of exercise activity together. Getting out first thing in the morning for a walk may be helpful.
• Help the person to stay with the prescribed treatment plan.

For more information on helping someone with SAD or depression, see:

Depression: Helping Someone Get Treatment.

Depression: Supporting Someone Who Is Depressed.

Unfortunately, many people don't seek treatment for mental health problems. You may not seek treatment because you think the symptoms are not bad enough or that you can work things out on your own. But getting treatment is important.

If you need help deciding whether to see your doctor, see some reasons why people don't get help and how to overcome them.