8 posts from January, 2018

Light therapy for depression: What is it, and how does it work?

Posted January 31st, 2018 by

Bright light therapy is a treatment that’s become increasingly common for treating seasonal affective disorder, a condition that impacts many during the winter months. We sat down with our in-house research specialist to discuss light therapy – what it is, how it works and if it can help treat other types of depression in addition to seasonal affective disorder.

What is light therapy?

Light therapy, sometimes called blue light therapy or light box therapy, involves sitting or working, for a prescribed amount of time, near a device that gives off light that mimics daylight. It’s thought to ease symptoms of depression by impacting brain chemicals linked to mood and sleep.

Light therapy effectiveness: What the research says

While additional studies are needed to fully understand the role of light therapy, so far results from clinical trials investigating the effectiveness of this treatment on people with major depressive disorder (MDD) have been generally positive.

  • One study, involving 50 inpatients with severe MDD, found that when researchers combined the antidepressant venlafaxine with light therapy, recipients experienced “significantly lower HDRS depression scores” than those only taking the antidepressant. The HDRS (Hamilton Depression Rating Scale) is a questionnaire that helps provide an indication of depression severity.
  • Another 8-week trial involving 122 participants living with non-seasonal MDD found that light therapy, both on its own and in combination with the SSRI fluoxetine, was effective and well tolerated in those who participated.
  • Another study found mixed results, highlighting the need for more research to fully understand the role of light therapy

It’s important to note that while these studies showed positive efficacy, researchers still don’t know what “dose” or duration of light therapy is best and for what variations of depression.

Results: What you can expect

Light therapy is unlikely to cure major depression, but it may ease symptoms, especially those related to the season, and might help you feel better. Here’s what some PatientsLikeMe members have said about using light therapy as a treatment:

Check out side effects, dosages and costs members have reported for this treatment.

Choosing a light box

Although you don’t need a prescription to buy a light therapy box, it’s best to ask your doctor or medical health provider if light therapy is a good option for you. Before beginning treatment, you should discuss whether you need to take any special precautions, and what type of light therapy box would best meet your needs so you get the most benefit and minimize side effects. You should also discuss how to introduce light therapy into your treatment regimen. Also, know that health insurance companies rarely cover the cost of this treatment.

According to the Mayo Clinic, a light box should:

  • Provide an exposure to 10,000 lux of light
  • Emit as little UV light as possible

Recommendations for using the light box typically include:

  • Use the light box within the first hour of waking up in the morning
  • 20-30 minutes is generally the recommended amount of time
  • Use at a distance of about 16-24 inches from the face
  • Eyes should be open, but not looking directly at the light

Things to consider:

  • Is it made specifically to treat seasonal affective disorder? Some lights are designed to treat skin disorders, make sure you’re selecting the right one for your needs!
  • How much UV light does it release? UV light can damage your eyes if used incorrectly. Light boxes used to treat SAD should filter out most or all UV light.
  • Is it the style you need? Light boxes come in all shapes and sizes – the effectiveness of light therapy depends on daily use so choose a product that’s convenient for you.

Light boxes are designed to be safe and effective, but they’re not approved or regulated by the FDA so speak with your healthcare provider to understand your options. Read more about things to consider before choosing a product here. Do you use a light box? Share your experience and advice in the comments for choosing a product.

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Primary care that treats mind and body? It’s happening in Alaska

Posted January 25th, 2018 by

Integrated care for both mind and body under one roof? It may sound pie in the sky, but it’s really happening at an award-winning healthcare center in Anchorage, recently featured in Politico. How does it work? And can it be replicated?

A shining example in Anchorage

“It’s a truism that the mind and body are connected, but the U.S. health care system has long treated them as separate — with separate doctors, separate hospitals, separate payment systems,” Politico reports (detailing the history of these health care “silos”).

The Southcentral Foundation, which runs a healthcare center for native Alaskans in Anchorage, is in the spotlight for successfully bridging the mind/body divide.

“In part because of their Alaska Native heritage, which puts a high value on spiritual health, the leaders of Southcentral recognized decades ago that behavioral health is tightly linked with bodily health,” Politico says. “So they became one of the early adopters of integrated care.”

At Southcentral, checkups include a mental health evaluation, and a patient’s primary care team includes on-site psychologists or social workers.

For one patient, Vera, profiled in the Politico piece, “accessing mental health treatment was as easy as going to her regular doctor, and there was no stigma attached: Her mental health services were provided at the same time and in the same place as other medical care, just like heading down the hall for an X-ray or a blood test.” Vera was sexually abused as a child and later diagnosed with major depression. She experienced suicidal thoughts and may not be alive today without the integrated care she received at Southcentral, she says.

Advantages of integrated care

The World Health Organization (WHO) has recommended integrating mental health care into primary care for decades. Here are some of the benefits of integrated mental/physical health care that WHO outlined back in 2001:

  • Less stigmatization of patients and staff, as mental and behavioral disorders are being seen and managed alongside physical health problems
  • Improved screening and treatment, in particular improved detection rates for patients presenting with vague somatic (physical/bodily) complaints which are related to mental and behavioral disorders
  • The potential for improved treatment of the physical problems of those suffering from mental illness, and vice versa
  • Better treatment of mental aspects associated with “physical” problems

A popular notion — and the roadblocks

Research has shown that Americans value physical health and mental health equally. Also, “nearly half of Americans think they have or have ever had a mental health condition (47 percent), yet fewer than two in five have received treatment (38 percent),” according to a 2015 survey by the Anxiety and Depression Association of America.

In a 2017 PatientsLikeMe poll of more than 2,000 members, support for the Affordable Care Act (or “Obamacare”) is highly popular among those living with mental health conditions, perhaps because the policy’s “parity” requirement means that insurers have to cover mental and physical health issues equally.

Politico reports that there’s broad support for physical/mental (behavioral) health integration in both the healthcare sector and in Congress.

The Southcentral Foundation won the Malcolm Baldridge National Quality Award in both 2011 and 2017 for its innovative, top-quality care (psst: 97% patient satisfaction) at a relatively low cost. Douglas Eby, vice president of medical services at Southcentral, says he is often invited to speak at conferences in Washington, D.C., because the Southcentral model is “popular with the whole political spectrum.” (What? Whoa.)

So what are the biggest hangups? Money and stigma.

The U.S. health care and insurance system is structured in such a way that doctors are paid more for (physical) procedures, and they can actually lose money by integrating mental health. The longtime stigma of mental illness extends into the provider space, where mental health clinicians and services are valued much less, dollar-for-dollar, than their “physical care” counterparts.

“Solving these problems will take more than money; it will require changing the culture of medicine,” Politico concludes.

On PatientsLikeMe, thousands of members are living with both physical and mental-health conditions. Join the community today to talk about topics like this with patients like you!

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