As the nights start drawing in, you may be considering a SAD lamp to combat the 'winter blues'. But is it the right solution for you?
A SAD lamp or light box works by replacing the light from sunshine that you’d normally see in the summer. It’s thought that when the light hits the retina at the back of your eye, it may help to tell the brain to make less melatonin, thereby improving mood. However, the evidence for their effectiveness is mixed.
To help you decide, we explain what the symptoms of seasonal affective disorder (SAD) are, recommended treatments and the pros and cons of SAD lamps, plus top tips for choosing the best SAD lamp if you do wish to buy one.
It’s not uncommon to suffer from a touch of the ‘winter blues’ when the days are short and we’re plunged into darkness from late afternoon.
However, in the UK, around three people in every 100 suffer from SAD – significant winter depression that can have a big impact on their daily lives.
There isn’t a test for SAD - instead it's diagnosed by the symptoms, which are similar to depression but usually specific to the winter months. These include low mood, lack of interest and enjoyment in life, low energy, feeling less sociable, feeling irritable, less interest in sex and, in extreme cases, suicidal thoughts.
SAD symptoms that tend to differentiate it from depression are:
Although men can suffer from SAD, three quarters of those affected are women.
Twin studies show there may be a hereditary element to it, too. SAD usually begins between the ages of 18 and 30, but can develop at any age, although children and older adults don’t tend to suffer from it.
Mind, the mental health charity, says that people who live near the equator for part of their lives then move further away might also be especially vulnerable to getting SAD.
About 10% of people with SAD get it during the spring and summer instead, and find that it goes away during the autumn and winter.
But they usually have trouble sleeping and loss of appetite - the opposite of what winter sufferers experience.
The exact causes of SAD aren’t entirely clear but research has suggested there may be a few things contributing to its development, including:
The Royal College of Psychiatrists (RCP) says that self-help will usually be enough to ease mild SAD and even help those with a severe form of the condition. This includes trying measures such as:
‘This is probably the most important point, since SAD is caused by lack of daylight,’ says Prof Workman.
Exercising outside, such as cycling, walking or running, can really help.
When you’re indoors, the NHS recommends making your work and home environments as light and airy as possible, and sitting near windows whenever you can.
If you are working from home more often, or indoors more than usual, it's particularly important, so try and create a routine to ensure you get out in the fresh air and daylight regularly.
If getting out more doesn’t help, you could try a light box, also known as a SAD lamp.
‘Some studies suggest 80% of people with SAD report a significant improvement,’ says Professor Workman.
The RCP says light therapy tends to work quite quickly so, if it’s going to help, you should notice some improvement in the first week.
‘Unfortunately, SAD often makes you want to isolate – but that’s one of the worst things you can do, so it’s a good idea to find a reason for a get-together’ says Prof Workman. This could be outdoors, virtual or otherwise, depending on your current circumstances.
If you think you do have SAD and are struggling to cope, it’s best to discuss this with your doctor.
The National Institute for Health and Care Excellence (Nice) says SAD should be treated in the same way as other types of depression.
These include talking treatments such as cognitive behavioural therapy (CBT) or medication such as antidepressants, both of which your doctor can discuss with you.
The best evidence is for the use of the SSRI medicines sertraline, citalopram or fluoxetine, which help to keep levels of serotonin up.
For SAD, it’s common to start them in the autumn and to stop them in the spring.
If SAD recurs, long-term or preventative treatment with an antidepressant called bupropion appears to be backed by strong evidence.
Light therapy is classified as exposure to very bright light for up to four hours a day (average one to two hours) - the light needs to be at least 10 times the intensity of ordinary domestic lighting.
In 2019, Cochrane – a global independent research network whose reviews are considered the gold standard for research – published a systematic review of light therapy for SAD, putting together and evaluating existing data.
It concluded that the quality of evidence about whether light therapy prevents winter depression is very low.
However, some studies have found it’s effective for treatment during a SAD phase, especially if used first thing in the morning.
SADA, the Seasonal Affective Disorder Association, says that light therapy has been shown to be effective in treating up to 85% of diagnosed cases.
It’s thought that light therapy is best for producing short-term results. This means it may help relieve your symptoms when they occur, but you might still be affected by SAD the following winter.
When light therapy has been found to help, most people noticed an improvement in their symptoms within a week or so.
If you’ve decided that you do want to try a SAD lamp, we’ve rounded up some helpful tips for getting the best one for you.
SAD lamps are available on the high street from retailers, including Argos, Boots and John Lewis & Partners, or you can search online where there are a number of specialist retailers.
SAD lamp brands include Beurer, Lifemax, Litebook, Litepod, Lumie, Philips, Rio and the SAD Light Co.
Before you buy, read through our tips, below:
Although most people can use light therapy safely, and reputable light boxes have filters to remove any harmful UV (ultraviolet) rays, exposure to very bright light isn’t suitable for everyone.
Speak to your GP if you're unsure whether a light box is a good idea for you.
Side effects of light boxes may include headaches, nausea and blurred vision, but the RCP says these tend to be mild.
Your purchase should be a medical device that’s registered with the Medicines & Healthcare products Regulatory Agency (MHRA).
This will be stated on the box or on the product’s website.
You need a bright white light emitting at least 2,500 lux (or lx, the units that visible light is measured in) and preferably 10,000 lux to benefit from the effects.
Research suggests that the most beneficial dose of light is 5,000lx hours daily, which equates to 10,000lx for 30 minutes each day, sitting comfortably around 40cm from the unit.
However, the light intensity and duration of treatment will depend upon your device and initial response – you may find that as little as 2,500lx works for you.
There is no known advantage to using blue or bluish SAD lamps over bright white ones.
The RCP advises using your lamp at breakfast time to help regulate the circadian pattern of melatonin secretion, something that is generally disrupted in SAD sufferers.
It also recommends that you avoid using it after 5pm because this may make it hard for you to get to sleep.
Use light therapy consistently on a daily basis, including at weekends, and carry on through the darker months until the days get longer in the spring and summer.
Keep a regular sleep schedule, too, going to bed and waking up at around the same time.
It may be tempting to buy a cheaper SAD lamp that requires sitting in front of the light for longer, but committing more time may make it more difficult to keep up your light-therapy regime.
Check the manufacturer's instructions for how long you need to use the lamp, to ensure it matches your needs.
A model with a clock and alarm that sounds to remind you to use it, and to alert you to when the time is up may suit you if you’re busy and have your mind on other things.
Some manufacturers allow you to try a SAD lamp for up to a month before you buy.
The other alternative is to consider hiring or renting one to see if it works for you.
Before you buy, think about whether looks are important to you.
If you find your SAD lamp large and ugly, you may be tempted to stash it away and get out of the routine of using it.
If you do buy one, SADA recommends replacing bulbs every three years, so it’s important to factor in the cost of replacements.
Also known as light alarm clocks or dawn-simulating alarm clocks, these slowly increase the light in the room over a period of up to 90 minutes, just before you’d normally wake up in the morning.
The RCP says these may be beneficial if you’re finding it hard to wake on winter mornings, helping to gently reset your daily body clock.
However, the light isn’t as strong as SAD lamps, so although they can be used in conjunction with SAD lamps for treating symptoms, they’re not a medical device and can’t be used alone for treating severe SAD symptoms.
You’ll need to sit with your eyes open about 50cm away from a SAD lamp for about 30 minutes to an hour each day.
The distance you sit from the lamp depends on its light intensity, and the manufacturer should specify the lux at given distances.
You can watch TV or work while you do so, but the light should fall on your face.