Watch out for medical quackery!

Coturnix,

I can't comment on the quackery of the site, but I disagree with your assertion that medication is always wrong.

Consensus guidelines from the Agency for Health Care Policy and Research recommend that medication be used as a first line treatment for SAD in cases of severe depression, where they have worked previously in a patient, when diagnosis is iffy, and when there isn't a clear history indicitive of SAD.

An admittedly old review of published treatment guidelines is available from this American Family Physician article.

There was nothing at the National Guidelines Clearinghouse which contradicted it.

It's because the shrinks learn nothing about sleep and clocks in med school, so they go with drugs for SAD which is just silly except in the hardest cases as an additional treatment on top of light therapy. Drugs should not be the first (and only) treatment.

I am dissapointed by the focus on drugs as the end all for mental "disorders." For something like SAD, they are just ridiculous. I understand that they may be indicated if the diagnosis is iffy or the depression severe, but there is absolutely no need for them as a long term treatment.

What drugs are very good for in dealing with most mental disorders is to make other treatment more effective. With someone dealing with SAD, effected by severe depression, they may well make it easier to effect circadian treatment - but should only be used if the depression is interfering with the effectiveness of the treatment.

I know that drugs are very effective in conjunction with therapy. When one is going through therapy, one has to bring the underlying issues to the fore and deal with them. When one is succesful at bringing them to the fore, they are in their face more intensely than they were before therapy - the drugs can help offset that in a big way.

The problem is that the drugs as an end all are not very effective over time. That is why the drug or drugs a person is on change, regularly. In effect, the issues or underlying problems work their way through the effects of the drugs.

Over all, I am not keen on using drugs at all, unless it is absolutely necessary.

My moods tend to fluctuate with the seasons, but light therapy is a total pain in the ass. I tried it for a couple weeks in college. It sucked. I was supposed to get up at the same time every day and sit in front of the light box. The real kicker was that I was supposed to be awake during this time.

My problem was that I literally couldn't sleep during the actual night. I would fall asleep around five or six am, nap for a couple hours, and then have to get up and sit in front of the damned light box, awake. Or, at least that was the idea. Mostly I'd fall asleep in front of the lightbox and defeat the purpose.

The drugs were hassle-free.

Get a dog. Train it to lick you in the face and drag you out of bed at dawn. Take it for a walk first thing in the morning and do some jogging. In two weeks you'll be precise like a Swiss watch and not depressed at all.

Wearing a light visor in the morning is much easier than the lightbox as it lets you be active i.e., excercise and eat - in the morning. Combination of light, food and excercise all together helps the best.

Lindsay, perhaps you should study Phase Response Curves. Getting to sleep at 6 and using a light box at 8 may well have moved your circadian rhythm in exactly the wrong direction.

I haven't tried a light visor, Coturnix, but I'm satisfied to have the box on a shelf above my monitor. Well, no exercise. But I have that half hour surfing with a good conscience.