Education

What They're Thinking: Combating SAD symptoms in a winter that won't end

'Folks with mood disorders seem to be especially vulnerable'

Patrick Rossmann, a behavioral health consultant with Student Health & Wellness at the University of Iowa, demonstrates a light therapy box in Iowa City on Friday, March 8, 2019. The light therapy boxes can be checked out from Student Health & Wellness to help students treat seasonal affective disorder. (Cliff Jette /The Gazette)
Patrick Rossmann, a behavioral health consultant with Student Health & Wellness at the University of Iowa, demonstrates a light therapy box in Iowa City on Friday, March 8, 2019. The light therapy boxes can be checked out from Student Health & Wellness to help students treat seasonal affective disorder. (Cliff Jette /The Gazette)

IOWA CITY — The winter blues can be real no matter your background or where you live, according to Jess Fiedorowicz, University of Iowa associate professor and director of the UI Mood Disorders Center. But they can be especially prevalent and debilitating for people with depression, bipolar or other mood disorders living in harsher winter climates with less sunshine — such as Iowa, especially in a year like this one, which has delivered ceaseless snowstorms, cold snaps and gray days.

Q: Have you seen more folks with seasonal affective disorder — or SAD — this winter?

A: “It’s hard for me to say, as I’m seeing folks who are depressed year-round … But (SAD) is a fairly controversial diagnosis. The way it is recognized is that mood disorders can have a seasonal pattern, so those folks who have major depression or bipolar disorder are indeed more prone to having depression in the winter time, and that’s fairly well established.”

Q: Why does the weather alter mood, and how?

A: “We respond quite a bit to light. Our bodies are evolved to be awake during the day — to have certain activity, meal and sleep patterns. The brain has several internal clocks, and the main clock — the most robust clock — is set primarily to daylight and high-intensity blue light. So the brain keeps track of day and night, and it influences mood, energy, sleep, appetite, even thinking.

This is true whether you have a mood disorder or not … but folks with mood disorders seem to be especially vulnerable to having their internal clocks get deranged or get off cycle.”

Q: Does something happen chemically in our brains when we’re deprived of sunlight?

A: “It’s not as simple as a chemical. … We have all sorts of genes in our bodies, and roughly 23 percent of our genome has a seasonal variation. So the level to which our genes are expressed, roughly a quarter of our genome changes with the season, which is pretty dramatic actually. And it seems to especially influence the immune system. For whatever reason, immune-related genes seem to have a particularly prominent seasonal variation.”

Q: So what can people do to help themselves?

A: “I do recommend light therapy for some patients — especially if there is a seasonal pattern. But what’s interesting is light therapy doesn’t just work for seasonal depression. It also works for non-seasonal depression. And even without doing light therapy, one can try to maximize the amount of light one gets throughout the day by trying to get outside, staying active.”

Q: What exactly is light therapy?

A: “It is full-spectrum and higher-intensity light. So if you’re in your office, the amount of light is so much less than if you are outside in full sunlight — you wouldn’t believe the difference. It’s pretty phenomenal, but our brain doesn’t see it as being as big of a difference because we get sort of used to it.”

Q: Can you quantify the difference?

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A: “If you’re in a family living room, it would be about 50 lux (a measurement of light intensity.) In an office building, it would be about 80 lux. But if you’re outside in direct sunlight, it can be as high as 100,000 lux. It’s a huge difference … and we often use 10,000 for light therapy.”

With that in mind, UI Student Health and Wellness this fall — for the first time — launched a “light therapy” program allowing students struggling with seasonally amplified depression to check out light boxes for free.

UI Student Health stocked itself with an initial supply of 46 boxes, which students can borrow for two weeks at a time. Since the program’s start Nov. 1, 110 students have checked out boxes, with 34 out on loan as of Friday, according to Patrick Rossmann, a behavioral health consultant and fifth-year doctoral student.

Q: How are students instructed to use the boxes?

A: “The recommendation is that they use it consistently each day, and the recommendation is it’s best in the morning — so turning it on and having the light on while you work on the computer, read, eat breakfast as it’s doing its thing.”

Q: Have students reported benefits from the light box?

A: “In checking it out, we have a pre-survey and a post-survey that’s a questionnaire around symptoms and change. And we are finding that there is a reduced level of depression. In asking, did you find it useful and effective, the majority find it useful or effective, which is really encouraging.”

l Comments: (319) 339-3158; vanessa.miller@thegazette.com

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