There are a number of treatments that can be used to help manage the symptoms of seasonal affective disorder (SAD). You may need to use a combination of treatments in order to get the best results. Your GP will be able to advise you on the most suitable treatment for you. They include:

Light therapy

This is a popular and often effective way of treating SAD. Light therapy involves sitting in front of a specially designed light box, which mimics outdoor light. A light box can encourage chemical changes in your brain that help to improve your mood.

A light box gives out a very bright and intensive light. Light intensity is measured in lux. Ordinary light bulbs give out 200-500 lux. To effectively treat SAD you need a light that gives a minimum intensity of 2500 lux. Light boxes come in all shapes and sizes and can range from a small table-top box to larger, wall-mounted fixtures.

Light therapy works for two out of three people with SAD and has few side effects. In rare cases, light therapy can give you a headache, affect your vision, make it difficult for you to sleep or leave you feeling irritable. If you experience these symptoms it is best to speak to your GP for further advice.

How does light therapy work?

You should begin using light therapy treatment in autumn or as soon as your symptoms begin. Sit a metre away from the box, facing the light but do not look directly at it. You may need to spend anything from 30 minutes to three hours in front of the box, depending on the strength of the light that it emits. Carry on with everyday tasks, such as reading, eating or working and use the therapy at a time which is convenient for you. However, it is best to avoid using it late in the evening, as it could make it difficult to get to sleep.

Most people will notice that symptoms improve after three to four days. However, in other people it can take up to six weeks before they begin to notice a difference. If light therapy has not worked after using it for six weeks then it is probably not a suitable type of treatment for you.

How do I get light therapy?

Light boxes are not currently available on the NHS. If you contact a SAD support group or organisation, such as the Seasonal Affective Disorder Association, they should be able to give you a list of suppliers. Boxes normally start at £100. There are a range of products available; for example, light visors that shine bright light into your eyes through a portable device fitted into a visor, and dawn stimulators that are usually connected to an alarm clock and mimic sunrise, allowing you to wake up gradually.

It is very important that you do not use home-made light units, tanning lights or tanning beds as a form of light therapy. They are not designed for use with SAD and usually emit a high level of UV rays, which can seriously damage your skin and eyes.

Before undertaking light therapy, it is best to visit your GP to discuss what type of therapy would be best for you. Your GP will be able to give you advice on how you should be using this type of treatment and will also be able to advise you on what to do should you suffer from any kind of side effects.

Although light therapy very rarely affects your vision, if you are using it on a regular basis then it is important that you tell your optician. You should also ensure that you have an eye test at least once a year. If you have existing eye problems it is best that you talk to your GP or optician before undertaking any form of light treatment to ensure it does not aggravate your condition in any way.

Antidepressants

If your symptoms are particularly severe, your doctor may suggest that you also take antidepressants. Antidepressants can take two to four weeks before they begin to work and it is important to keep taking your medicine until your doctor advises otherwise. The antidepressants used to treat SAD are usually only taken during the winter months as symptoms tend to naturally improve by the spring.

You will normally be a prescribed a type of antidepressant known as selective serotonin reuptake inhibitors (SSRIs). These work by increasing the level of serotonin (a chemical found in the brain which affects mood). The most commonly prescribed SSRI medicines are fluoxetine, paroxetine and sertraline. Side effects are relatively rare, although you may experience some vomiting, diarrhoea, nausea or headaches. If you have these symptoms, go back to your GP for further advice.

Talking treatments

Talking treatments, such as counselling and psychotherapy, may be useful in helping you to cope with your symptoms. This type of treatment can help you to identify negative thoughts and feelings that may be making your symptoms worse. A counsellor or psychotherapist will help you to devise positive ways to deal with any feelings of stress and anxiety and can provide you with information on self-help, such as relaxation and breathing exercises.

Ask your GP about the availability of such treatment in your area.

Self-help

There are a number of simple lifestyle changes you can make to help improve your symptoms. These include:

• trying to get as much natural sunlight as possible - even a brief lunch time walk can be beneficial,
• making your work and home environments as light and bright as possible,
• sitting near windows when indoors,
• getting regular exercise, particularly outdoors in daylight if possible,
• eating a healthy, well-balanced diet,
• avoiding putting yourself into stressful situations, and
• talking to your friends about your condition, so that they can understand why your behaviour changes in the winter months. They should be able to give you better help and support if they understand your condition.