What is your approach to recommending bright light therapy devices to patients with (seasonal) depressive disorders?

Bright light therapy has a strikingly positive evidence base for seasonal affective disorder, major depressive disorder, and even bipolar depression. I recommend shopping for a lamp with 10,000 lux, a large format, diffusion screen (possibly fewer headaches), and one that is on a stand so that it shines down on the face. Cet.org. is a reputable site with a very helpful buying guide. Unfortunately, a good lamp is fairly expensive, but it might be a waste of money and convince users that BLT is in...

I screen for seasonal depression in every initial interview. I tell patients in whom I suspect it to get either a 10,000 lux white light or a smaller blue light, to sit 18-24 inches from it, and look at it for a few seconds repeatedly for 15-20 minutes initially, using it for longer periods as the days get shorter. I explain that this is NOT full-spectrum light and that it will not cause cataracts or tanning. I tell them it is ok to buy a second-hand, but to avoid green lights, which may damage ...

Similar to above, with the following addition, question:

• For patients with bipolar depression with seasonal exacerbations, I counsel them on shorter duration intro and that 12-2 p.m. exposure may be safer (less likely to trigger mania) than early morning, as long as insomnia is not occurring.
• The type of device to recommend has become confusing, especially with so much data on fluorescent lights, but LEDs being more common now and cheaper. Ideally, the 10,000 LUX standard would be verified some...

I agree with the above posts on this. Most of the data is on 8000-10,000 lux intensity for 40-60 minutes for seasonal depression, used in the morning. For patients who have bipolar disorder, I recommend 20-30 minutes to minimize cycling into hypomania. There is data showing that some patients who have bipolar disorder respond best to using the light at that dose at noon.

Of note, too much use of the light can lead to side effects such as nausea, headache, dizziness, and insomnia. I had a patient...

Not much to add to these superb answers. I also tell my patients with SAD to BEGIN therapy mid-September to early October.

I heartily endorse light therapy. Very little, if any downside, easy and inexpensive, and has a great response rate. Many people are sensitive to the change in photoperiods. SAD can be a "soft sign" of cyclothymia and bipolar disorder.

Must be 10,000 lux. I like Northern Lights and Sunbox, but so many others have come out as well, and the cost has gone down.

Agree with all of the above. Northern Light Technologies offers a number of SAD lights. I would note that for individuals on antidepressants already, the SAD light may reduce the need to raise antidepressant doses in the winter months, which many patients appreciate.

I live and work in Texas, and I recommend that patients take a walk or sit in the afternoon sun for at least half an hour.

The only thing I would add is that I typically will tell people to use it before the sun comes up, essentially tricking their brain that the daylight hours are longer. Some very cautious use after sunset may be warranted in select patients, but definitely start with very brief exposure and increase slowly if doing this. I find that even in sunny Arizona, people are still affected by shorter daylight hours. Not like the PNW, but it happens.