Harvard Women's Health Watch

In the journals: Cognitive behavioral therapy more effective than light therapy for relieving seasonal depression

Up to 10% of Americans, about three-quarters of them women, have depressive symptoms at roughly the same time every year, usually November through March. The condition is known as seasonal affective disorder (SAD), and the first-line treatment today is light therapy — daily exposure to artificial bright light. But according to a study led by investigators at the University of Vermont, cognitive behavioral therapy (CBT) is more effective. The results, which appeared in the September 2009 issue of Behavior Therapy, showed that the benefits of CBT lasted for at least a year.

That finding may be especially significant given the shortcomings of light therapy. The patient has to sit near a "light box" every day for 30 to 45 minutes throughout the winter, a regimen that many can't maintain. There's also a risk to people with certain eye conditions, such as macular degeneration and diabetic retinopathy. Light therapy can trigger mania or hypomania in people with bipolar disorder. Most important, 20% to 50% of patients just don't respond to it.

Antidepressants, including bupropion (Wellbutrin) and fluoxetine (Prozac), are also an option. But like any drug, they can cause side effects. And they need to be taken daily throughout the winter. By contrast, participants in the CBT study met twice a week for six weeks and needed no additional "doses" of therapy.

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