We must guide patients in obtaining an optimal device for bright light therapy and give them the following instructions about doing the light therapy. (Note: the instructions below are provided to help treating clinicians counsel their patients.)
In which months?
Start the light therapy preventively when you notice the days getting clearly shorter. If you are in the US, one way to remember the duration of the light therapy is to start light therapy when Daylight Savings Time ends on a Sunday in the Fall and continue until Daylight Savings Time starts again on a Sunday in the Spring. However, many persons may find it helpful or necessary to start a little earlier than that, e.g., end of September, and continue a little beyond the date when the clocks change, i.e., middle of March.
Even if you start to feel completely fine, do not stop doing the light therapy. Continue the light therapy throughout the winter.
Most people don’t find it a problem to miss the light therapy if they have to go away for a one or two days.
What time of the day ?
You cannot just do bright light therapy at any time of the morning or the day. It is central to how light therapy works to do the light therapy as soon as possible after you wake up. Try to maintain a fixed time to go to sleep and to wake up, as much as possible, so that you will be doing the light therapy at approximately the same time every day.
Sometimes, the bright light therapy can be split between the morning and evening. This is not the best way to do bright light therapy. The best time to do it is early in the morning, very soon after waking up. Do not do light therapy in the evening without discussing it with your doctor. The technical reason for this is that while bright light therapy in the morning moves your circadian rhythm in one direction (towards earlier in the day), doing bright light therapy in the evening may move your circadian rhythm in the opposite direction (towards later in the day).
In any case, do not do the light therapy too late in the evening because it can impair your sleep.
How should I use the light box or lamp?
The light box should be placed at an appropriate distance from your eyes (as described in the Manufacturer’s instructions)
The bright light therapy works through your eyes. Therefore, your eyes must remain open for it to work. Make sure you don’t fall asleep while getting the treatment.
It is fine to read or to eat your breakfast while getting bright light treatment.
Your face should be generally facing towards the light.
However, it is not required that you keep looking directly at the light. In fact, this is likely to be harmful.
Rather, glance briefly at the light from time to time, e.g., about once a minute.
How long should the session last?
If you are using a 10,000 lux lamp (recommended), start with doing the light therapy for about 30 minutes every morning.
Most persons feel a bit better within a few days of starting bright light therapy. If there is not a clear improvement after about 14 days of doing the light treatment, increase the duration of treatment to 45 or 60 minutes every morning.
Continue to discuss with your treating clinician the details of how you are using the light therapy. Small changes may be suggested in order to individualize the treatment to help you best.
Dr. Raymond Lam on Seasonal Affective Disorder-Part 1 (YouTube video)
Dr. Raymond Lam on Seasonal Affective Disorder-Part 2 (YouTube video)
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