A team of psychiatrists and psychobiologists at the National Institute of Mental Health has relieved medical depressions in certain patients just by--literally--lighting up their lives a little.
No surgery, no long-term psychotherapy, no drugs. Just a bright shining light.
These are cautious people, these government scientists, and they are being very careful not to make exaggerated claims. Their patient group was a small one: 30 people were monitored this past year; 11 received the light treatments. Nevertheless, the sense of excitement at NIMH is genuine and despite their cautions and their caveats there is a sense of being on the leading edge of new and important discoveries.
After a period of careful screening to identify victims of what one termed "the gray sky syndrome," the scientists installed special bright white lights in the homes of volunteers with a history of winter depression and summer elation. The volunteers were asked to switch on the lights during the winter for the three hours preceding dawn.
Meticulous, video-taped interviews documented the onset of depression with the end of summer, the elevation of mood after the lights were used and a relapse into depression when softer lights were substituted. Every one of the 11 showed some improvement, some mood elevation after exposure to the lights.
Somehow, the researchers believe, their brains were fooled into thinking winter was summer. (Not a mean trick when you think about last winter's weather. But of course it wasn't weather at all--it was light . . .a lengthening of the day.)
Dr. Norman Rosenthal, NIMH staff psychiatrist, Dr. Thomas Wehr, acting chief of Clinical Psychobiology, and other scientists began speculating some months ago that certain depressions were related to seasonal changes. In one case a woman who likened herself to a hibernating bear described how her winter depressions came on earlier and lasted longer when she was living in Canada, and lessened when she moved south.
The NIMH scientists are researchers in the Circadian rhythms by which humans live, sleep, wake, eat, mate and by which many other human neurological and hormonal feedback systems operate. Similar cycles govern the activities of animals and birds. The volunteers in this study had an unusual sleep disorder for depressed patients. Whereas sleeplessness is a not uncommon companion of depression, these winter depressives slept too much and might have, if left to their own devices, slept the winter away . . .
The scientists speculated that somehow it was the length of the daylight hours that determined the seasonal mood swings. An inability, perhaps, of certain persons to process light the way most others do.
But it is not only the success of the light that intrigues the researchers. The characteristic syndrome of manic summers and depressed winters was discussed in this column last June and a call put out for volunteers. As a result, there were some 3,000 responses from other parts of this country and Canada. They were mostly women, almost universally creative, sensitive and intelligent who identified their own cyclic experiences with those of the patient who thought she'd have been better off as a bear.
"One thing we learned," says Wehr, "was that there are many, many people out there with the syndrome and one thing that was striking to me was the similarity from one person to the next. The description of their symptoms became almost monotonous. That sort of sameness really gives you a much stronger feeling that we're dealing with a real syndrome, not just a whole lot of different people's vague reactions. There are more human bears around than we thought."
From one of the letters:
October was fine, warm and beautiful. The beginning of November wasn't so bad, but by Thanksgiving the depression wasn't just a once-in-awhile thing anymore. It was there. By Christmas I was scared to death. My thoughts were so frequently suicidal. The only way I escaped was to stay in bed and sleep . . .
"Changes in energy were another striking characteristic," says Wehr. "These people would be quite energetic in the summer and in the winter would feel it was a struggle just to go through the motions of the minimum requirements of housework or job. These people, mostly artistic, creative, would be quite productive in the spring or summer but would more or less shut down in the winter. If they were functioning creatively as a means for a living, they would be engaging in a sort of holding operation, struggling to just get the basics they needed to get by with and hope for improvement in the spring."
Rosie Springer (not her real name) is one of the NIMH volunteers.
She has permitted videotapes of her interviews with NIMH psychiatrists to be made public, so long as her anonymity is protected. She is young, married and holds a responsible job.
From the first interview, in early winter, 1981:
Rosie sits, unresponsively, and answers the psychiatrist's questions unemotionally, flatly. Her eyes seem puffy. Her demeanor is not so much sad as, perhaps, "blah."
As she responds to questions it becomes clear that she is truly depressed. She has trouble concentrating, feels her thinking has slowed down, is "not very hopeful about the future" and avoids seeing people. She is not very interested in sex and is "hungry almost all the time." She has, she says sadly, gained 20 pounds in the past couple of months and "craves sweets."
When she is not eating she is sleeping: about 10 hours a night with a two-hour nap during the day when she can get it.
Changes in eating habits were another common characteristic of the volunteers.
"They did eat more when they were depressed," says Rosenthal. "A majority spoke of a carbohydrate craving. You know, before hibernating animals go into hibernation they overeat and fatten up so they can lie dormant during the winter. And they undergo a food preference change. Rabbits will preferentially eat carrots in the summer, but as late summer and fall come on, they begin to eat potatoes because they need to accumulate extra weight.
"There is an interesting difference between the hibernating animal and our subjects, in that the animal then stops overeating and our subjects continue to overeat during the winter."
Rosenthal also speculates that "the depression itself may, in part, be secondary to the environmental demands. Many of these people say they're not really depressed, they're just kind of running on low energy. After all, if you ask a hibernating bear to get up and clean the bathrooms, she'll get depressed."
The patients almost universally expressed a desire to withdraw from others. Rosenthal sees this, too, as related to a need to hibernate.
Rosie Springer, after several weeks under the lights appears a changed person. Her eyes are bright and sparkling. She is animated, smiling. Her whole body seems to exude energy and enthusiasm. She tosses her head as she speaks, almost coquettishly. There is a lilt to her voice.
On the whole, she says, "Life is pretty good." The future "appears better than it has for a long time."
She finds she needs less sleep and is "getting in the mood to diet." Her sociability and interest in sex have been reawakened.
A graduate student in psychology who became interested in the project kept track of another dozen--in addition to the original 30--from various parts of the country.
"We noted a change around Daylight Savings Time in the mood ratings," says Rosenthal. "But of course we were all skeptical because we didn't know if this was just a group of people who read an article and convinced themselves that they had this problem. . .We didn't even know these people would all get depressed as we predicted.
"And then once they did, the idea that they would respond to light as they have is really quite amazing. . ."
From another letter:
As a child I used to gaze out the window in the wintertime and dream of the summer, counting the days. I don't experience severe depression in the winter, although everything seems gloomier and more difficult. There is a sadness looming over everything. I find it hard to stay on a diet and feel I need to fill up with food to keep warm. It is more difficult to concentrate during work. I often feel like going home afterwards to hibernate like a bear rather than going out with friends. Once the warm weather arrives I feel a burden has been lifted from me. I feel freer and happier. People seem friendlier . . .
The last videotape of Rosie Springer was made after her bright lights were switched to ordinary soft lights. She was weepy, discouraged, sleeping 12 or more hours a day and gaining weight again.
Her relapse into depression reflected that of the other subjects as well. But they all recovered again quickly when the bright lights were switched back on. As spring approached, the lights were tapered off and the natural summer feelings of well-being re-emerged.
Future work will probe the biochemical aspects of the syndrome, and experiment with the amounts of light needed. (Some animals, for example, can be tricked into coming out of hibernation by a mere flash of light in the morning and another in the evening, artificially elongating the day.)
From a science professor's letter:
I have long been convinced that sunlight affects me as described . . .I have often in jest expressed the concern for my being in a lower state of evolution since I seem to function by photosynthesis. . .