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Thursday, 14 December 2017
Light Therapy

Seasonal changes in mood and wellbeing

For about 25 years it has been recognised that for some people autumn and winter time bring about a significant change in their mood, energy levels and sleep. In its severe form, this is known as Seasonal Affective Disorder (SAD). Some people find they experience many of the symptoms of SAD but to a less severe extent; this is known as ‘sub-syndromal SAD’.

During the autumn and winter, many people who experience these types of symptoms notice:

  • Increased appetite (especially for carbohydrates or sweet foods)
  • Sleeping more than during spring and summer
  • Loss of interest in usual activities
  • Sadness or low mood
  • Fatigue / tiredness / lack of energy
  • Poor concentration
  • Weight gain

 

How light therapy works

Image of the sun and a cloudIt is thought that these seasonal changes in mood / wellbeing are due to lower levels of natural light in autumn and winter, which in some people can lead to:

  • changes in the chemicals and hormones in the brain which affect mood and energy levels
  • circadian rhythms (the “body-clock”) getting out of sync, which affects sleep and appetite

Light therapy can help to improve mood by mimicking natural light, and acting on these mechanisms to reverse their mood-lowering effects.

The research does not clearly state whether or not light therapy is helpful. Some studies say it is as effective as anti-depressants, others say it is not. Unfortunately the results are not clear because the studies are not always comparing like-for-like light therapy. However, a lot of people find that light therapy helps them, and it is very often recommended for people with seasonal mood variations. The light boxes have already helped some people in the Pain Clinic here. The only way to find out for you personally is to take a box out on loan and try it!

 

Is light therapy for me?

If you regularly experience the symptoms described above during the autumn and winter months, light therapy might help.

 

How can I get a light box on loan?

We are only able to loan our light boxes to people who are patients of our service. If you are a patient of ours and would like to take a light box out on loan for a trial of light therapy, please contact either Ms Maggie Spong, Consultant Clinical Psychologist or Dr Toni Miles Specialist Clinical Psychologist at the Pain Clinic on 01473 703435.

If you find a light box to be helpful, we can let you know about places locally and online where you would be able to buy your own.

 

How does a light box work?

You will be given full verbal and written instructions on using the light box when you take one out on loan. You can keep the box for two weeks to try it out, and after the trial is over you return the light box to us.

Using a light box is simple and safe. You only need use the box for between 15–30 minutes a day, and so long as the box is positioned correctly, you can get on with your daily activities whilst using the box.

 

So why is a pain clinic loaning out light boxes?

We know that there are clear links between mood and pain. When our mood is low, the chemicals and hormones which are released by our brains act to ‘turn up’ the pain signals in the nervous system so that we feel more pain.

If you routinely experience lowered mood in the winter, light therapy can help to boost your mood, and this can help with your pain. In that way, for some people, light therapy can act as an additional element in their ‘tool kit’ to manage pain.

 

Are there any other ways to boost my mood in the autumn and winter?

Absolutely. You might find the following helpful:

 

Make time for enjoyment

When we are feeling low, it is easy to stop doing pleasurable, enjoyable or fun things because we are too tired or cannot get motivated. It is really important to make the effort to keep doing these things even if you feel low, because they will help lift your mood.

Think about things that you enjoy doing (however simple), and make the time to do one or two of them every day. Here are a few ideas to get you started:

Having a friend over for coffee, chatting on the phone, visiting a museum, having a bath, buying yourself some flowers, people-watching from a café, day dreaming, having your hair done, stroking a dog or cat, baking, watching a favourite film, listening to music, doing a hobby, singing, looking at a photo album, doing art or crafts, cooking a nice meal, reading a good book.

 

Spend time with other people

It can feel hard to be around other people when your mood is low or the pain is worse. It is really important to keep socialising with other people though; although it may feel like a big effort, people almost always find that being around others is worth the effort. It is proven to help reduce isolation and loneliness and to help improve mood.

Plan to spend time with a friend, relative, partner, or doing something in a group. If you work, then why not suggest lunch with a colleague?

If you’re not able to spend time with someone face-to-face, then there are other ways. You could phone someone for a chat, talk to them over a free internet video link (like Skype), or meet people in an internet chat room.

 

Keep active (remembering to pace yourself)

Exercise has been shown to be really beneficial because it causes the release of chemicals in the brain which make us feel good.

Exercise doesn’t have to be strenuous to be good for you! Maybe you could try going for a short walk, swimming, doing a bit of light cleaning around the house, or doing some gentle stretches. Anything that gets you moving is good – there’s no need to go to a gym, or to exercise hard.

Remember to pace yourself – it should be possible to do it in a way which doesn’t make your pain worse.

 

Be aware of your thoughts

It has been shown that when people are feeling low, they can get into patterns of thinking which make them feel even worse. For example, people might give themselves a hard time for not being able to do something, predict that the worst will happen, or focus on all the things that are going badly in their life.

Becoming aware of your thoughts, and their impact on how you feel can be really helpful. The next step is to challenge the thoughts that make you feel low. Ask yourself:

  • Is this thought really true? Is there any evidence against the thought?
  • If your friend thought this, what would you say to them?
  • Are you predicting the worst, blowing things out of proportion, jumping to conclusions, trying to read someone else’s mind, or only focusing on the negatives?
  • Are you giving yourself an unnecessarily hard time by thinking this? Could you be kinder and fairer to yourself by changing the thought?
  • What might be a more helpful, balanced alternative way of thinking about things?

 

Noticing the positives

When your mood is low, it can be easy to focus your thoughts on the bad, difficult or upsetting things in life. Spending time reflecting on some of the positive things that happen can help to balance this out, and focus your mind on the things that are going well.

Spend a few minutes at the end of each day, and reflect on three positive things that have happened in the day (if you can think of more than three, even better!). They might be very modest, or they may be bigger.

Examples might be spending time with someone you care about, someone being helpful in a shop, a bill being for less than you expected, having helped someone out, achieving something you set out to do, the sun shining, having had something nice to eat, or a favourite programme being on TV.

 

Get a good night’s sleep

This is important for managing mood. For some people with chronic pain getting a good night’s sleep can be difficult, but there are some steps you can take to help:

  • Avoid caffeine (tea, coffee, cola, chocolate) from mid-afternoon onwards – caffeine stimulates your body and brain, and can take hours to fully leave your system.
  • Do something relaxing in the hour or so before bed (such as: reading, listening to a relaxation CD).
  • Have a warm bath an hour or so before bed.
  • Have a warm milky drink before bed, and don’t go to bed hungry.
  • Make sure your bed is warm enough (but not too hot).
  • Ensure that the room is dark and quiet – wear earplugs / an eye mask if you need to.
  • Write down anything that’s worrying you, or anything that’s on your mind, and promise yourself you’ll deal with it or think about it in the morning. This can help stop worrying thoughts running through your head when you’re trying to sleep.
  • Avoid try to avoid watching the clock when you’re trying to get to sleep. This can make you stressed about not sleeping, which makes falling asleep even harder.
  • If you have problems falling asleep, try relaxation exercises. Breathe deeply and evenly, in through your nose and out through your mouth. Picture a relaxing scene in your mind’s eye and try to concentrate on every element of it.
  • Take any sleeping medication as prescribed. Some people find natural herbal sleep remedies, available from a chemist, helpful too.

 

Be kind to yourself

Acknowledge that autumn / winter may be a particularly difficult time because of seasonal changes in your mood. Give yourself permission to give yourself extra care, attention and kindness. Looking after yourself and prioritising your needs will help you to manage your mood as effectively as you can.

If you need to make adjusts to your routine or do things a bit differently during the winter months (for example achieving a bit less during the day so you can go for a walk at lunchtime), try not to feel bad. Feeling guilty or frustrated will only make you feel worse.

 

Is using a light box the only way to get more light in the autumn and winter?

Not necessarily. Try the following suggestions to get as much natural light as you can during the winter months:

  • Remove clutter from window sills and remove net curtains to allow more light into a room
  • Pull curtains right back to allow in as much light as possible
  • Sit by a window
  • Take regular outdoor walks during the day time
  • Make an extra effort to get outside on a sunny day and at midday
  • Especially on sunny autumn and winter days, make time to be outside (remember to wrap up warm!)
  • If you can, have a ‘winter sun’ holiday!

 

Sources of information and support

PLEASE NOTE: This page contains links to websites operated by other parties. The inclusion of such links does not imply endorsement of any or all of the material or opinion expressed on these websites, or of the other parties. The Ipswich Hospital NHS Trust does not control such websites, is not responsible for the content on them, and will admit no liability for their use.

You can also find more information and advice on dealing with low mood in winter on the following websites. (If you do not have the internet at home, there will be free access in your local public library. If you are not confident about using the internet, the librarian will be able to help you get online.)

 

NHS Choices

Computer icon  www.nhs.uk/Conditions/Seasonal-affective-disorder

 

BUPA

Computer icon  http://hcd2.bupa.co.uk/fact_sheets/html/sad.html

 

Healthtalkonline

Healthtalkonline.org.uk presents short videos of people talking about their own experiences of low mood, about how to manage it, and ways of helping to improve things

Computer icon  http://www.healthtalk.org/peoples-experiences/mental-health

 

Seasonal Affective Disorder Information and Advice

Computer icon  www.sad.org.uk

 

Seasonal Affective Disorder Association

Computer icon  http://www.sada.org.uk/