Although light boxes can be purchased without a doctor’s prescription, it’s best to obtain professional guidance when starting bright light therapy, because it can be harmful to people with certain psychiatric conditions and some eye diseases, including diabetic retinopathy. In addition, if used incorrectly, bright light treatment can make things worse by causing insomnia, agitation, or other problems. If a light box is deemed inappropriate, another lighting device — the dawn simulator — may be a promising alternative. As the name suggests, this device provides light that gradually brightens to simulate the rising of the sun; it is normally used when waking up. For more information on both devices, visit www.cet.org.
Winter blues expert and psychiatrist Dr. Norman Rosenthal observes that SAD sufferers tend to produce a surplus of insulin during the winter months; this excessive insulin production “appears to subside” with bright light therapy and with the advent of summer. You should therefore closely monitor your blood glucose levels and insulin doses when either starting or stopping bright light therapy. Be sure to tell your primary-care doctor or endocrinologist about your bright-light therapy, even if it is being supervised by another care provider such as a professional counselor.
Just as extra light can help people with winter blues, restricting light exposure — by spending more time indoors and using special blue-blocking glasses — may benefit those with summer SAD. (See www.cet.org for information on blue-blocking glasses.) In addition, the information in the following sections can help improve your mood regardless of the season.
You probably already know that exercise benefits people with diabetes by improving the body’s sensitivity to insulin, whether it is produced by the pancreas or injected. But physical activity can also help chase away the winter blues. Numerous studies confirm what runners have long maintained: that vigorous exercise makes you feel better. Even if you never work out long or hard enough to get that “runner’s high,” modest physical activity is likely to leave you feeling more energetic and content. Good exercise choices may include fast walking or jogging, bicycling, aerobics, or vigorous yoga. For some people, making exercise a social activity by doing it with a partner or attending a class may lead to an even greater mood-lifting benefit.
Researchers have found that exercise is as effective as medication in relieving depression. Exercise triggers the release of the energizing hormones norepinephrine and epinephrine (also called adrenaline) and the mood-enhancing chemicals serotonin and endorphins. Regular exercise also improves blood circulation and stimulates the growth of nerve cells in brain regions responsible for mood regulation.
It’s best to start exercising before you’ve fallen into a wintertime slump. If you’re currently physically inactive, see a doctor first to see if there are any precautions you may need to take to exercise safely. Check your blood glucose before, during (at least at first), and after exercise, and make any necessary adjustments to exercises to accommodate your fitness level — for example, simplify aerobics moves or alternate jogging and walking as needed. Consult your doctor if you have any concerns about starting or intensifying your exercise regimen.
Eat, drink, and be merry
Maintaining a healthy diet is likely to benefit your mood. Science has begun to identify some of the specific dietary nutrients that play a role in maintaining good mental health, including omega-3 fatty acids, B vitamins, vitamin D, calcium, and iron. Leafy green vegetables, citrus fruits, and beans are good sources of vitamin B9, also known as folate. Cold-water fish such as salmon, sardines, and anchovies are high in omega-3 fatty acids. Calcium can be found in a variety of dairy and fortified products, as well as in canned fish (with bones) and some leafy green vegetables. Good sources of iron include a variety of fortified products, including many breakfast cereals, as well as chicken liver, oysters, beef, spinach, and several varieties of beans.