A new Yale invention may brighten the lives of those suffering from the “winter blues.”
Paul Desan MED ’93, director of the Winter Depression Research Clinic at the Yale School of Medicine, recently submitted an design for a new version of a light box — one of the most popular treatments for Seasonal Affective Disorder — to the Food and Drug Administration for review. If approved, the device would be the first-ever light box to be federally recognized as a treatment for the illness, greatly improving the light box market for consumers by increasing both transparency and competition, Desan said. One student with SAD interviewed said she would welcome the device for its convenience and efficiency.
SAD is a highly prevalent, annually occurring mood disorder whose symptoms include depression and low energy. Scientists believe the symptoms are a result of a shift in the patient’s sleep cycle, also known as the circadian rhythm. While approximately 11 million Americans will suffer from SAD at some point during one of the four seasons, most individuals feel its effects from October through March, causing it to be known colloquially as the “winter blues.”
In all people, decreased exposure to sunlight during the winter triggers increased levels of melatonin, a hormone that induces sleep. In SAD patients, this increase in melatonin causes the “winter blues.” For our distant ancestors, “winter blues” was an adaptive advantage, similar to hibernation, Desan said, because the scarcity of food during the winter forced people to conserve energy.
“It is hard to escape the implication that [SAD] is a biological reflex,” Desan said. “Now, of course, it is not adaptive.”
Desan, an assistant professor of psychiatry at the Yale School of Medicine, co-founded the Winter Depression Research Clinic approximately 11 years ago to study the body’s instinct to slow down during the winter months. His primary goal has been to develop a more effective and convenient light box treatment for SAD.
Traditional light boxes are large lamps that use very bright light to simulate exposure to sunlight. Many patients suffering from SAD choose to sit in front of the light box for 30 minutes each morning and each evening, tricking the body into producing melatonin levels as if the mornings came earlier and the nights later.
The light box is an attractive treatment because of the relatively few associated hazards compared to its benefits, said Gerard Sanacora, director of the Yale Depression Research Program.
“As a physician, we look at treatment with a risk-benefit approach,” Sanacora said. “With the light box, the ratio is very high in its favor.”
Despite the effectiveness of the current light box model, which Desan said “works like a charm,” he sees room for improvement in terms of convenience and efficiency. Not only are the boxes inconvenient because of their size and need for a fixed power supply, they are inefficient because they produce a broad spectrum of light instead of targeted wavelengths of light that are most effective at countering SAD, Desan said.
After 10 years of design, in partnership with manufacturers, Desan has proposed a new light box that is smaller, more portable and battery-powered. Its targeted light spectrum emissions give it twice the impact as previous light boxes in the same amount of time.
Desan said he is not discouraged by the fact that the FDA has never approved this type of device before. He attributed past FDA decisions to the failure of past research groups to present enough evidence to convince the FDA of their device’s effectiveness.
FDA approval would greatly improve the quality of treatment for individuals suffering from SAD by highlighting those products with legitimate clinical backing, an important role given the wide range of light boxes confronting consumers and physicians, Desan said. Federal recognition would also make it illegal for other companies to market light boxes as treating SAD, giving Desan’s light box a “monopoly status” until the FDA approves another product. Desan, who has no financial stake in the product itself, said this status would spur other companies to innovate products for FDA approval, thereby helping consumers in the long run.
A Yale freshman with SAD, who wished to remain anonymous because of the sensitive nature of her illness, said that she would benefit in multiple ways from FDA approval of Desan’s device. She said that searching for the proper device in an unregulated market is confusing, and FDA approval would provide a stamp of legitimacy to certain products. She added that the new light box would be more convenient than her current one, and she would likely purchase it if it received FDA approval.
“There is hassle associated with my current [light box] being this big and having to plug in,” she said. “If I could lie on my back and use it, that would be great.”
John Krystal MED ’84, chair of the Department of Psychiatry at the Yale School of Medicine, said he shares the belief that convenience is an important factor for a treatment to be successful.
“If its not handy, people will not use it,” he said.
Desan said that he expects the FDA to come to a verdict within the next half year.