Our internal biological clock, which strongly influences our daily patterns of alertness and energy, sleep and waking is very sensitive to early morning light. Since the sun rises later in winter the biological clock is vulnerable to drifting later, leaving us tired in the morning. The essence of morning light therapy is to correct that drift, thereby restoring normal morning energy and alertness.
It is OK, as long as the lenses are not colored or tinted (which would reduce the lux level). We advise not using contacts for the first few days of treatment (regular glasses would be fine), since some people initially experience eye irritation, which might be exacerbated with contacts. Either way, if eye irritation proves a problem, using artificial tears just before and after the treatment session sometimes helps.
We always recommend that the box be placed at or above the line of sight in order to project light downward toward the eyes. One should never stare directly into a light box, but instead orient forward and concentrate on reading, writing, breakfast, etc., in the illuminated field.
A short dose of light from your SAD Light Box 10 minutes before you feel the slump set in, but often, the afternoon slump dissapears when the morning light dose is increased.
Not to worry! However, add those extra few minutes to the end of the session.
You need to start using the your SAD Light Box about 15-30 minutes before your normal wake-up time, which will start to move your internal clock earlier. Every few days, you can advance your wake-up time by 15-30 minutes, depending on how early you can wake up easily. Over a period of time -- which might last two weeks, for example -- you will be able to approach your target (early) wake-up time. This cannot be done abruptly!
The first thing to do is use your light box whenever you get up, even if its late. This will have the effect of making it easier to rise earlier. Every few days, advance the time of your light therapy sessions earlier by 15 minutes or more. Before long, you should be able to wake up earlier without effort. The major reason one cannot get up earlier, no matter when you go to sleep, is that the internal circadian rhythm clock in the brain is not producing its wake-up signal until later. The essence of morning light therapy lies in resetting the internal clock earlier.
There is no clinical evidence of any adverse effects of light therapy. A small number of users will experience headache, eyestrain, jitteriness or mild stomach discomfort. Usually these symptoms pass after a few exposures. When they do not, the dose of light (intensity or exposure duration) needs to be reduced.
Normal glasses can be worn during a light treatment. If you have tinted glasses that change in the light, place your glasses right up to a regular fluorescent bulb (obviously, not while wearing them!) If they remain clear, there will be no problem. If they darken, you should leave them off.
Headache (though not migraines) in some cases is reported as a side effect during the first few days of light therapy, but the problem usually resolves quickly. If not, reducing light dose for examle, with shorter treatment sessions often provides relief. Extremely few users have experienced long-term, intractable headache under light therapy.
Aerobic exercise can indeed complement the antidepressant and energizing effect of light therapy. Problem is, many people suffering depression cannot garner the motivation to maintain a regular exercise regimen. We suggest first starting with bright light therapy, and as its beneficial effect sets in, taking the opportunity to begin a daily aerobic routine. As for diet, regular healthy measures are all we would suggest. Once the antidepressant effect from light sets in, it becomes far easier to control excessive carb intake.
You will know if you are getting too much light if you become speedy, hyper, or high to the point that you're slightly out of control ('hypomanic') . . . or if you start having insomnia with unreasonably early waking. In most cases of SAD, patients sense correctly that they no longer need supplementary light exposure by early May. That said, however, new investigations are pointing to year-round use of light therapy by patients with chronic (non-seasonal) depression. In certain circumstances, then, this strategy can be useful.
As the amount of light received from a light box depends on the distance from the source, there is no problem leaving your light box switched on during the day if you are not physically close to it. By remaining outside the active therapeutic range of around a metre you can enjoy the enhanced ambient room illumination.