This little book tells you about bright light therapy for depression and sleep, how it can be used, and why we need it. CHAPTER 4 USING ANTIDEPRESSANT DRUGS AND COUNSELING

Table of Contents Chapter 1 We Wilt In The Dark Chapter 2 Depression & The Droopy Dims Chapter 3 Treating Depression With Light Chapter 4 Using Antidepressant Drugs & Counseling Chapter 5 Bright Light For Depression: The Scientific Evidence Chapter 6 Advanced & Delayed Sleep Phase: Bright Light Treatment Chapter 7 Side Effects of Bright Light Chapter 8 Good Sleep Habits Chapter 9 About This Web Book: Printing & Copying Chapter 10 About Dr. Kripke

Remember the caution with which we started discussing light treatment of depression.  You should check with your doctor.  If you have significant depression, especially if you might have a major depressive disorder, if bad mood is keeping you from your normal activities, or you have any thought of hurting yourself, you should certainly get your doctor's help.  It is nice that light is sometimes enough for the mild problems, but please do not count on bright light alone if your depression is really causing trouble.

This caution is similar to the caution with other health aids.  An average person knows how to get some exercise, but if you have had a heart attack, you would need to discuss exercise with the doctor.  An average person knows it is good to skip dessert, but if you have diabetes or a stomach ulcer, you need to discuss your diet with your doctor.  Similarly, people might try light for minor problems by themselves, but for serious depression, a doctor's advice should always be sought.

We used to think about bright light as an alternative to the better-known treatments for depression, especially as an alternative to antidepressant medicines and counseling.  That is not my viewpoint any more.  Experience shows that even when light treatment helps, it is often not enough.  We realize now that light treatment works very well in combination with the antidepressant drugs.  These are drugs like Prozac, amitriptyline, trazadone, and lithium--there are quite a few kinds which are good.  In fact, it seems that bright light often works best along with antidepressant drugs.  The benefits may multiply each other.

I really am quite enthusiastic about the antidepressant medicines.  These medicines help millions of people.  Government authorities think Americans should be using antidepressant medicines MORE, because more people can be helped.  Antidepressant medicines are not at all like cigarettes, alcohol, and narcotics or cocaine, which Americans consider addicting drugs of abuse.  Antidepressant drugs are not addicting.  Depressed people do better with antidepressant medicines than without them. There have been literally hundreds of studies which prove that the antidepressant medicines provide more benefit than they do harm. 

Do not be scared by all the sensationalism about side effects which has appeared in certain news media.  It is true that all antidepressant drugs have side effects, but so do water, sugar, salt, apples, oranges, and just about anything else in life.  Compared to driving an automobile, much less a riding a bicycle or trying roller blades, antidepressant drugs are very safe.  For most people who are really depressed, the side effects of antidepressant drugs are worth it.  Talk to your doctor about it.

Counseling is also good for depression.  There are new kinds of psychotherapy of depression which really do work.  There have now been many studies which prove the benefits of modern psychotherapies of depression.  A long time ago, I was trained in the old Freudian methods of treating depression (dream analysis and talk about childhood, for example), and I have to say that I do not believe that those old methods helped depression much.  Doctors trained in the newer methods accomplish more.  Psychotherapy certainly is safe.  In all probability, psychotherapy plus antidepressant drugs works better than the medicines used alone.  There have been no good tests of the combinations of bright light and psychotherapy or bright light, medication and psychotherapy, but there is every reason to think that these combinations would be safe and more effective than a single treatment.  Indeed, the combination of bright light, antidepressant drugs, and psychotherapy might be the best for many people.  I wish there were more results of testing light's benefits to describe, but no treatment in medicine has been tested long-term in every possible combination with other treatments.  Talk to your doctor about psychotherapy.

Continued in Chapter 5

Brighten Your Life, in all its formats, including this eBook, Copyright ©1997-2002 by Daniel F. Kripke, M.D., all rights reserved.