Q: For most of my life I have suffered from depression during winter. My doctor has given me antidepressants, but I would like to avoid these if possible. Is there another way of dealing with it? I understand it is due to a lack of sunshine. I try to go for a walk most afternoons, but sometimes it is too cold or snowy. Do those special lights really work?
A: You have what is known as seasonal affective disorder, or SAD. Many people suffer from this form of depressive illness, which is now thought to be hereditary. According to recent studies, only about one person in 10 receives adequate treatment. It is true that none of the treatments are 100 percent effective, but in a 1999 study, 60 percent of sufferers got better when they received a concentrated dose of bright light treatment. This appeared to work better when it was given in the morning. The treatments were given for 90 minutes, six days a week. Only 30 percent of those who got the light therapy in the evening improved.
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Antidepressant medications work as well, but you might be able to manage with the light treatments alone. You may wish to discuss this with your doctor. You should only use fluorescent light boxes approved by the Canadian Standards Association. One of the least expensive methods is to buy a visor with lights attached at a fixed distance from the eye. This costs about $100.
More expensive units that can be programmed to simulate an “artificial dawn” range in price from $150-$600.
You are correct to go for outdoor walks as often as possible, but it would be better if you walked in the morning instead of the afternoon. Do not wear sunglasses as they will filter out the light too much. It is important that the sunlight enters the eyes. It seems to have an effect on the part of the brain that is situated just behind the eyes. This is where the pigment and brain chemical melatonin is made. Better still, take a holiday in some warm sunny place like the Caribbean where you can get more useful hours of sunlight.
Diabetics need leg checks
It is well known that about two-thirds of diabetics, particularly those with late onset or type 2 diabetes, do not adequately control their blood sugar levels.
In those who are older than 50, this situation can lead to peripheral artery disease, which is a hardening and narrowing of the arteries.
Most people assume that arterial disease mainly affects the heart and brain, leading to heart attacks or strokes, but the circulation in the legs is also affected. Without proper treatment the arteries in the legs may become completely blocked and cause the loss of the limb.
There is a simple check that should be performed by all diabetics over 50. It involves checking the blood pressure at the ankles and comparing it with the reading from the arms.
If there is a significant difference, then the arterial circulation to the legs could be compromised.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
