Table of Contents


Special article: 

Light precautions
Managing winter depression

A few simple behaviors - like adjusting bedroom shades -
can make a big difference.


Persons with mood illnesses are more sensitive to light than others (see the current article of the month below):  Too much light causes manic symptoms, too little light causes depressive symptoms.  In the spring and summer there is too much light, in the fall and winter there is not enough light.  You thus need to modulate your light exposure to avoid causing mania in the spring and summer and depression in the fall and winter.  Mood episodes go together, so if you want to prevent winter depression, you should also try to prevent summer mania. 

Fall and Winter (September-January)

In winter, there is not enough light.  Therefore you will sleep in the morning longer than you should, and that will throw off your circadian rhythms. You therefore need to increase your light exposure.

  • Keep shades and curtains open at night, to maximize morning light exposure.  This is the simplest thing you can do to reduce your risk of winter depression.  
  • Don't wear sunglasses in routine activity, or use them less than you normally would (or limit only to driving).Go for walks around noontime, without sunglasses, for up to an hour.
  • Go to bed at a regular time at night. Wake up at a regular time in the morning; use an alarm.

Light therapy

Plan on spending $200-300.  There is no need to spend more.  The dose is 10,000 lux (most lightboxes are at that dose).  There are many companies - the internet engines will help you.  Use indirect light; do not look into the light box directly (treat it like the sun). Have it on the table while you read or eat in the morning. Dose is 25- 30 minutes to one hour as long as depression persists. Use the lightbox daily initially, and then reduce use to every other day for prevention. Use the lightbox in the morning (before 10 AM): remember you're trying to replace the morning sunlight which declines in winter.

"Keep shades and curtains open at night, to maximize morning light exposure. This is the simplest thing you can do to reduce risk of winter depression."

Spring and Summer (March-August)

In summer, there is too much light.  Therefore you will sleep in the morning less than you should, and that will throw off your circadian rhythms. You therefore need to decrease your light exposure:        

  • Wear sunglasses at all times.
  • Wear an eyemask to sleep. If possible, get room-darkening shades and close them.
  • Close all curtains at night, to minimize morning light exposure.
  • Go to bed at a regular time at night. Wake up at a regular time in the morning, but not early.

The PL Bottom Line

There are simple guidelines that all patients can follow: Lift the shades in the winter, and pull them down in the spring and summer.  Use an eyemask (or get room darkening shades) in spring/summer.  If you're still depressed in winter despite raising the shades, use a light box in the morning as explained above. 

Stay tuned for next month's Special article:

The use of antipsychotics in bipolar depression

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