Wednesday, August 29, 2007

Light treatment for postpartum depression

If one good thing came from Tom Cruise's public insult of Brooke Shields - and the cadre of new mothers who have taken antidepressants for postpartum depression (PPD) - it's that people started paying attention to a disorder that is often hidden because of fear and stigma.

Postpartum depression is characterized by any of the following symptoms over a 2-week period or more within the first year after delivery: restlessness, irritability, sadness, hopelessness, feeling overwhelmed, crying a lot, having little energy or motivation, appetite changes, sleep disturbances, difficulty focusing, remembering or making decisions, feeling worthless or guilty, loss of interest in pleasurable activities, withdrawal from friends and family, headaches, chest paints, heart palpitations, hyperventilation, not having interest in the baby, and thoughts of hurting the baby or oneself. There are a number of contributing causes of PPD. These include rapid changes in hormonal levels (specifically progesterone and estrogen) after delivery, low thyroid levels, exhaustion from delivery, broken sleep patterns, feeling overwhelmed by parenting responsibilities, doubting one's ability to be a "good" mother, stress resulting from changes at work and home, feeling a loss of one's pre-pregnancy identity, having less free time, and having less control over time.

The two most common treatments for PPD are talk therapy and antidepressants. Findings from a study released this month, however, show that light therapy may be a promising new treatment, especially for women who refuse medication because they are breastfeeding or simply do not like the idea of taking medicine. Light therapy involves exposure to specific wavelengths of light, or very bright full-spectrum light, for a prescribed amount of time. It has been used successfully to treat a variety of conditions, including acne, seasonal affective disorder, and non-seasonal depression.

Researchers in Canada studied the effects of light therapy on 15 women who had a diagnosis of PPD but who were not taking antidepressants. The women were assigned to one of two treatment groups: 30 minutes of daily light exposure between 7AM and 9AM using a 10,000-lux bright light or 30 minutes of daily light exposure between 7AM and 9AM using a 600-lux red light. After 6 weeks of light therapy, both groups of women showed significant reductions in their depressive symptoms, with an average of 49% improvement. Additionally two women (one in each group) experienced a complete remission, or absence of PPD symptoms.

While these findings are encouraging, this study followed a small number of patients, and the authors acknowledge that more work needs to be done to determine whether this approach is as useful for PPD as it is for seasonal affective disorder. Additionally, none of the patients were suicidal, so nothing can be said about how light therapy might work for women with more severe symptoms. However, the upside is that more treatment options offer women more control over how their depression is managed, which can improve the ability to cope with the disorder.

If you are interested in learning more about light therapy, the Mayo Clinic has a nice piece with information about the risks and benefits. You also can talk to your doctor or mental health care provider about whether light therapy may be worth a try.

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