Winter Blues Got You Down? Here’s How Light Therapy Might Help—But It’s Not for Everyone.
Dear Readers, let’s shed some light on a topic that affects many during the colder months: Seasonal Affective Disorder (SAD). It’s more than just disliking the short, gray days of winter—it’s a form of major depression with a clear seasonal pattern. But here’s where it gets controversial: while bright light therapy is a popular treatment, it’s not a one-size-fits-all solution. Let’s dive in.
Dear Dr. Roach,
I’m 78 and dread the winter months. I’ve heard light therapy can help with SAD, and I’d like to try it. How do I choose the right light box? Does it need to block UV rays, and how much light is enough?
— K.J.
Dr. Roach Responds:
SAD isn’t just about feeling down when it’s cloudy outside. To be diagnosed, you must meet specific criteria for major depression, such as changes in appetite, sleep, concentration, and persistent feelings of sadness or loss of interest—lasting at least two weeks. If diagnosed, treatment might include medication, bright light therapy, or both. For light therapy, the standard is 10,000 lux of white light for 30-60 minutes daily, ideally first thing in the morning. When choosing a device, ensure it’s UV-free. And this is the part most people miss: if you have eye conditions like cataracts or glaucoma, consult your eye doctor regularly.
But here’s the twist: While bright light therapy works wonders for seasonal depression, it’s ineffective for the inverse form of SAD, where symptoms worsen in summer. Controversially, some argue that relying solely on light therapy without addressing underlying mental health issues could delay proper treatment. What do you think? Is light therapy a cure-all, or just one piece of the puzzle? Let’s discuss in the comments.
Asthma, Steroids, and Osteoporosis: A Delicate Balance
Dear Dr. Roach,
I’m 71 with osteopenia in my spine and hips, and osteoporosis in my forearms and wrist. My asthma has worsened post-COVID, and my pulmonologist prescribed 320 mcg of budesonide and formoterol daily. I’m worried about steroids worsening my bone health, but my doctors say it’s fine. What’s your take?
— A.W.
Dr. Roach Responds:
Here’s the hard truth: sometimes, doctors must prescribe treatments knowing they might cause harm. In your case, the low dose of inhaled steroids you’re taking has minimal impact on fracture risk, according to most studies. Plus, you’re already on Fosamax, a solid treatment for osteoporosis. Your doctor’s recommendation to use a spacer is spot-on—it ensures more medication reaches your lungs and less lingers in your mouth, reducing the risk of fungal infections like thrush.
But here’s the debate: While inhaled steroids are effective for moderate to severe asthma, some argue that the risks to bone health outweigh the benefits, especially in older women. Should we prioritize breathing over bones, or are there safer alternatives? Share your thoughts below.
For those with severe osteoporosis, non-steroid asthma treatments are available. Regular bone density monitoring is key, especially as we age. If you’re concerned, email your questions to ToYourGoodHealth@med.cornell.edu. Let’s keep the conversation going—your health depends on it!
