Psychotherapy Beats Light Treatment for SAD

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The treatment addresses attitudes, thoughts and behaviors which contribute to SAD.

For the initial study, 69 people with SAD were randomized to receive light therapy, CBT, a combination of the two or neither (they were wait-listed).

Six weeks after treatment started, 80 percent of those receiving combination therapy were in remission vs. 50 percent for CBT and the same for light therapy. Only 20 percent of those in the control group experienced remission.

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The current paper adds data collected a full year after the first treatment.

This time, 5.5 percent of those receiving the combo therapy and 7 percent of those receiving CBT alone had a SAD recurrence, vs. 36.7 percent of those treated with a light box. That represents a sharp drop in the number of people benefiting from light therapy, possibly due to the inconvenience of the method, which must be used every day.

In this study, only four people continued their light therapy into the following winter.

Individuals receiving CBT alone also had less severe depression than either of the other two groups, indicating that CBT may be the way to go.

What's puzzling is the fact that combining CBT and light therapy didn't work as well as CBT alone. "There's something about being initially treated with the combination that seems to water down the effectiveness the next winter," Rohan said.

This all seems to suggest that CBT could be the way to go.

"It's [working] from the very first symptom, which for most people is October or November through March or April. The initial time in treatment is less with CBT and it's also meant to be over and done with -- the treatment that keeps on giving," Rohan said. "Once you're finished, you don't have to be in treatment every winter for the rest of your life, whereas you are expected to get the light box out and use it for every day of fall and winter. You undergo [psychotherapy], you learn, you keep using the techniques in the future."

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