Tag Archives: anxiety

Everything You Need to Know About Light Therapy for Seasonal Affective Disorder (SAD)

Toronto Naturopathic Doctors - Seasonal Affective Disorder (SAD)

The value of light therapy for treatment of Seasonal Affective Disorder (SAD) is well established1, 2, 3, but for those interested in  pursuing this approach, the obstacles are the time to determine which product will be potentially most effective, and how to implement use  to achieve a therapeutic effect.

The purpose of this post is not to contain “everything”, just everything you need to know to how to find a product that works for you, and how to use it effectively (that’s a disclaimer).

My interest in this topic is somewhat personal: as I age, I am becoming aware that during the winter, my mood changes. To describe my mood as “depressed” is a disservice to people experiencing depression. It’s more of a “joylessness” or “flatness” that I begin to notice after a few weeks of dark days (this post is prompted by the consistently gloomy autumn we’ve had this year).

On one hand, this is a part of life (my grandmother had the same experience – she simply accepted it and carried on).

On the other, as someone (Peter Beard, I think) remarked: “I wake up every morning because this is my one and only life” (or words to that effect, I’m paraphrasing from memory). Life is too short to let half the year(/your life) pass feeling flat.

What is the Relationship Between Light and Seasonal Affective Disorder (SAD)?

In a nutshell, the relationship between mood and light is thought to be rooted in our circadian rhythm (although the scientific support for this is at this time not robust2). Certainly, there does exist evidence that secretion of melatonin (a hormone secreted by our pineal gland) and  is disrupted in persons experiencing Seasonal Affective Disorder (SAD).3

The main roles of melatonin in our body are to regulate our sleepiness and wakefulness, and in sexual development.

Melatonin levels respond to the level of light in the environment: it is “turned off” by bright light.5 Melatonin levels are nearly undetectable during the day.5

How Does Light Therapy for Seasonal Affective Disorder (SAD) Work?

If the thought is that low levels of light during the winter, affect melatonin levels, affecting wakefulness and mood, the obvious course is to use a Light Therapy products during the day to replicate exposure to daytime light.

Specifically:

The guideline is 30 to 60 minutes daily of “white light” exposure, between September and April.1

If using a “blue light” product (which is required if melatonin suppression is the goal of Light Therapy use) 45  minutes of morning exposure is the prescription.1

You will notice that most products (at the time of this writing) deliver “white light”, and even the manufacturers customer service professionals appear not to know why a blue light mode is offered on certain devices (“Some people prefer the ‘softer’, blue light”) . Blue light (specifically light in the 446-477 nm wavelength) is required to suppress/regulate melatonin.6

Further, “full spectrum” light, although most closely mimicking natural light, does not offer any benefit with regard to mood, over white light.7

Importantly, although it is blue light specifically that supresses melatonin secretion, white light (full spectrum or otherwise) has proved to benefit mood for those experiencing Seasonal Affective Disorder (SAD).1

What Type of Light Therapy Product to Purchase

Light therapy products have become much more accessible over the years. Early in my practice I recall recommending these products, but the options were very limited, and the cost was in the 300 CAD range (and that’s in early-aughts dollars). Today, many products are available in the 50 to 100 CAD range (a dilemma of a different sort).

Based on the the research to date, important considerations when purchasing a Light Therapy product include:

  1. A blue light option (446-477 nm is the most potent wavelength region providing circadian input for regulating melatonin secretion–  I haven’t seen a product offering this level of detail in their listing; this is more of a “FYI” for if you do). Many products deliver only white light.
  2. 10’000 lux of brightness. Some products deliver less (e.g., 7500 lux).
  3. Ultraviolet (UV)-free light (all the products I have seen are UV light-free).

Other, more personal considerations may include:

  1. Ability to adjust light intensity. I have read reviews that describe certain products as delivering an uncomfortably bright light.
  2. Low glare. Most products I’ve seen appear to be “low glare”, but not all advertise this feature.
  3. Full spectrum light. Although full spectrum light confers no special benefit with regard to affecting mood when compared to white light, it offers what many consider a more pleasant  (natural light-mimicking) light.
  4. Some products may emit a “hum” which may be annoying to some.
  5. Use of LEDs as a light source to minimize maintenance.
  6. Portability. Most of these units are quite small, but some have more a “notebook” design that lends itself to transport for use at home and at work.

This is the product I’ve found that checks the important boxes (PureGuardian SPA50CA Light Therapy Lamp for those reading this after this link has expired).

Apparently it does emit a hum at higher intensity settings, and uses a timer that must be reset after 30 minutes maximum (i.e., you are not able to simply set it beside you and work for an entire afternoon), but those are shortcomings I can live with.

How to Implement a Light Therapy Strategy for Reducing Seasonal Affective Disorder (SAD) Symptoms

As written above, it is blue light specifically that suppresses melatonin. To reduce melatonin levels at waking, to increase alertness and “set” your circadian rhythm for the day, expose yourself to blue light, for 45 minutes at waking.

These devices suggest use at a distance of 6 to 24 inches (ideally seven inches), so depending on your morning routine, you will have to either wake earlier (and retire earlier the night before) to rest, read, meditate, etc. in bed for 45 minutes while using the device on your nightstand; or set it in your washroom vanity and/or kitchen counter as you begin your morning routine.

If you purchase a portable device, you can bring your unit to your workplace and position it on your desk, within 24 inches from where you sit (obviously this recommendation applies to those working in an office environment. These devices are not effective as “ambient light” – i.e., placed on the other side of the room as you go about your day). You can expose your self to bright (10’000 lux) white light for the day, but research suggests 30 to 60 minutes at least. My personal experience suggests between the hours of approximately 3:00 PM and 5:00 PM (the hours when in Toronto it begins to become perceptively darker), work well.

If you are considering a second, white light device for workplace use, here are two options that you might consider, a sleek, lower cost, option; and a slightly more expensive, adjustable light intensity option.

Lastly, there are obviously many other strategies that naturopathic medicine offers for management of Seasonal Affective Disorder (SAD), depression, anxiety and other mood disorders, that are outside the scope of a blog post, but if you are at the point you want to be aggressive about resolving your mood issues, get in touch.

Jonah Lusis, ND

References

  1. Thase ME. The new “blue light” intervention for seasonal affective disorder (SAD). Medscape [Internet]. [cited 2018 Dec 5]. Available at: https://www.medscape.org/viewarticle/550845?src=ppc_google_rsla_ed_ous_9mo&gclid=Cj0KCQiA6JjgBRDbARIsANfu58GtBXQyoQes-QHyfMws5tvmpq4UYR72kn4aVHKFIUgg_mPusQtl7q4aAnljEALw_wcB.
  2. Menculini G, Verdolini N, Murru A, Pacchiarotti I, Volpe U, Cervino A, et al. Depressive mood and circadian rhythms disturbances as outcomes of seasonal affective disorder treatment: A systematic review. J Affect Disord. 2018 Dec 1;241:608-626.
  3. Srinivasan V, Smits M, Spence W, Lowe AD, Kayumov L, Pandi-Perumal SR, et al. Melatonin in mood disorders. World J Biol Psychiatry. 2006;7(3):138-51.
  4. Sargis RM. An overview of the pineal gland: maintaining circadian rhythm. endocrine web [Internet]. [cited 2018 Dec 5]. Available at: https://www.endocrineweb.com/endocrinology/overview-pineal-gland.
  5. National Sleep Foundation [Internet]. Melatonin and sleep. [cited 2018 Dec 5]. Available at: https://www.sleepfoundation.org/sleep-topics/melatonin-and-sleep.
  6. Brainard GC, Hanifin JP, Greeson JM, Byrne BGlickman G, Gerner E, et al. Action spectrum for melatonin regulation in humans: evidence for a novel circadian photoreceptor. J Neurosci 2001 Aug 15;21(16):6405-12. Available at: http://www.jneurosci.org/content/21/16/6405.long.
  7. Lighting Research Centre [Internet]. How valid are the claims regarding full-spectrum lighting sources? [cited 2018 Dec 5]. Available at: https://www.lrc.rpi.edu/programs/nlpip/lightinganswers/fullspectrum/claims.asp.

 

 

Posted: 2018 Dec 6

Bowen Therapy: Help for Pain and Anxiety

Toronto Naturopathic Doctor

A little known, but gentle and effective technique for reducing pain and inflammation, and reducing anxiety: Jonah Lusis, ND introduces you to Bowen Therapy!

 

 

For more great videos on health and wellness, visit our YouTube Channel!

 

Posted: 2017 May 24

Bowen Therapy (Bowen Technique)

Toronto Naturopathic Doctor

Relax, Reset, Rebalance

Bowen Therapy is a gentle, hands-on treatment used primarily to decrease pain and increase mobility, and reduce stress and anxiety.

A much more gentle intervention than many conventional pain treatments (e.g., some forms of chiropractic manipulation or physiotherapy), Bowen Therapy may be an effective alternative for patients having much pain (e.g., severe injury), increased sensitivity to pain (e.g., having fibromyalgia); or simply requiring gentle treatment (e.g., elderly, children).

It addresses an area that most pain therapies ignore, “centralized pain”, “re-training” your brain to “let go” of it’s pattern of experiencing pain, particularly chronic pain, pain that has not responded well to other treatments (e.g., “frozen shoulder”), and pain in persons seeming to be extraordinarily sensitive to pain (e.g., fibromyalgia).

Bowen Therapy may be used as either a primary treatment, or supportive treatment. As a primary treatment, it typically used for chronic conditions affecting the musculoskeletal system (e.g., fibromyalgia, recovery from injury, “frozen shoulder”).

It is used as a supportive treatment in cases where the autonomic (“unconscious”) nervous system appears to be in need of being “re-set” (e.g., constipation, heart palpitation) or for stress management (e.g., management of anxiety).

The goal of treatment using Bowen Therapy is usually complete resolution of pain, or complete return to previous function.

Benefits of Bowen Therapy

Bowen Therapy may be of benefit, in some capacity, the treatment almost any health condition.

A study titled “The Bowen Technique: a study of it’s prevalence and effectiveness”, presented at the University of North Carolina, Chapel Hill found that Bowen Therapy treatment was:

  • 95% effective in the treatment of temporomandibular joint (TMJ) dysfunction
  • 88% effective in the treatment of neck pain
  • 85% effective in the treatment of low back pain
  • 83% effective for the treatment of stress and tension
  • 80% effective for the treatment of fibromyalgia
  • 80% effective for the treatment of hip pain
  • 75% effective for the treatment of non-specific pain conditions

Other research has demonstrated that Bowen Therapy:

  • Improves decreases tremor and improves sleep quality in patients having Parkinson’s disease
  • Reduces heart rate variability (“normalized” heart rate) and slows heart rate in 100% of fibromyalgia patients
  • Increased neck range of motion, and decreased “disability scores” in patients having trapezitis (neck and shoulder pain, and restricted movement) when combined with physiotherapy
  • Improves mobility and function; and reduced pain (on average) from a score of 7/10 to 1/10 in 100% of “frozen shoulder” patients
  • Reduces migraine headache frequency and/or intensity in 80% of patients
  • Improves symptoms of restless legs syndrome in 3/5 patients receiving treatment
  • Completely reduces symptoms of carpal tunnel syndrome in 4/6 patients receiving treatment, with complete resolution of symptoms  in 3/4 of these cases
  • Significantly improves motor function of patients recovering from stroke
  • Improves sleep and a general sense of well-being

A single Bowen Therapy treatment has been demonstrated to:

  • Decrease feelings of depression by 51%
  • Decrease feelings of anxiety by 21%
  • Decrease fatigue by 41%
  • Decrease sense of tension by 62%
  • Decrease feelings of anger by 47%
  • Decrease confusion by 33%
  • Increase flexibility (in hamstrings) by 26-34%

Learn more about the experience of, and results from Bowen Therapy treatment for a range of health conditions at these sites:

  • Details of some of the research described above, including studies on treatment of frozen shoulder, carpal tunnel syndrome and restless leg syndrome
  • Six case reports, including treatment of disc injury
  • Six case reports, including treatment of sciatica, carpal tunnel syndrome and “tennis elbow”
  • Six case reports, including treatment of hip and knee pain, and recovery from knee and lung surgeries
  • Six case reports, including treatment of various neuralgias
  • Five case reports, including treatment of sciatica; and further insight into potential mechanisms of action of Bowen Therapy
  • Four case reports, including treatment of migraine headaches, sciatica and “frozen shoulder; and further insight into potential mechanisms of action of Bowen Therapy
  • Three case reports, including recovery from auto collision
  • 22 case reports, including treatment of children, “frozen shoulder” and sciatica
  • Seven case reports, including treatment of “frozen shoulder”, carpal tunnel syndrome and migraine headaches
  • Two case reports of treatment of Parkinson’s disease
  • A case report of treatment of migraine headaches

What to Expect

Bowen Therapy involves application of gentle pressure to the muscles, tendons and other soft tissues at specific points, and in specific sequence.

Treatments are approximately 30 to 45 minutes long, and performed weekly or bi-weekly for the first four sessions.

Treatment frequency is then individualized to your response to treatment (e.g., if your pain is resolved, but returns after three weeks, treatments will be scheduled at three week intervals).

Improvements in pain levels or function may be experienced after as few as one treatment.

Bowen Therapy at Toronto Centre for Naturopathic Medicine

Bowen Therapy treatments at Toronto Centre for Naturopathic Medicine are performed by Du La, ND and Jonah Lusis, ND, both of who have been certified in Bowen Therapy by the Bowen Therapy Academy of Australia since 2002.

Bowen Therapy treatments provided at Toronto Centre for Naturopathic Medicine are covered by most extended healthcare plans.

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Reflexology for Stress Relief: The Answer is Right Under Your Feet

Toronto Naturopathic Doctor

Welcome to the third and final installment in our March series on anxiety.

This week, we’re discussing an old-but-new therapy that’s making a comeback as one of the easiest and surprisingly effective treatments for stress: reflexology.

How Reflexology Works

Based on the same principles as acupuncture, reflexology is foot massage taken to a scientific level of precision. The idea is that certain areas of the feet correspond to particular organs and systems of the body. By applying pressure to those key areas, it’s possible to stimulate flagging health and correct imbalances.

The reflexology points for the eyes, ears, nose and throat are on the toes; the heart and lungs are represented near the ball of the foot; the reproductive organs on the ankles. Other points correlate to specific emotional states and other parts of the body.

During treatment, a reflexologist uses varying pressure to massage part or all of the foot. Areas that are sensitive often correlate to health issues that need attention. Even if nothing is sensitive, though, reflexology can be relaxing and therapeutic, especially for people who are depressed, anxious or who have chronic pain or stress.

Research Studies on Reflexology and Anxiety Show Significant Results

Several reflexology studies have shown improvements in pain and anxiety among cancer patients and chronic pain sufferers. In one study, pain and anxiety decreased during reflexology treatments, while another study showed these benefits were long-term improvements.

Compared with a control group, hospitalized cancer patients who received reflexology had almost ten times the improvement in their anxiety as that of the group that received special attention but no reflexology. (The reflexology group’s anxiety dropped an average of 7.9 points on the test scale, while the control group dropped only 0.8 points on average).

What’s more, physical results after reflexology show that it’s not just a question of a soothing effect. A double-blind study published in 2012 found that healthy volunteers experienced a drop in their cardiac index, a major indicator of heart function used in intensive care. It’s also used as a physical measurement of anxiety and stress, so a modest drop like the one observed is generally a good indication of lessened stress.

Reflexology for Anxiety

Like many mental health issues and stress-related concerns, anxiety is a problem that can creep up on you and that can be difficult to treat. There are so many options and the choice of a practitioner – not to mention, the first visit to that practitioner – can be overwhelming. At TCNM, we know that there is no one perfect treatment that fits the bill for everyone. It’s important to find the right doctor and the right approach for you.

Are you interested in trying out reflexology or another anxiety treatment for yourself? Learn more about reflexology at our reflexology page, or  give us a call or e-mail us at info@tcnm.com to book a session with Melissa or Melanie, our resident RMTs and reflexology experts.

 

 

Posted: 2013 March 18

St. John’s Wort: A Balm for Anxiety

Toronto Naturopathic Doctor

St. John’s Wort is well known for its effectiveness against depression, but what many of our clients don’t realize is that this herb is also a powerful tool in fighting stress-related anxiety. According to the National Center for Complementary and Alternative Medicine, St. John’s Wort is as effective as antidepressant drugs in treating mild to severe cases of depression. One study even found it more effective than Prozac.

Known by its scientific name, Hypericum perforatum, St. John’s Wort is widely prescribed for depression in Europe for a simple reason: it works. But depression isn’t its only use in herbal medicine.

St. John’s Wort and Anxiety

Most of the research on St. John’s Wort in the past two decades has focused on depression, and as a result we’ve found that family doctors and psychiatrists tend to dismiss the other benefits of St. John’s Wort in favour of the tried and true – depression. Even natural health experts and knowledgeable health food store staff won’t necessarily know that St. John’s Wort can do a lot more than relieve depression, and that one of its greatest benefits is the ability to combat anxiety.

Although St. John’s Wort has little impact on acute anxiety caused by trauma, it does have an effect on slow-building stress that leads to chronic anxiety. The “Bible” of eclectic herbalism, King’s American Dispensary (Felter & Lloyd, 1898), recommends St. John’s Wort for “nervous affectations.” Anxiety connected with stress or depression is exactly the sort of case indicated.

Prolonged stress is an increasingly common concern among our clients at TCNM. Whether it’s due to work stress, family obligations, or financial worries, ongoing stress is exhausting and we know it can eventually lead to loss of interest in life, mild depression, withdrawal from key relationships and painful anxiety. St. John’s Wort has come to be one of the first treatments we consider in cases of stress-related anxiety and depression.

Bear in Mind – The Importance of a Medical Opinion

As with any other health condition, the bottom line, of course, is to speak with a health care professional before you attempt to treat or diagnose the problem yourself. Punch “anxiety” into any search engine and you’ll get millions of results, but very little practical information. Finding the right solution for your particular mind and body is a puzzle that takes training and medical experience to solve.

Even natural remedies like St. John’s Wort can have side effects and interactions with other supplements or medication you might be taking. That’s why it’s so important to consult a medical or naturopathic doctor before you start taking any treatment for anxiety. Our naturopaths might spot a crucial piece of information in your medical history or symptomology that’s easy to overlook if you’re too close to the problem, and save you months or years of trouble.

Interested in learning more about the benefits of St. John’s Wort? Looking for a natural solution for anxiety and depression in Toronto? Please contact us at info@tcnm.ca or give us a call.

 

 

Posted: 2013 March 1

The Four Foundations of Children’s Health: Pillar One – Whole Family Health

Toronto Naturopathic Doctor

In October, I had the privilege of meeting with a group of parents to discuss strategies for optimizing their children’s health. The discussion centered around four “pillars” of health that form the strong foundation for future health.

The first “pillar” of the foundation is “Whole Family Health”. By “whole family health”, what I refer to, is the state of harmony in the family unit as a whole, a concept absent from most discussions on “personal health”. Parental stress has an enormous impact on our children’s well-being. In this video Dr. Gabor Maté, a leading authority in the area, gives a great overview of this concept.

The majority of brain development and maturation occurs from birth to the age of three. Over this period our brain weight increases from 18% to 80% of our adult brain weight. One of the ways parental stress directly affects children is through the creation of anxiety, which in turn affects their brain development during this crucial time.

Uncontrollable, chronic adversity experienced early in life may cause detrimental effects in developing brain architecture, as well as the chemical and physiological systems that help an individual adapt to stress, setting the stage for a lifetime of anxiety.

Two common stressors for most of today’s parents are:

  1. The pressure to be a “perfect” parent
  2. Over-scheduling

The pressure to be a “perfect” parent

A better goal (for you, and your child) is striving to be a “happy, healthy parent”. Here are some guidelines to help with this concept, offered by renowned herbalist and women’s health expert, Aviva Romm, MD.

Over-scheduling

In our family, we address this by limiting our children’s involvement in extra-curricular activities, even if this means they will never be a multi-lingual, prima ballerina, concert pianist, with black belt in karate, who will attend Oxford on a Rhodes Scholarship.

We tend to forget that even without extracurricular activities, our children have nearly the equivalent of a full-time job with their regular schooling.

We commit to a “family day” on week-ends, on which we schedule no activities, but rather spend time together allowing the day to unfold as it will, and lastly, are open to giving them a day away from school if we feel they need it.

These relatively simple steps have allowed us to be more relaxed, and therefore “present” as parents, and resulted in more relaxed and happy children.

In my next posting, I will elaborate on the second “pillar” of health we discussed, “Family Nutrition”.

Please join us in moving our families towards better health and improving the health of our children and future generations!

Until next time,

Du La, ND, Acupuncturist

 

Posted: 2014 December 4