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P&S Journal

P&S Journal: Spring 1996, Vol.16, No.2
Clinical Advanaces
A New Day Dawns for Many With Depression

For about 36 million people in the United States, the coming of winter heralds more than just colder temperatures and shorter daylight hours. It also brings on a type of depression called seasonal affective disorder. For some of these people, shorter daylight hours lead to clinical depression; others suffer less severe winter doldrums.

Researchers at P&S and at the New York State Psychiatric Institute (NYSPI) have developed an electronic device to help people who tend to become despondent in the fall and winter, particularly those in the north latitudes where diminished daylight hours are most dramatic. The device mimics the dawn's early light of spring or summer.

Dr. Michael Terman, associate professor of clinical psychology and director of the Clinical Chronobiology Program at NYSPI, and his colleagues theorized that if they could imitate the lighting pattern of the spring and summer, they might be able to treat people who suffer from winter depression and winter doldrums.

The device, invented by Dr. Terman; Bill Perlman, a private engineering consultant; and Stephen Fairhurst, a computer specialist and research scientist at NYSPI; consists of a computer program that drives a light simulation device. The Macintosh computer-based program calculates the dynamically changing pattern of outdoor light for any latitude, longitude, and day of the year.

The program drives a light diffuser, trademarked under the name Pillow Light, that bathes a sleeping area in a naturalistic dawn and dusk of summer and spring. Pillow Light was created by the lighting designer Gary Regester of SphereOne Inc. in New Jersey. The dawn/dusk simulator functions like an automated light dimmer and reproduces the gradually increasing light intensity of daybreak and the decreasing light of dusk. The inventors received a U.S. patent in 1994 and assigned their rights to NYSPI's Research Foundation for Mental Hygiene Inc.

About 100 patients have been evaluated in dawn simulation studies at CPMC and at Harborview Medical Center in Seattle, Wash. Treatment success for depression has been similar to that seen during post-awakening artificial bright light therapy (for which Dr. Terman holds another patent) but no time needs to be set aside for daytime treatment sessions.

"The dawn/dusk simulator works while the patient is asleep, penetrating the eyes when they are closed," says Dr. Terman. "Within a few days, the person adapts to the natural summer pattern. In most cases, patients who relied on antidepressant drugs no longer needed them."

Several clinical research centers have installed the dawn/dusk simulator system, including Harvard Medical School, the Hebrew Home for the Aged in Riverdale, the National Institute of Mental Health, and the University of Zurich.

Based on the success of the device, Dr. Terman and his collaborators have begun exploring expanded uses. For example, a simplified, portable home consumer model has been developed. This model uses Pillow Light but is driven by a chip in a small control box rather than by a computer.

The investigators are also examining the possible use of the device for people who are not clinically depressed but who could benefit from simulated light patterns. This includes people who oversleep but are not depressed, patients with chronic fatigue syndrome, demented elderly patients with disrupted sleep, night shift workers, and people who suffer jet lag.

copyright ©, Columbia-Presbyterian Medical Center

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