Næste generation af lysterapi mod vinterdepression har set lyset, og forsøg bekræfter, at lysterapi kan bruges som en metode til at forebygge og behandle sæsonbetinget depression.
Af Kristine Bindslev
Artiklen blev bragt i magasinet sund-forskning og //mig// – december 2015/januar 2016
Mange danskere lider hver vinter af vinterdepression. Op til 2/3 af danskerne oplever, at deres humør i en eller anden grad bliver påvirket af de mørke vintermåneder. Der er til gengæld mange ting, man selv kan gøre for at få bugt med det dårlige humør om vinteren. Lysterapi er en af dem. Læger ved, at der er en klar sammenhæng mellem depressioner og lys. Og læger anbefaler lysterapi både som behandling og forebyggelse af vinterdepression. Men det kan være temmelig besværligt at sidde helt op til 90 minutter foran en skærm, og heldigvis er en ny generation af lysterapi trådt frem i rampelyset.
Sådan foretog man studiet
Den canadiske psykiater og læge Craig Hudson fra Toronto University, som i årevis har studeret tryptofan og søvnrytmer, har i et forsøg med lysterapi med apparatet YumaLite og vinterdepression set opløftende resultater. Tredive forsøgspersoner med diagnosticeret vinterdepression blev rekrutteret og randomiseret til to behandlingsgrupper. Gruppe A modtog en times lysbehandling hver morgen i fire uger. Gruppe B modtog fem minutters lysterapi i de to første uger og en time om dagen de resterende to uger. YumaLite lysbehandlingen er særligt fremstillet til at behandle vinterdepression.
Måling af depressive symptomer
Hamilton Rating Scale for Depression (HAM-D) blev brugt som vurderingsredskab i forhold til graden af depression. Det er den skala, læger bruger verden over for at give en standardiseret, pålidelig og gyldig måling af mængden og styrken af depressive symptomer. Og ved vinterdepression anvendes ligeledes HAM-D. I lysterapiforsøget vurderede man patienter hver uge ud fra skalaen. Patienterne var randomiseret på både køn, alder og indledende HAM-D score. Resultaterne af HAM-D viste en tydelig reduktion i depressionssymptomer allerede ved første uges behandling og med fortsat effekt resten af forsøgsperioden. Forskellen i eksponering af lysterapien, fem minutter versus en time, viste ingen stor forskel. Begge doseringer var virksomme. I et andet forsøg kiggede man på intensiteten af lysbehandlingen. Forskere sammenlignede 60 lux, 600 lux og 3500 lux i et tougers randomiseret parallelt studie. De fandt ingen signifikant forskel i den antidepressive virkning af de tre intensit eter af lys. Sagt med andre ord: Alle lysintensiteter virkede lige godt.
Vinterdepression versus depression
En vinterdepression adskiller sig fra en almindelig depression på flere punkter. For eksempel spiser og sover depressive mindre, end de gør normalt, i modsætning til vinterdepressive, som spiser og sover meget, og behandlingsformerne er også tilsvarende forskellige. Træthed, mangel på energi, øget appetit og dårligt humør kendetegner den årstidsbestemte depression, også kaldet vinterdepressioner eller SAD (Seasonal Affective Disorder). Især på de nordlige breddegrader er lidelsen udbredt pga. af vores mørke vintermåneder.
November, november og november
Vinterdepressioner begynder typisk i november, hvor den daglige lysmængde bliver mindre. Lysforhold er helt afgørende faktorer for udviklingen af vinterdepression: Om vinteren er der jo mindre lys, og det er netop lysmængden, som i undersøgelser har vist sig at have indflydelse på udviklingen af vinterdepression. Derfor er det vigtigste, man kan gøre, når man lider af vinterdepression, selv at sørge for at genskabe det lys, man er omgivet af om sommeren. Men hvad sker der i kroppen, når mørket falder på og varer ved en hel vinter? Her skal vi have fat i hormonerne for at forstå mekanismen og behandlingen.
NB! Det er vigtigt at gå til lægen først, hvis du føler dig træt og depressiv om vinteren. Lægen kan undersøge, om der eventuelt er noget andet galt, som fx en stofskiftesygdom eller en reel dyb depression, inden du kaster sig over lysterapien.
Signalstoffet serotonin er indblandet
Det er ikke fuldstændigt fastlagt, hvad der forårsager vinterdepression, men videnskaben mener, at signalstoffet serotonin spiller en rolle sammen med generne. Lys påvirker niveauet af stoffet serotonin i hjernen, og det er manglen på det stof, der ofte spiller en afgørende rolle, når man bliver deprimeret. Serotonin regulerer nemlig dit humør, dine følelser og din appetit. Det er også hormonet serotonin, der danner melatonin, og melatonin spiller en afgørende rolle i reguleringen af døgnrytmen, som igen har kontrol over søvnmønstret. Det vil sige, at mangler du serotonin, påvirker det produktionen af melatonin, og så påvirkes din døgnrytme.
SSRI-præparater og lysterapi øger serotonin-niveauet
Vi ved, at serotonin hjælper nervecellerne i hjernen med at kommunikere med hinanden. At mængden af serotonin i hjernen har stor indflydelse på humøret, ser vi ved den effekt, antidepressiv medicin, som SSRI-præperater (Specific Serotonin Reoptake Inhibitors), netop har. Vi ser nemlig, at SSRI-præparater, det man kalder lykkepiller, øger mængden af serotonin i hjernen og bedrer fx den vinterdepressive tilstand. Selv om videnskaben endnu ikke ved med sikkerhed, hvad der forårsager en vinterdepression, kan forskningen observere, at selv små mængder af lys kan påvirke melatoninproduktionen i din hjerne. Lysterapi giver dig på meget kort tid evnen til at holde de mørke måneder ud. Om man vil behandle sin vinterdepression med antidepressiv medicin eller lysterapi er op til lægen og den enkelte, men sidstnævnte behandling er 100 % bivirkningsfri. Og da lysterapien som regel er meget virksom, er det som regel det, de fleste i første omgang forsøger sig med.
Lysterapi:
* stabiliserer døgnrytmen
* giver mere energi
* får niveauet af serotonin i hjernen til at stige
Lavt tryptofan-niveau forværrer vinterdepression
Når man nu taler om serotonin, er det klogt at træde skridtet tilbage, lige før serotonin dannes til aminosyren tryptofan. Tryptofan virker nemlig som byggesten for serotonin, og har du ikke tryptofan i kroppen, kan du ikke producere serotonin. Da vi ikke selv kan danne tryptofan, skal vi have den tilført fra kosten eller som tilskud. Fra forskning ved man ligeledes, at hvis man fjerner aminosyren tryptofan fra kosten, så bliver den vinterdepressive tilstand forværret. Det kan altså være en god idé for den vinterdepressive at prøve et tilskud tryptofan. Og helst i naturlig form. I et studie så forskerne, hvorledes tryptofan fra økologiske græskarkerner blev nedbrudt og optaget gradvist i kroppen modsat her-og-nu-virkningen fra den syntetiske udgave. Resultatet er en mere stabil tilførsel af tryptofan og dermed en mere stabil døgnrytme. Befolkningsstudier har også vist, at tryptofan-indtagelse virker positivt over for følelsesmæssige forstyrrelser som angst og aggression – klassiske vinterdepressionssymptomer. I et randomiseret klinisk forsøg med personer, der led af angst, oplevede deltagerne 16 procent mindre grad af angst og nervøsitet.
Er du SAD om vinteren, så er du langt fra alene
Vinterdepression, også kendt som Seasonal Affectiv Disorder (SAD), er meget normalt. Hele 9 % i Skandinavien lider af denne tilbagevendende og sæsonbetonede depression. Derudover mener man, at op mod 25% af os lider af vintertræthed, som giver sig udtryk i, at vi er mere trætte, har svært ved at komme op om morgenen og i gang i vinterhalvåret.
Se lyset i din vinterdepression: Prøv lysterapi – det er effektivt og har ingen bivirkninger. Tag også et tilskud tryptofan via Zen Bev.
Lysterapi er ikke almindeligt lys
Lamperne til lysbehandlingen er særligt fremstillet til at behandle vinterdepression, og det er derfor ikke ligegyldigt, hvilken lampe man sætter sig foran. Traditionel lysterapi har indtil for nylig betydet, at du skulle sidde foran det kunstige lys og kigge direkte ind i lysapparatet i op til 90 minutter hver dag. Nok ikke noget, der passer ind i de fleste menneskers morgenrutiner. Dertil kommer, at især apparater med blåt lys kan være skyld i øjendegeneration. Den næste generation af lysapparat fungerer anderledes og mere praktisk. YumaLite er et batteridrevet, letvægts, ergonomisk apparat uden ledninger, som sidder på hovedet. Mens du får det vigtige lys for at undgå vinterdepressionen, kan du altså gøre andre ting imens. Lysbehandlingen foregår, samtidig med at du spiser morgenmad, læser avisen, gør rent eller motionerer. YumaLite er ligeledes det første lysterapiapparat, som giver både et hvidt og rødt lys. Lyset afgiver lux 300.
Kend din depression
Det er karakteristisk for mennesker med vinter blues, at så snart det bliver mørkere, typisk fra oktober til marts, forekommer symptomerne, og de forsvinder igen, når lyset vender tilbage i foråret modsat en reel depression, som ikke forsvinder sammen med solen og lysets genkomst. Symptomerne er:
- Nedtrykthed, tristhed og dårligt humør
- Nedsat energi
- Øget træthed
- Øget søvnbehov
- Øget appetit
- Specielt behov for kulhydrater
Vinter Blues –hvad kan du selv gøre?
Når du nu en gang bor på de nordlige breddegrader, gælder det om at:
1 Opholde dig udenfor så meget som muligt
2 Opholde dig i nærheden af vinduer – hav eventuelt dit skrivebord på dit arbejde stående tæt ved et vindue
3 Placere dit soveværelse, så vinduerne i rummet vender mod øst – eller brug en lyssimulator til at give dig morgenlys
4 Brug et lysbehandlingsapparat på et fast tidspunkt om morgenen
5 Rejs om muligt til et solrigt rejsemål i januar/februar
Zenbev fra Biosential er en naturlig kilde af tryptofan. Tryptofanen er skånsomt afledt af olien fra de økologiske græskarkerne. YumaLite fra Biosential er fremtidens lysterapi. YumaLite er udviklet af den nyeste teknologi samt seneste forskning inden for lysterapi. Apparatet har en lav ere intensitet end traditionelle lysapparaturer, og lyset skinner indirekte takket være et visir. For dem, der er følsomme over for hvidt lys, er der mulighed for at skifte til kun rødt lys. I et nyt, klinisk forsøg med YumaLite så man, hvorledes apparatet reducerede symptomer på vinterdepression med 50 % i løbet af en uge.
Se vores filmklip om tryptofan med Craig Hudson på sund-forskning.dk.
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