The Effectiveness of Light Therapy for College Student Depression
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Journal of College Student Psychotherapy ISSN: 8756-8225 (Print) 1540-4730 (Online) Journal homepage: http://www.tandfonline.com/loi/wcsp20 The Effectiveness of Light Therapy for College Student Depression Lisa A. House & Barry Walton To cite this article: Lisa A. House & Barry Walton (2018) The Effectiveness of Light Therapy for College Student Depression, Journal of College Student Psychotherapy, 32:1, 42-52, DOI: 10.1080/87568225.2017.1321975 To link to this article: https://doi.org/10.1080/87568225.2017.1321975 Published online: 22 May 2017. Submit your article to this journal Article views: 745 View Crossmark data Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=wcsp20 JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2018, VOL. 32, NO. 1, 42–52 https://doi.org/10.1080/87568225.2017.1321975 BRIEF REPORT The Effectiveness of Light Therapy for College Student Depression Lisa A. Housea and Barry Waltonb aCenter for Counseling and Human Development, Millersville University, Millersville, Pennsylvania, USA; bInformation Systems Services, Millersville University, Millersville, Pennsylvania, USA ABSTRACT KEYWORDS There is a growing number of students on college campuses College student mental with mental health problems and college counseling services health; depression; light box; are reporting significant increases in student demand for light therapy; seasonal counseling. Depression, a mental illness consisting of pro- affective disorder found sadness, fatigue, and irritability, as well as low motiva- tion, poor academic performance, and suicidal behaviors, is one of the top presenting concerns for students who seek help. This study investigates the effectiveness of light therapy in a sample of 79 college students who suffer from depres- sion. This study examines changes in overall depression scores and also assesses changes in sleep, appetite, pain, and concentration levels. Results showed significant improve- mentsinoveralldepressionscoresaswellasimprovedsleep- ing behaviors and decreases in somatic aches and pains, concentration difficulties, and appetite problems. These pro- mising results suggest light therapy may be an effective and inexpensive means for reducing symptoms of young adult depression. Widely known to the field of college counseling is that college counseling services are reporting significant increases in student demand for counseling services, severity of mental health problems, and student crises (Gallagher, 2015). Depression is one of the top reasons students are seeking help, with approximately one third of college students in the United States reporting that they were “so depressed that it was hard for them to function” (American College Health Assessment, 2014). Depression can profoundly impact an individual’s ability to perform simple daily tasks and often leads to low motivation, impaired concentration, fatigue, irritability, sleep difficul- ties, sadness, and apathy. Depression is also the biggest risk factor for suicidal ideation. Thirty percent of college students report that they have seriously considered suicide (American College Health Assessment, 2014), with suicide the second leading cause of death among college students. Depressed stu- dents are also more likely to drop out of college, have low self-esteem, CONTACT Lisa A. House, PhD [email protected] Center for Counseling and Human Development, Millersville University, P.O. Box 1002, Millersville, PA 17551-0302, USA. © 2017 Taylor & Francis JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 43 perform poorly academically, be at risk for substance abuse, and have an increased risk for developing mental health problems later in life (Merikangas et al., 2010). Developing effective therapeutic approaches for depression among college students takes on an increased sense of urgency when considering these alarming trends. Although the number of students seeking mental health services on college campuses is increasing, there has not been a parallel increase in funding for these services. As a result, developing brief and cost effective interventions for college student depression is critical. One treat- ment that meets this criteria is light therapy, which for three decades has been repeatedly tested and employed as a means to treat some forms of depression, particularly Seasonal Affective Disorder (SAD) (Privitera, Moynihan, Tang, & Khan, 2010; Rastad, Ulfberg, & Lindberg, 2008; Reeves et al., 2012; Rohan et al., 2016). SAD is a type of recurring depression that presents during winter months with remission in the spring and summer. Symptoms of SAD include low energy levels, concentration difficulties, low sex drive, carbohydrate cravings, sleep problems, irritability, social withdra- wal, and feelings of hopelessness. The age of onset for SAD is between the ages of 18 to 30 and it is estimated that 5% to 10% of the college population in the Northeast is affected by SAD (Cotterell, 2010). Research on the efficacy of light therapy supports its capacity to treat milder forms of depression such as SAD (Privitera et al., 2010; Rastad et al., 2008; Reeves et al., 2012; Rohan et al., 2015). Other studies found that light therapy also helped participants with irregular sleep patterns and irritability (Altabet, Neumann, & Watson-Johnston, 2002) and resulted in a reduction in suicidal ideation (Lam et al., 2006). In a recent study, Knapen, Van De Werknm, Gordijn, and Meesters (2014) found that light therapy reduces depression in participants experiencing SAD, however, no significant differ- ences in the overall duration of light therapy were demonstrated. These authors reported a more rapid reduction of depressive symptoms in the 1- week group (30 minutes each day for 5 days) compared to those in the 2- week group (30 minutes each day for 10 days) and suggested that expecta- tions of therapy outcomes could “play a role in the speed of therapy response” (Knapen et al., 2014, p. 343). In a direct comparison with antidepressant medication, light therapy has been shown to provide comparable results for the treatment of SAD (Lam et al., 2006). In addition, studies looking at a combination of cognitive behavioral therapy with light therapy compared to light therapy alone found that the combination was most effective, however, the light therapy alone group still showed reductions in their depression (Rohan et al., 2015, 2007). In a recent study, Rohan and colleagues (2015) found light therapy to be as effective as cognitive behavioral therapy in a sample of 177 adults with SAD. At the end of a 6-week treatment protocol, a remission rate of 47% for 44 L. A. HOUSE AND B. WALTON participants in both the light therapy and cognitive behavioral therapy groups was found (Rohan et al., 2015). Based on the success of light treatment for SAD, research efforts have now extended to examining the effectiveness of this intervention with nonseasonal depression (Terman, 2007). Further research into the effectiveness of light box therapy as a treatment for depressive mood disorders will provide stronger empirical support for its therapeutic use. At present, the research specifically targeting college students and light therapy is minimal. The goal of this study is to examine the effectiveness of light therapy, utilizing a light box, in a sample of college students who suffer from depres- sion. This study will look at changes in overall depression scores before and after the light box therapy treatment and also assesses for changes in sleep, appetite, pain, and concentration levels over the course of treatment. Method Participants Participants in this study were college students from a midsize public uni- versity in the Northeast. The study took place from October to March, which is when seasonal mood fluctuations are predominately found. A total of 95 students were screened for this study, of which four were excluded, 12 did not finish, and 79 completed the study. Of the four students who were excluded from the study, two were taking vitamins with a side effect of light sensitivity, one had a history of eye problems, and one had a long history of psychotic manic episodes. Of the 79 complete participants who finished the program, 61 were female (77%) and all participants ranged between the ages of 19 and 21. Ninety two percent of the participants were Caucasian. Of the 79 complete participants, 44% were in therapy at the university’s Center for Counseling and Human Development. Procedures Students who participated in the study were either referred from faculty at the Center for Counseling and Human Development or from staff at the university’s Health Services because they showed signs and symptoms of depression or SAD. Students were also self-referred after seeing advertise- ments throughout campus. For instance, flyers were posted, information was displayed on digital signage boards in high-traffic areas around campus, advertisements ran in the campus newspaper, and faculty in various depart- ments promoted the project. Potential participants completed brief medical and psychological screen- ings to rule out contraindications for inclusions. Potential participants with a JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 45 medical condition that makes the skin sensitive to light, eye problems, a history of skin cancer, pregnancy, psychotic disorder, and bipolar disorder with manic episodes were excluded from the study and treatment protocol. After passing both the medical and psychological screenings, the student was educated