Occupational therapy is used to manage the issues caused by seasonal affective disorder (SAD). Occupational therapists assist with the management of SAD through the incorporation of a variety of healthcare disciplines into therapeutic practice. Potential patients with SAD are assessed, treated, and evaluated primarily using treatments such as drug therapies, light therapies, and psychological therapies. Therapists are often involved in designing an individualised treatment plan that most effectively meets the client's goals and needs around their responsiveness to a variety of treatments. Occupational therapists often have the primary responsibility of informing individuals with SAD of the etiology, prevalence, symptoms, and occupational performance issues caused by the disorder, as well as possibilities for positive intervention. The main symptom of SAD targeted is low energy levels, remedied with fatigue management and energy conservation strategies.
Biomedical approaches The most common biomedical approaches used by occupational therapists in the treatment of SAD are light therapy; the use of exposure to various types of light, and pharmacotherapy.
Light therapy Bright light therapy, commonly referred to as phototherapy, has been documented in multiple studies to be an effective treatment of SAD. A study completed in 2009 revealed that as little as twenty minutes of light exposure can improve the mood of those with SAD. Additionally, it has been found that bright light (at a minimum of 2500 lux "at eye level") has a higher rate of effectiveness than dimmer light levels in protecting against the "mood lowering" symptom that is characteristic of SAD. Due to its high success rates, it is regarded as a first-line treatment for SAD in Canadian, American, and international clinical guidelines. The most widely available method of administering phototherapy to those exhibiting symptoms of SAD is through a light therapy box, which is a commercially available device designed to emit light of a brightness and colour temperature similar to sunlight. Modern devices most frequently use light-emitting diodes in either a lightbox format or alternatively in the form of a wearable device resembling a visor or glasses. Devices that emit blue-enriched white light or devices emitting only blue, only green, or a combination of blue and green wavelengths have been found as the most effective in treating SAD. However, light boxes are not currently regulated by the U.S. Food and Drug Administration (FDA), therefore it is advised to those seeking to purchase one for light therapy to exercise caution when buying. The role of Occupational Therapists in the use of phototherapy when treating SAD is to ensure that clients are aware of the typical usage guidelines provided to users of light boxes and fulfil the need for clinical monitoring to ensure the appropriate doses of light by their clients. Studies have shown effective doses ranging between 3,000 lux, 2 hours a day, for 5 weeks to 10,000 lux, 30 minutes a day, for 8 weeks. As effective doses of light therapy vary depending on the individual, occupational therapists are often responsible for ascertaining the most effective levels of light therapy for an individual patient. Since commercial light boxes are often not regulated by law, Occupational therapists provide necessary medical consultation and advice for selecting and using the boxes. As only approximately 41% of SAD patients comply with clinical practice guidelines and use light therapy as recommended, occupational therapists provide support for the effective incorporation of phototherapy into client's daily routines while complying with clinical guidelines.
Medications Antidepressant medication has been shown to be effective in treating various forms of depression caused by seasonal affective disorder. Bupropion, a norepinephrine-dopamine reuptake inhibitor, was approved by the FDA for the prevention of seasonal affective disorder. Other types of antidepressant medication used to treat SAD include selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline, which also appear to be effective. While occupational therapists are unable to prescribe these medications, they play a role in informing clients of how these prescribed medications can decrease acute symptoms of SAD and lead to enhanced engagement in daily occupations. There is also evidence that psychosocial approaches to therapy that occupational therapists can provide, such as cognitive and behavioural interventions, may have more enduring effects than biomedical interventions.
Effectiveness Light therapy has been shown in studies to have mixed results; in some studies, 20% to 50% of those diagnosed with SAD did not gain adequate relief from the use of light therapy. Individuals may also explore alternative treatments if they are unable to commit to the time required and the recurrence of the treatment that is necessary. However, in a study comparing the effectiveness of light therapy and the antidepressant medication fluoxetine, both treatments were found to be both effective and tolerable in the treatment of SAD.
Psychosocial approaches Occupational therapists also implement psychotherapeutic interventions, which follow psychosocial rehabilitation and recovery-based approaches. The precise roles of occupational therapists in psychosocial rehabilitation include the following:
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