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Great, Now Canada’s Handling Depression Better Than Us, Too

What’re they even sad about?
Image: Rene Johnston / Getty

February is the month when winter, for those in northern regions, begins to feel like a personal vendetta on the part of Mother Nature. Anecdotally, nine in ten denizens of colder climes spend up to four hours a day in the late winter months Googling cheap flights to Mexico. Statistically, studies suggest between two and five percent of Canadians and as many as nine percent of Alaskans will experience Seasonal Affective Disorder at some point in their lives.


SAD is not the winter blues. Everyone cries when they have to shovel the driveway again. Symptoms, according to the National Institute of Mental Health, include major depression and, at its worst, suicidal ideation. That's why, in an effort to help, the Toronto Public Library installed full-spectrum SAD therapy lights earlier this month.

"The winter here is long and dark," says Alex Carruthers, manager of learning and community engagement at the library. Four lights were installed, to the tune of $240 each, at two library branches. So far, the feedback is good. "One person said that they are a person who suffers from Seasonal Affective Disorder and when they read online that we were offering the lights, it made them get out of bed and leave the house, because they had been still in bed in the middle of the afternoon," Carruthers says.

Toronto is not the first. The Edmonton Public Library installed therapy lights in 2014. Whitehorse, Dawson City, Winnipeg and Ottawa followed suit. In the Swedish town of Umea, lights installed at bus stops give commuters a dose of Vitamin Light. In Alaska, some hospitals and other public buildings have them as well, but many Alaskans also have them right at home. And in the US, the skyrocketing popularity of light boxes and "dawn simulators" will drive the untested, unregulated US light therapy market to north of $1 billion annually by 2026, according to a recent report from Future Market Insights.


Image: Toronto Public Library

Seasonal Affective Disorder was first described in a 1984 study by the National Institute of Mental Health. With an acronym like SAD, the disorder was a media darling. Though the exact cause remains unknown, SAD is a recognized clinical diagnosis. Therapy can include full-spectrum light, medication, psychotherapy and Vitamin D. Then, last year, a new study cast a shadow over the very existence of the disorder. Using data from a Centers for Disease Control study of the health of the US population, a team from Auburn University at Montgomery set out to look at the seasonal variation in depression rates. "I thought, This will give us an opportunity to get some very good, very accurate estimates of prevalence," says Steven LoBello, one of the authors and a professor of psychology at Auburn University Montgomery. "I thought I would see more depression in the winter than in the summer and that I would see depression more common in the north than in the south."

That is not what they found. The advantage of the CDC data was that it was not gathered as part of a study specific to SAD; reports were gathered with no reference to the season. "When you don't ask it directly, apparently you don't find it," he says. "I think maybe it doesn't exist." The double-blind data did not show rates of depression increasing in winter. But people believe that they do, he suggests. "I think it [SAD] reinforces a cultural belief," he says.

The Canadian Mental Health Association did not respond to requests for an interview, nor did the head of research on mood and anxiety disorders at the Canadian Centre for Addiction and Mental Health. Both recognize SAD as a disorder. In a video on the center's website Robert Levitan, research head at the Center for Addiction and Mental Health's Mood and Anxiety Disorders Program, says two to five percent of Canadians suffer from a severe clinical form of seasonal depression, while another 10 to 15 percent have a milder form. As many as 25 to 35 percent experience the "winter blues."Light therapy is the most common treatment, he says.

Regardless of whether SAD is a real thing, light therapy seems to have some positive effects on depression.A 2015 study funded by the Canadian Institutes of Health Research, among others, found light therapy is effective for depression classified as both seasonal and non-seasonal. One hundred and twenty-two patients received either light therapy alone or in combination with antidepressants, or placebos of both. Among those who received both lights and medication, about 75 percent reported reduced symptoms. Half of those who took 30 daily minutes of light therapy alone reported an improvement.

"These results are very exciting because light therapy is inexpensive, easy to access and use, and comes with few side effects," says Raymond Lam, lead author and a psychiatrist at the Djavad Mowafaghian Centre for Brain Health.

Carruthers, from the Toronto Public Library, was not aware of the great SAD debate—and to her, it's not relevant to the Toronto Public Library program. The disorder is recognized by the Canadian Mental Health Association and research says the lights are safe. Response to the pilot program will determine whether more therapy lights will go on in other branches next year. "What I've heard from the branch heads is that people are using them pretty regularly and that we've been getting a lot of really positive feedback," she says.