Complementary Treatments

Bright Light Therapy

Bright Light Therapy has been widely studied and found to be effective in adults with major depression, seasonal affective disorder, perinatal depression and bipolar disorder. The efficacy of bright light therapy in adults approaches that of antidepressant medications, and bright light therapy is generally well tolerated. Bright light therapy in adolescents with depression has been less studied, and most trials have taken place in inpatient units. However, bright light therapy appears to be well tolerated in adolescents and may be an acceptable treatment option for individuals with mild to moderate depression who would like a non-pharmacologic treatment option.

If you suggest bright light therapy to an adolescent with depression, you should plan to follow their progress in the same way you would if you prescribed a medication.

Bright light therapy can be used adjunctively with psychotherapy and/or antidepressant medication.

Bright light therapy should be used with caution in people with bipolar disorder as it may trigger a manic episode.

How to guide your patients in starting bright light therapy:

  1. Choose and purchase a light therapy box. Bright light therapy requires a box that emits 10,000 lux. Several consumer advocacy organizations have rated light therapy boxes. You might choose a review site that you share with your patients.
  2. Place it in front of you or slightly off to the side. Don't look directly at the light but keep your eyes open. You can eat, read, watch television, or work on a computer while you're using the light.
  3. Start with 30 minutes of light box use, ideally first thing in the morning.
  4. Many adolescents find morning light box use incompatible with their sleep and school schedules. Some evidence suggests that afternoon use is well tolerated in adolescents. If afternoon use interferes with sleep onset, consider trying to make morning use work.
  5. Symptomatic improvement often occurs in the first 2 weeks of treatment. If your patient is not responding by week 2, increase daily light box use by 15 minutes/week up to 60 minutes.
  6. Once symptom response occurs, continue light box use. There is no known contraindication to indefinite light box use but most patients will want to reduce or discontinue use. Recommend weekly tapering off by 15 minutes while monitoring symptoms.

A handout with information on light therapy is available here.

Ballard, R., Parkhurst, J., Julian, K., Pasetes, L. N., Fawcett, A., Li, A., Goel, N., & Sit, D. K. (2023). Light Therapy for Adolescent Depression: A Scoping Review. Current Psychiatry Reports, 25(9), 373–386.