A 34-year-old woman has recurrent winter episodes of depressed mood, hypersomnia, carbohydrate craving, and weight gain, remitting fully each spring. Her psychiatrist plans first-line treatment for this pattern. Which intervention has the best evidence for this condition?
- A Sleep deprivation therapy on alternate nights
- B Bright light therapy administered in the early morning ✓
- C Dim red light exposure in the evening
- D Total darkness therapy during waking hours
Correct answer: B. Bright light therapy administered in the early morning
Explanation
Seasonal pattern depression responds to timed bright light exposure of about 10,000 lux given in the early morning, which advances circadian phase and corrects the phase delay thought to underlie the illness. Evening light can worsen alignment, and darkness or deprivation therapies have no established role here. SSRIs remain an alternative, but morning bright light is the classic evidence-based first-line answer examined for seasonal pattern depression.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.
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