Accounting for the toll winter can take on the emotional well-being of members diagnosed with seasonal affective disorder (SAD), Harvard Pilgrim offers reimbursement for light boxes (complete with replacement bulbs) for phototherapy treatment.
With the abundant darkness of the winter months leading to this form of depression in as much as 6 percent of the population, it is important to be prepared to identify and effectively treat SAD. Although they come and go annually, the symptoms of SAD are similar to those of general depression. Symptoms of SAD usually begin in October and November, though they may not appear until January, and often subside in March or April. Patients may experience:
- Lethargy and fatigue
- Irritability or hopelessness
- Strong cravings for carbohydrates
- Weight gain
- Loss of interest in activities they once found pleasurable and/or decreased socialization
- Lack of concentration
SAD may be brought about by an imbalance in the levels of melatonin and serotonin, produced in the absence and presence of sunlight, respectively or by a disruption in a patient’s circadian rhythm, or biological clock. People — particularly those in the northern U.S. — get less exposure to sunlight as winter approaches, as a result of the days getting shorter and the colder weather deterring them from spending as much time outside each day. SAD is more common in women and younger people than in men and those over the age of 55. In addition, individuals with a close relative affected by SAD tend to be at an increased risk of developing it themselves.
While some patients also benefit from psychotherapy and antidepressant medications, light therapy — or phototherapy — alone can be effective in the treatment of SAD. Sitting in front of bright artificial light for about 30 minutes a day can help relieve the symptoms of winter depression in many patients, and Harvard Pilgrim’s durable medical equipment benefit covers the special equipment required for this treatment. These table-top light boxes emit light at an intensity of 10,000 lux, as opposed to the 100 lux produced by standard indoor light and 50,000 lux or more of a sunny day.
While patients do not need a prescription to purchase a light box, it is best to work with a professional to monitor the treatment. PCPs may wish to refer certain patients with SAD to a behavioral health care provider for assessment and treatment.
How Optum/UBH can help your patients — For complex clinical situations, Optum/UBH is available to provide consultative assistance. Practitioners can call the Optum/UBH Physicians Consultation Service at
800-292-2922. To refer a patient for behavioral health services and to facilitate the coordination of care, call Optum at 888-777-4742.