For people who suffer from winter depression triggered largely by reduced sunlight, a bedside device that simulates the rising of the sun may provide relief, a study shows. "Negative air ionization," also delivered at the bedside, seems to be effective as well.

"Dawn simulation and negative air ionization are two naturalistic, non-pharmaceutical environmental enhancements now verified superior to placebo and remarkably effective in the treatment of winter depression," Dr. Michael Terman stated.

In the study, dawn simulation and negative air ionization, both activated toward the end of sleep, proved to be as effective as bright light therapy after waking up -- an established treatment for winter depression, also known as seasonal affective disorder or SAD.

With bright light therapy, SAD sufferers sit at a bright light box for 30 minutes at breakfast time. Dawn simulation and negative air ionization are more convenient, being delivered automatically and innocuously during the final hours of sleep by an apparatus placed next to the bed.

In their study, Dr. Michael Terman and Dr. Jiuan Su Terman of Columbia University in New York randomly assigned 99 adults with SAD to one of five treatments: dawn simulation equivalent to that May in northern temperate latitudes; a brief dawn "pulse"; bright light after waking; high flow rate negative air ionization; or low flow rate ionization.

Full dawn simulation, high negative air ionization, and bright light therapy proved roughly equal in terms of improvement in symptoms of SAD, the investigators report in the American Journal of Psychiatry.

Improvement was seen in 57 percent of subjects in the bright light therapy, 50 percent of those in the dawn simulation group and 48 percent in the high air ionization group. By contrast, improvement was seen in just 23 percent of those who got low ionization and in 43 percent of subjects in the sunrise pulse group.

Although the sunrise pulse treatment was "therapeutically active" in some patients, it led to the persistence, emergence and exacerbation of depressive symptoms, making it an "unfavorable option," the Termans write.

Summing up, Michael Terman said while morning bright light therapy "remains the first-line intervention for SAD, with thousands of successes and satisfied patients," dawn simulation and negative air ionization may also be considered as options.

If you think you may suffer from winter depression, Terman suggests, as a first step, completing the Personalized Inventory for Depression and SAD survey, a free and confidential online self-assessment questionnaire posted on the nonprofit website of the Center for Environmental Therapeutics, www.cet.org.

The site also includes more detailed description of light and ion therapy.

SOURCE: American Journal of Psychiatry, December 2006.