To get an idea of the intensities of the light sources used for treatment, think of a bright, sunny day. The light falling on your eyes is equal to 100,000 lux. A standard light box puts out between 2,500 and 10,000 lux.

There also are experiments with a visor, as on a baseball cap. This special visor has small battery-powered lights, and the illumination falls directly on the eyes. You cannot look away. Early results suggest that this device works at least as well as the panels of light, whether the light output is 600 lux or 32,000 lux.

Although these light sources are commercially available, all the experts warn against buying them without first consulting a psychiatrist trained to recognize SAD. (Take the test at the end of this article.) Diagnosing SAD can be tricky. The same symptoms may arise from other types of depression. Also, prescribed durations and intensities of light may vary. For some patients, light therapy doesn’t work at all. Dr. Rosenthal says they may need other treatments: drugs, psychological therapy, relocation to a warmer winterless climate. He adds that studies show fewer cases are found the closer you go to the equator (perhaps 10 percent of New Hampshire’s population may have SAD, but only 1.5 percent of Florida’s) and that women with SAD outnumber men by 7 to 2 – possibly, scientists say, because of hormonal differences.

Dr. Wehr says that children suffer from SAD and respond to the light as adults do. “It has a tremendous impact on their ability to function in school,” he observes. “They start out the school year fairly strong, thinking they will enjoy it. In November, it starts to fall apart. They sleep 12 hours a day. They’re not creative; they’ve lost the spark. Those with winter depression are slowed down. Their behaviors include overeating, oversleeping, and sluggishness.” Other SAD symptoms include anxiety, irritability, an inability to tolerate stress, and withdrawing from others.

And then there’s the summer SAD, a condition less studied than its winter form. Dr. Wehr says summer SAD patients have decreased sleep and loss of appetite and weight. “They are more agitated,” he adds.

One of Dr. Wehr’s patients, Helen O’Lone, a homemaker from Rockville, Maryland, suffered from depression all year. “But July was one of the worst months for me,” she says. “The whole world seemed black. I had no appetite.

My sleep was restless, agitated.” Dr. Wehr prescribed Prozac, an anti-depressive drug. “Now I feel the best I’ve ever felt in my life,” Mrs. O’Lone says. “I love to do water exercises and swim.”

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GENERAL HEALTH

The Older Americans Act includes funding for a nutrition program that provides one meal a day for at least five days a week for elderly persons who can come to a center for senior citizens. Each meal is planned to furnish at least one third of the recommended allowances. Provision for modified diets can usually be made in these centers. Nutrition education, periodic health checks, and recreational activities are important components of this program.

Two programs provide meals for persons who are home bound. One of these is federally funded and originates in the centers for older Americans. At least one hot meal is delivered five days a week. In some circumstances arrangements are made for two daily meals, including weekends. “Meals on Wheels” is a program that provides a hot noon meal and a cold evening meal. The program is sponsored by community agencies, for example churches or hospitals. The recipient pays for the meals on a sliding fee scale according to ability to pay.

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GENERAL HEALTH