I have been using my light box for 30 minutes per day for 3 days in the morning and have noticed an increase in baseline anxiety. If i have baseline anxiety that seemed worse in the winter, is light therapy recommended or contraindicated?  I don’t have any history of hypomania. Should I stick it out for 2 more weeks and see if it resolves? Or do you recommend decreasing duration in front of lights to 15 minutes per day? At what point is light therapy contraindicated?

Another really good question.  First off, we want to emphasize a general point about clinical questions of this kind:  specific therapy  recommendations for a given individual in a given situation should come from one’s doctor and the ongoing treatment process.  As an educational website, our job is to provide general information about chronotherapy to the public.   The responses we provide are thus general, educational ones and should not be taken as clinical recommendations.  With that caveat, let me share some thoughts about this type of situation.
First, baseline anxiety is something that I pay a great deal of attention to as a clinician when I am considering any antidepressant treatment.  There is data that suggests that when depression is mixed with anxiety symptoms, the rate of antidepressant-induced manic response is heightened.  Even when there’s no past history of manic symptoms, antidepressants can sometimes activate and reveal underlying bipolar dispositions that were not evident.  Apart from the risk of treatment-induced mania, bright light therapy can cause or worsen ordinary (ie, not related to mania or bipolar disorder) anxiety as a side effect.
Second, I wasn’t clear about the nature of the diagnostic problem for which bright light therapy is being used here:  were you using light therapy for seasonal anxiety, for depression, for depression mixed with anxiety?  This would also have a bearing on how to manage your response to bright light therapy.
As a general rule, if someone that I am treating with bright light therapy experiences an increase in their anxiety, I would move to reduce and/or consider discontinuing the treatment.  The good news is that bright light therapy can be quickly and incrementally adjusted in several ways:  many light therapy lamps have a low and high lux option that allow for switching to a lower light intensity setting; the duration of exposure can be reduced; the distance from the light box can be increased; last, some studies suggest that light delivered later in the day, towards midday, causes less anxiety than early morning light.  So there are several, easy tweaks that can be done to reduce bright light therapy-induced anxiety.   The easy and rapid adjustability of treatments is a distinct characteristic and advantage of most chronotherapies.

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