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Having extolled the benefits of increasing the amount of environmental light, I hesitate to confuse matters by mentioning that for some depressed people, an opposite solution may solve the problem – that is, increasing the daily exposure to darkness. Dr Thomas Wehr at the US National Institute of Mental Health has suggested that a cause of depression in some people may be our use of artificial lighting to shorten the hours of darkness to which we are exposed each day. Certain people, he argues, may be physically unable to cope with the legacy of Thomas Edison – universal illumination of the night – and may benefit by returning the night to its natural length. By adopting this strategy for one man, a middle-aged engineer who had cycled in and out of depression for years, Wehr and colleagues enabled him to stay free of depression for many months simply by asking him to remain in darkness for 12 to 14 hours each day. Since then a few other individuals have derived similar benefit from this treatment. Although at this time extending the hours of darkness remains a highly novel treatment that may benefit only a few of those patients who cycle in and out of depression, it is another demonstration of the importance of the environment in regulating mood, and the value of manipulating the environment as part of an overall treatment plan for depression.

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