Is Your Loved One S.A.D?

The change in seasons from fall to winter brings shorter days and less sunlight, which can lead to seasonal affective disorder (SAD) in older adults and others. SAD is a cyclical form of depression that typically starts in the late fall and continues through the winter months. The condition makes seniors – and others who experience it – feel lethargic, tired and less interested in daily activities.

What Causes Seasonal Affective Disorder?

Decreased sunlight affects our circadian rhythm, which helps to regulate our body’s internal clock, and can create issues with our sleep-wake cycle. Longer periods of darkness increases the level of melatonin in our brain, making people sleepy and more susceptible to depression. Reduced sunlight during the winter months suppresses the level of serotonin in the brain, which affects mood and can foster depression. Together, these changes can cause seasonal affective disorder. For seniors who aren’t able to get outside during the day to enjoy sunlight, SAD may be more common.

Typical SAD Symptoms

Common signs of seasonal affective disorder include:

  • Sleeping longer at night and more during the day
  • Reduced energy levels and fatigue
  • Loss of interest in typically pleasurable activities
  • Overeating and cravings for carbohydrates
  • Weight gain
  • Social withdrawal or a desire to “hibernate”

If you suspect that you or a loved one is showing signs of seasonal affective disorder, schedule an appointment with a medical professional to confirm the diagnosis.

Risk Factors for SAD

Conditions that may increase the risk of SAD range from where you live to family history:

  • Living far from the equator. The incidence of SAD is greater in people who live farther north or south of the equator because they are exposed to fewer hours of sunlight in the winter. A study showed that while only 1% of people who live in Florida experience SAD, 9% of people who live in New England or Alaska do.
  • Being a woman. Women are four times more likely than men to be diagnosed with SAD.
  • Family history. Those with family members with other forms of depression are more apt than others to experience SAD.
  • Having depression or bipolar disorder. Depressive symptoms may worsen in the winter months for these people.
  • Lower vitamin D levels. Because vitamin D may affect serotonin activity, having a vitamin D insufficiency may worsen depressive symptoms.

Treatments for SAD

The National Institute of Medical Health recommends four types of treatments and therapies for SAD.

  • Antidepressant medication: Selective serotonin reuptake inhibitors (SSRIs) such as Celexa, Prozac and Zoloft can be effective in treating SAD symptoms in seniors. Other treatment medications include bupropion (Wellbutrin SR or Wellbutrin XL) and serotonin-norepinephrine antidepressants such as Cymbalta and other medications.
  • Light therapy: On its own or in conjunction with antidepressants, light box therapy can be effective in treating SAD, particularly for seniors and others who don’t get enough sunlight in the winter. Optimal exposure is 30 to 45 minutes daily in the morning after waking. Opening curtains and blinds to maximize natural light exposure can also help.
  • Psychotherapy: Cognitive behavioral therapy adjusted for SAD encourages the replacement of negative thoughts with more positive thoughts, along with identifying pleasurable activities to participate in during winter months.
  • Exercise: From walking outside on a sunny winter day when conditions are safe, to walking inside on a treadmill or at the mall with a friend or in small groups, to participating in water aerobics, getting moving can boost the spirits of seniors.

How to Help Seniors with SAD

Because seniors may be lonely, face immobility or be sensitive to the cold, which can make getting outside in the winter challenging, they may be at an increased risk for seasonal affective disorder. Caregivers should be aware of SAD symptoms and help their loved ones seek treatment so they feel better and their winter months are more enjoyable. Staying connected with family and friends and engaging in fun activities can also help to lift seniors’ spirits any time of the year!

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