Coping with the seasonal blues

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Seasonal affective disorder (SAD) is a condition characterized by symptoms of depression that occur only at certain times during the year. Although it can happen at any time of year, most people are affected in fall and winter.

Contributing factors

According to the Centers for Disease Control and Prevention, seniors are at an increased risk of depression. “As a general rule, seniors have experienced more life events such as the loss of a spouse or friends, health problems, or financial difficulties,” says David Tuuk, M.D., medical director at Wind Crest, an Erickson Living community in Highlands Ranch, Colo. “Any of these can temporarily contribute to the onset of SAD, and if someone has had depression in the past, they may be even more prone to it.”

A decrease in exposure to outdoor light seems to be a main trigger for SAD. Your biological clock is disrupted, which may cause a drop in the natural brain chemicals that regulate your mood. Genetics and your body’s natural chemical makeup may determine whether or not light exposure (or the lack thereof) will affect you.

In winter, other factors besides a lack of light may play into feeling blue. “At certain times of the year, seniors may not have as much contact with family or friends, and that can be a reason for the onset of SAD,” says Gloria Blackmon, B.S.N., R.N.-B.C., director of nursing for long-term care at Levindale Hebrew Geriatric Center and Hospital in Baltimore, Md.

Symptoms

Symptoms of SAD may be interpreted as something else, especially in seniors. “If an anniversary of a spouse’s death occurs in the winter, it may be hard to determine whether depression symptoms are due to feeling blue about that event or the presence of SAD,” Tuuk explains.

Classic symptoms of depression include appetite changes, low mood, problems concentrating, disrupted sleep patterns, and losing interest in activities that used to be pleasurable. According to the National Alliance on Mental Illness, some typical symptoms of wintertime SAD include oversleeping, daytime fatigue, weight gain, and a craving for carbohydrates. In summertime SAD, on the other hand, people may experience weight loss, insomnia, and anxiety.

Individualized treatment

What is best treatment-wise depends upon how much SAD is affecting your daily functioning. “If you can’t eat, can’t sleep, or you are isolating yourself in your home, then we need to discuss treatment,” Tuuk says.

Medication isn’t necessarily the answer. “Many people are taking a number of medicines already and they don’t want to add one more,” Tuuk says. “Counseling is often sufficient.”

“Using a light box is effective for many people,” Tuuk adds. In light therapy, you sit close to a specialized box that emits bright light similar to outdoor light. Exposure to this light seems to affect brain chemicals linked to mood—specifically serotonin and melanin—both of which need to be at sufficient levels for your mood to stay up. Research shows that it is as effective as antidepressants for many people who have less severe types of SAD.

Light therapy starts working quickly for many people, sometimes in a few days. Side effects, although uncommon, include eyestrain, headaches, nausea, and irritability.

If you want to try dietary supplements such as St. John’s Wort, SAMe (s-adenosyl-l-methionine), melatonin, or omega-3 fatty acids (all of which are purported to help depression), check with your doctor first. Some may interact with other medications. “They might be worth a try if your doctor determines that they are safe,” Tuuk says.

Other alternative therapies may help some people, such as acupuncture, massage therapy, or yoga. “I’ve heard some patients say that acupuncture in particular is helpful,” Tuuk says. “No matter what treatment you choose, counseling and support are essential for everyone.”

Prevention and self help

There are a number of things you can do to maximize your treatment’s effectiveness or prevent SAD altogether.

Brighten up your environment. Open the curtains, trim foliage that may be blocking light, or add skylights to your home.

Get outside in any weather. “Many people are hesitant to go out in winter for fear of getting a chill, or in summer because of the risk of skin cancer,” Blackmon explains. “But even a brief walk or sitting on a porch for a short period can help.” Experts say that exposing yourself to outdoor light is most effective if you do it within two hours of waking up in the morning.

Exercise regularly. Physical activity is proven to lighten your mood and relieve anxiety, and being in better physical condition improves your overall health.

“Family members and friends can be an enormous help for seniors prone to SAD,” Blackmon says. “If you have a loved one who has SAD and lives alone, do whatever you can to help get them outside.”


Light therapy tips

To get the most out of using a light box, follow these tips:

Find the proper box. Get your doctor’s recommendations for a safe and effective box. Do some research beforehand and compare prices—A higher price does not necessarily guarantee a better box.

Follow a routine. Maintaining a consistent schedule every day will maximize your therapy.

Timing is everything. Keep using it until your doctor says you can safely stop. Don’t skip a day because you feel better or stop therapy in the springtime because your symptoms improve.

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