The holiday season is a time that
can provide much joy and togetherness - but it can also be a period of great
loneliness and even depression for certain people. Seasonal affective disorder
(SAD) is a cyclical form of depression that can affect people at specific times
during the year, mostly in the fall and winter, and its symptoms can be severe.
In your interactions with the
seniors in your care, be careful not to ignore potential SAD symptoms.
The individual might even brush off his or her own symptoms, attributing them
to temporary "winter blues" or a "seasonal funk." But such
temporary down moods can be persistent and quickly resist improvement. Turning
your back to such signs can lead to more serious problems, including thoughts
of suicide.
Be sure to watch for the following
symptoms of SAD:
- anxiety and irritability
- sadness
- lack of energy and increased fatigue
- hopelessness, discouragement and feelings of
worthlessness
- changes in appetite/weight gain
- concentration/memory problems
- problems sleeping
- confusion
- suicidal thoughts
SAD Seniors
People of all ages can experience
SAD, but seniors represent a particular challenge. It can be difficult to
properly diagnose older people who might be exhibiting symptoms of depression
that actually result from other serious medical conditions, such as cancer,
stroke or heart disease. Seniors are also susceptible to vascular depression,
which occurs when blood vessels harden and constrict over time. This loss of flexibility
in the vessels can disrupt normal blood flow to the brain. And certain
medications can have side effects that resemble depressive symptoms.
Indeed, depressive symptoms can
arise from a number of factors closely associated with growing older. A general
biological slowdown can lead to decreased energy, increased health risk, fewer
opportunities for social interaction and a loss of independence. Because these
factors are so common, seniors or their caregivers might be inclined to believe
the symptoms of depression are not serious.
However, although depression isn't a
normal component of the aging process, it is quite common among seniors.
Studies have shown that about 6 million Americans age 65 and older suffer from
depression — and a mere 10 percent of those receive proper treatment.
White males age 85 and older have
the highest suicide rate of any age group, and the main cause is untreated
depression. Many have a depressive illness that their doctors might not detect.
What causes SAD?
The cause of SAD is unclear, but it
might result from several factors related to age, genetics and body chemistry.
In particular, drops in levels of the natural hormones melatonin and the brain
chemical serotonin might lead to SAD symptoms. Both chemicals play a role in
mood, but it's the connection of sunlight with serotonin — and the reduced
level of sunlight in fall and winter — that provides perhaps the biggest clue.
It's well known that these darker seasons can disrupt the body's biological
clock or circadian rhythm.
Put simply, SAD might very well be
caused by the body's reaction to light deprivation — a lack of sunlight.
Treatment
Typically, older adults suffering
from depression show improvement after receiving treatment such as
antidepressants and psychotherapy. In fact, psychotherapy alone might be
particularly effective in addressing mild forms of depression. But perhaps the
most effective way to handle SAD is a combination of psychotherapy, medication
and phototherapy (light therapy).
Caregivers should already be
encouraging the seniors in their care to bring more sunlight (and Vitamin D)
into their lives. During the shorter, colder days of fall and winter, it can be
more of a challenge to seek the sun; even something as simple as opening the
blinds or taking a walk outside can help.
In the absence of such
opportunities, doctors can prescribe phototherapy (or light therapy) to treat
SAD. There are two types of light therapy:
- Bright light treatment — The individual sits in front
of a special fluorescent lamp (a "light box" or
"sunbox") for a specific length of time.
- Dawn or sunshine simulation — In the morning, a light
box gradually brightens from dim to brilliant, like a sunrise, while the
individual is still asleep.
It's amazing what a little sun can
do! Light therapy has a high success rate, typically bringing relief from SAD
within days. But the individual needs to keep up with the treatment. Adding
other simple, proactive measures — getting regular exercise, keeping a
strict sleep schedule and eating a healthy diet — can further enhance the
person's mood.
If a depressed person does not
respond to lifestyle changes such as increased light and exercise, it's
important to seek the help of a health care professional promptly. With proper
attention, SAD is a very treatable condition.
Blog post provided by Society of Certified Senior Advisors
