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
- lack of energy and increased fatigue
- hopelessness, discouragement and feelings of worthlessness
- changes in appetite/weight gain
- concentration/memory problems
- problems sleeping
- suicidal thoughts
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.
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