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Shining a Light on Seasonal Affective Disorder

Eran Metzger, M.D.'s picture
Shining a Light on Seasonal Affective Disorder
Shining a Light on Seasonal Affective Disorder

It’s that time of year again when the days get shorter and colder.  It is also the time of year when a condition known as fall-onset seasonal affective disorder, or SAD, becomes a problem for some older adults. I have blogged about this in the past, but with the shortest days of the upon us, I thought it would be helpful to revisit, and expand on the topic.

Fall-onset SAD is a form of depression that is distinctly linked to loss of daylight, beginning in the fall and lasting through the winter months. In addition to causing anxiety and a sense of helplessness, it can have a cascading effect on an individual’s overall health and quality of life.

While it is certainly normal to respond to colder and darker days by hunkering down inside with a cup of hot cocoa by a cozy fire, it is not normal to become socially isolated, depressed and physically dysfunctional.  The latter are signs that an individual should be evaluated for SAD, and if diagnosed, treated by a physician.

Social isolation may well be the most serious risk factor associated with SAD. Those of us who care for older adults know that maintaining a strong social network is essential to their overall wellness. SAD is notorious for sapping an older person’s motivation to get together with family and friends.  Research has shown that social isolation impacts health and behavioral habits, contributing to poor nutrition and physical, as well as cognitive decline. It has even been shown to be a predictor of death from coronary disease.

SAD also causes its own unhealthy biological symptoms. SAD is known to cause hypersomnia, which is a term applied to disorders characterized by excessive daytime sleepiness. Appetite also often increases, causing cravings for carbohydrate-rich foods, which can lead to weight gain. Isolation, lack of motivation, weight gain, and energy loss all contribute to a sedentary lifestyle, which often sets individuals on a trajectory toward immobility.  And as we know all too well, immobility has a profound effect on quality of life and ultimately, independence. 

Although anyone can suffer from SAD, it does tend to affect people later in life, afflicting both men and women equally. The good news is effective treatment is available. Unlike other depressions, there is a biological treatment that addresses the physiologic problem associated with SAD.

Experts think that light therapy is often the best treatment to try first for fall-onset SAD, but only if the person is not severely depressed or thinking about suicide. For those patients, antidepressant medicines might be a better option.

You and your doctor, nurse, or counselor can decide which treatment is best for you. Some people do well if they combine different treatments.

Whatever treatment you try, keep in mind that it sometimes takes patience to find a treatment that works. In some cases, people who take medicines have to try a few different medicines before they find one that works for them. Plus, most treatments take some time before they start working. The key is to work with your doctor, nurse, or counselor, and to keep him or her informed about any problems.Don’t succumb to SAD, but rather “lighten up.” Spring will come again!

If you're interested to learn more on the subject, I recently filmed a video about SAD for Boston's Elderly Comission. Click here to view the video on their YouTube channel. 

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Director of Psychiatry

Eran D. Metzger, M.D., is director of psychiatry at Hebrew Rehabilitation Center. Board certified in psychiatry, neurology and forensic psychiatry, Dr. Metzger's clinical interests focus on the interfaces between medical illness and emotional disorders, as well as medical ethics. He is a graduate of the Pennsylvania State University College of Medicine and completed his internship at Brockton Hospital and his residency and fellowship at Beth Israel Deaconess Medical Center. An assistant professor of psychiatry at Harvard Medical School, Dr. Metzger's research interests include...

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