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20 Feb, 2023
Seasonal affective disorder (SAD) usually pops up in the news when the leaves start to fall and the days become noticeably shorter. In the United States, an estimated 10 million people experience SAD. SAD is a type of depression characterized by feelings of sadness and sluggishness brought on by the changing of the seasons. While many people don’t experience full-blown SAD, their moods and outlook may still change due to the seasons. This can be particularly true for hospice and home health patients.
Most people who experience seasonal mood shifts see a profound change during the winter when the days are short. Researchers speculate that this could be due to vitamin D deficiency from lack of sunlight and the disruption to a person’s circadian rhythm. People’s bodies react to changes in light, producing hormones that make them sleepy when it gets dark and becoming more alert when the sun rises.
During the winter months, this pattern is often disrupted. Sunlight impacts how the brain produces serotonin and melatonin, which both impact mood, concentration, and sleep patterns. Although it’s not as common, some people experience SAD in the spring and summer, which usually causes them to experience insomnia and anxiety.
SAD may be hard to diagnose in home health and hospice patients because they are prone to depression. Estimates vary widely, but anywhere between 24% and 70% of palliative care patients experience depression.
If a hospice or home health patient only experiences depression around the changing of the seasons, it’s likely due to SAD. Patients experiencing SAD probably had it before their illness. If a person usually experiences mood disorders in the fall or spring, they will likely continue experiencing them during hospice or home health care. Providers should ask their patients’ family members if they were prone to seasonal mood changes.
Patients with SAD benefit from light therapy in which they use a special light within the first hour of waking up to mimic natural circadian rhythms. They may also benefit from antidepressants during the winter.
Some patients with SAD have been treated with emotional support animals. Animals offer a physical and emotional connection that helps alleviate some of the depression that comes from a change in the seasons. It also helps them concentrate on something other than their shifting mood.
For hospice and home care patients who are strong enough to walk a dog, they have a reason to go outside and get some fresh air, which helps treat their seasonal mood changes. Sun exposure also helps people with SAD, so home health and hospice patients experiencing seasonal disorders should have a place near the window where they can sit comfortably during the day.
SAD can also be treated with cognitive behavioral therapy, which can also help home health care and hospice patients navigate palliative care. This type of therapy helps patients identify their negative thoughts and recognize how their behavior patterns might be connected to the changing seasons.
Recognizing how seasons impact mental health is the first step in effectively treating SAD. Hospice and home health providers should stay alert to behavioral changes at the onset of fall so they can work with patients on an effective treatment plan.