Beating the Winter Blues: Combating Seasonal Affective Disorder
Winter is here. The sun does not rise until after 7:30 AM and sets at around 4:30 PM. People feel lethargic all day. Curling up in bed seems like a great option. The holidays are just around the corner. But holiday cheer seems to be a distant dream. It becomes difficult to find the motivation to get through the day.
People colloquially call it the “Winter Blues.” In the healthcare community, it is “Seasonal Affective Disorder” or SAD. Norman Rosenthal a South African author and psychiatrist, was the first to recognize and describe SAD along with his colleagues in the early 1980’s. He was curious why he felt sluggish and lethargic during winter after he moved from South Africa to New York. Initially, his work was met with skepticism. Today SAD is a depressive condition recognized in the “Diagnostic and Statistical Manual of Mental Disorder.” According to the Mayo Clinic, over 3 million North Americans suffer from SAD every winter.
Common symptoms of SAD include lethargy, fatigue, overeating, weight gain, anxiety, irritability, and inability to concentrate. The symptoms of SAD can have significant impacts on a patient’s health. Lethargy and fatigue can disrupt daily routines leading to missed or late medication dosages. Overeating and weight gain can negatively impact the health of patients with diabetes, heart disease, and other disorders where diet and exercise are a part of managing the condition. SAD can also exacerbate the symptoms of patients suffering from bipolar disorder and depression.
As a regular point of contact, patients tend to turn to pharmacists to ask questions and seek advice about their health. Pharmacists can play a crucial role in the management and treatment of SAD. Here are a few ways pharmacists can help manage SAD.
Establish open communication 
Pharmacists (along with nurses) are consistently one of the most trusted professions. Pharmacists should reciprocate this trust by building a relationship based on transparency, trust and open communication. Show genuine interest in your patient’s health and well-being and communicate with them regularly.
Educate people about SAD
Make people aware of SAD. Let them know that “Winter Blues” is not just something they have to “get over”and deal with on their own. It is a depressive condition that can be identified and managed with support from their healthcare team. Help them identify symptoms and encourage them to share all health concerns with their care team.
Check in on their well being
Check in with your patients regularly to see how they are doing. Ask them how they are feeling. Inquire if they have any questions or concerns with their medications. Check in to see if their medication is working as expected, they have been persistent in taking their medication and they have experienced no medication-related issues. Questions like “how is the winter going for you?” or “has the time change impacted your medication schedule?” can help build rapport and encourage patients to open up to you. Regular well-being check-ins not only can identify symptoms of SAD but can also help quickly if a medication is not working as intended.
Suggest light therapy
Light therapy is one of the ways to combat SAD. It uses light boxes or sun lamps that mimic the appearance of natural sunlight. Studies show that the simulation of natural sunlight alleviates the symptoms of SAD. Light boxes and sun lamps come in a wide variety of price ranges and features. While a prescription is not necessary, patients may find it beneficial to consult with their doctor about recommended usage.
Encourage socialization and activity
Lethargy and fatigue can prevent people from engaging in regular socialization. Loneliness from being cut off from usual activity can trigger depression. It can be difficult to be active when it is overcast and dark for a large portion of the day. But there are ways to address these issues. Recommend your patients to pursue a winter sport to maintain their fitness and training regimes through the winter. Work with your patients to brainstorm a list of activities they can enjoy indoors and outdoors. Help them find a club or hobby group to pursue activities of interest. Suggest that they plan some social activities with friends like a meal out, going to a play or just having a few people over for wine and cheese or movies. Small amounts of socialization and activity can go a long way in making people feel rejuvenated and energized.
Let them indulge in little things
Denmark consistently ranks as one of the happiest countries in the world. The Danish have a concept known as “hygge.” It loosely translates into “comfort, warmth, and peace.” It means finding comfort and warmth in little things. It includes savoring elements like the light of a candle, the scent of potpourri or the taste of wine. Let your patients know that they can indulge in moderation in activities that bring them comfort, warmth, and peace.
Practice Mindfulness and Optimism
Recent studies in neuroplasticity have shown that people can train their brain to be happier. Meditation, gratitude journals, setting intentions are various techniques people use to feel positive year round. Encourage your patients to find something that works for them and practice it year round to help combat SAD.
Help them seek the help they need
Not everyone will be able to combat the symptoms of SAD on their own. Depression is a serious mental health condition and may require professional help. Certain metabolic conditions like hyper/hypothyroid and diabetes may also need professional intervention to adjust the dosage or manage diet to manage symptoms of SAD. Ask questions and listen. If they are in need of medical assistance, encourage them to go to their doctor or specialist for help. Encourage them to advocate for themselves and advise them on questions to ask/talking points to discuss so that the healthcare team can provide them the help they need to combat SAD.
We hope these tips help you become aware of patients who need assistance and work with them to identify and manage SAD. Practicing these tips will also continue building trust, enhance communication with your patients and help you become a better advocate for their healthcare needs. The Division of Pharmacy Professional Development offers several CE courses for Pharmacists and Healthcare Professionals to improve patient outcomes.
References:
- https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651
- https://www.rd.com/health/wellness/scandinavian-seasonal-depression/
- https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682039/