Winter Blues? Feeling Sad? Dementia and Seasonal Affective Disorder (SAD)



“This little light of mine…”




Do you or your loved ones suffer from:




∞  Feeling sad, grumpy, moody, or anxious

∞  Avoiding social situations and feeling a loss of interest

     in the activities you used to enjoy

∞  Eating more and craving carbohydrates, such as bread

     and pasta

∞  Weight gain

∞  Sleeping more and feeling drowsy during the daytime

∞  A drop in energy level and fatigue

∞  A tendency to oversleep

∞  Difficulty concentrating

∞  Increased sensitivity to social rejection

∞  Feeling that your physical problems worse (even if they aren’t)


Then you may be suffering from the winter blues or seasonal affective disorder (SAD). It is a type of depression that affects a person during the same season each year. If you get depressed in the winter but feel much better in spring and summer, you may have SAD. Anyone can get SAD, but it is more common in:

  1. People who live in areas where winter days are very short or there are big changes in the amount of daylight in different seasons.
  2. Women.
  3. People between the ages of 15 and 55. The risk of getting SAD for the first time goes down as you age.
  4. People who have a close relative with SAD.

It is possible for an individual to experience many or all of the above symptoms but yet do not feel depressed. I used to see this more frequently with patients who have more difficulty being in touch with their feelings.

For someone suffering from aging or dementia along with SAD, whether mild or severe, their behaviors and moods may be markedly worsened and more difficult to understand. He/she may feel more confused earlier in the day (sundowners) than usual. Their aches and pains might be worse or they might become more withdrawn. Their dementia may not be getting worse. This is because we turn the clocks back one hour and the days are ‘shorter’ which result in less sunlight.

As many as half a million people in the United States may have winter-onset depression. Another 10% to 20% may experience mild SAD. SAD is more common in women than in men. Although some children and teenagers get SAD, it usually doesn’t start in people younger than 20 years of age. For adults, the risk of SAD decreases as they get older. Winter-onset SAD is more common in northern regions, where the winter season is typically longer and more harsh.

When I practiced psychiatry in Pennsylvania, the phone calls always increased during October and particularly after Daylight Saving Time ended. Ironically, I saw very little SAD in patients where I lived in California where it could even be sunny in the winter.

SAD has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and a lack of sunlight in winter. Just as sunlight affects the seasonal activities of animals, SAD may be an effect of this seasonal light variation in humans. As seasons change, people experience a shift in their biological internal clock or circadian rhythm that can cause them to be out of step with their daily schedule. For those who care, research locates the clock in the suprachiasmatic nucleii of the hypothalamus. It’s common to all mammals and that is rather interesting since the hypothalamus is our primitive brain. That primitive part of our brain is very concerned with basic survival and knowing instinctively when darkness is coming, how long the days are, or when it may be time to seek shelter from predators; just the kinds of things that concerned primitive man.

Symptoms come and go at about the same time each year. For most people with SAD, symptoms start in September or October and end in April or May.

Symptoms of SAD keep coming back year after year. They also tend to come and go at about the same time every year. The changes in mood are not necessarily related to obvious things that would make a certain season stressful (like regularly being unemployed during the winter).



A modest improvement in symptoms of dementia has been associated with the use of bright light in daytime, in an effort to improve their circadian rhythms, according to a study released on June 10, 2008 in the Journal of the American Medical Association (JAMA). Additionally, the use of melatonin resulted in improved sleep.


Not to worry! Tomorrow, I will discuss some of the treatments for SAD. I am still impressed with some of the results my patients and I would see when they received the appropriate treatment! They ended up feeling as happy as this smiling lady in the picture.




And a new vocabulary word today.   adumbrate  [a-duhm-breyt, ad-uhm-breyt]

  1. to produce a faint image or resemblance of; to outline or sketch
  2. to foreshadow; prefigure
  3. to darken or conceal partially; overshadow


Do you know the 80/20 rule?

— This is one of the best ways to make better use of your time. The 80/20 rule – also known as The Pareto Principle – basically says that 80 percent of the value you will receive will come from 20 percent of your activities.


— So a lot of what you do is probably not as useful or even necessary to do as you may think.


— You can just drop – or vastly decrease the time you spend on – a whole bunch of things.


— And if you do that you will have more time and energy to spend on those things that really brings your value, happiness, fulfilment and so on.


I utilize the 80/20 rule when it comes to managing my desk. 80% of the time I only use 20% of ‘stuff’ on my desk. The other 80% of my ‘stuff’ gets used only 20% of the time.









2 Responses

  1. Hi David,
    Sad is another thing no one understands, like Chronic Fatigue.
    We moved to Las Vegas area to be near the sunlight, and I have to tell you it does help. A lot!
    People don’t even realize what is wrong with them, we need to shed more light on the subject. Thank you for doing that.
    It’s especially important for dementia patients..they start to sundown when it gets dark. I’m so glad you are explaining this to all of us.
    Thank you.
    Keep love and kisses in your life, and my best to Pam.
    read my blog

  2. hi,thanks for the above advice.tho i experience a feeling of saddness and depresion everyday during sunset hours.

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