Seasonal Affective Disorder (SAD) in Children and Teenagers

Seasonal Affective Disorder (SAD) or winter depression as it is also known, is a form of depression that follows a season pattern and appears and disappears at the same time each year. SAD appears when winter approaches and daylight hours become shorter and when spring returns and days become longer, the symptoms resolve, and mood returns to normal. It is estimated that three to five percent of kids age 9 to 17 years old have SAD.

It is believed that SAD is triggered by the brain’s response to decreased daylight exposure. Whilst this still isn’t fully understood yet, many researchers believe that the role of sunlight in the brain’s production of two specific hormones that help regulate sleep-wake cycles, energy and mood is key. The two chemicals are melatonin which is linked to sleep and serotonin which is linked to mood and energy. The more sunlight exposure, serotonin production increases. During winter, greater quantities of melatonin are produced and this increased production of melatonin can cause sleepiness and lethargy. However, with the decrease in daylight and sun exposure, serotonin levels actually decrease thereby depressing mood and energy.

Signs and symptoms of SAD are very similar to major depressive disorder and can be mild, moderate, or severe. The main difference is that the symptoms of SAD only occur for a few months each year, for at least two years in a row, and not during the other seasons. For a diagnosis of SAD, symptoms must be present most of the time for at least two weeks, and include:

  • Sadness
  • Irritability, temper tantrums
  • Anxiety
  • Hypersensitivity
  • Self-critical
  • Crying and easily upset
  • Low energy
  • Changes in sleep especially oversleeping
  • Difficulty concentrating
  • Changes in diet e.g. crave carbohydrates, ‘junk’ food
  • Reduced socialization
  • Feelings of hopelessness and worthlessness
  • Lack of interest, enjoyment

Risk Factors

  • Family history
  • Females are four times more likely than males to develop SAD
  • Current environment (think ACE’s)
  • SAD is more prevalent in those living in higher latitudes e.g. SAD is seven times higher among people in New Hampshire than in Florida

Treatment
Physician assessment is required for a diagnosis of SAD especially as the symptoms often mimic those of ADHD and other mental disorders. Treatment options include:

  • Increased light exposure e.g. use of full spectrum bulbs in home
  • Light therapy e.g. lamp specifically designed for SAD which tricks the body into thinking it is receiving extra hours of daylight. Of note, due to very limited research, light therapy is not recommended for children under the age of 9 years old
  • Talk therapy and family counselling
  • Medication may be used in combination with therapy. The most effective drugs are antidepressants namely the SSRIs which help to regulate the balance of serotonin and other neurotransmitters in the brain that affect mood and energy
  • Human Lumie light e.g. Human Charger headphones which uses fibre optic UV-free blue-enriched white light directly into the ears. Studies indicate the light increases energy levels, boost productivity and lessens effect of SAD.

What Can Parent(s) Do?
If you notice your child/teenager suddenly appears sad, tired, disinterested, ask yourself these questions: Q1. How was your child/teenager in the Summer?
Q2. Was he/she like this the same time last year?
Q3. Is anything else going on?

Once a diagnosis of SAD is confirmed, parents, siblings and family may find the following suggestions helpful:

  • Learn all you can about SAD and help your child/teen, other family understand what is happening
  • Participate in the treatment plan, ensure medications are taken, monitor for any changes
  • Be supportive, non-judgemental and patient
  • Set up a bedtime routine to promote restful sleep
  • Purchase a bedside lamp/alarm so your child/teen will awaken to light in room
  • Spend quality time with child/teen, talk with and listen to concerns, fears, etc.
  • Promote healthy diet and reduce access to junk food, carbohydrate laden foods, sodas
  • Encourage child/teen to exercise outdoors daily e.g. walk, play ball, walk dog, snowball fight
  • Follow up with school and set up homework plan. Kids with SAD do experience difficulty completing assignments during the winter season
  • At home, consider moving bed, chair, desk closer to window. At school ask teacher if desk can be moved closer to window
  • Show love and be there for your child/teenager

In my next Blog #29
I Will Discuss Obsessive Compulsive Disorder in Children and Teenagers

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