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Winter Blues and Seasonal Affective Disorder

As winter approaches, some of us may experience the “winter blues” – feeling sad from shortening days, climbing into bed earlier and resenting waking up on dark mornings.

That’s different than Seasonal Affective Disorder (SAD), a term used to describe a type of depression that follows a seasonal pattern.

The most common form of SAD occurs in winter, although some people do experience symptoms during spring and summer. And while SAD is often talked about in terms of adults, children and adolescents are not necessarily immune.

Who is at risk for SAD?

SAD usually develops in a person's early 20s but can occur in older children and teens. The risk for the disorder decreases as you get older. SAD is diagnosed most often in young women, but men who have SAD may suffer more severe symptoms. People with a family history of SAD or those who live in northern latitudes where daylight hours during winter are shorter are at a higher risk for developing SAD.

Symptoms of SAD

When experiencing SAD, a person may

  • withdraw socially and no longer enjoy things that used to be fun. It's as if a person's batteries have just run down.

  • crave comfort foods, including simple carbs such as pasta, breads, and sugar. With excess unhealthy calories and a lack of fresh fruits, vegetables, and whole grains, fatigue often sets in, leading to increased sleepiness and weight gain.

  • feel anxious, irritable, have trouble sleeping, or decreased appetite. These symptoms are more common with the spring/summer form of SAD.

​No Known Cause​

Researchers have not determined what causes SAD. There is some evidence pointing to a disruption of a person's "circadian rhythm" — the body's natural cycle of sleeping and waking. As the days shorten, the decreasing amount of light can throw off the body's natural clock, triggering depression. Sunlight also plays a role in the brain's production of melatonin and serotonin. During winter, your body produces more melatonin (which encourages sleep) and less serotonin (which fights depression). Researchers do not know why some people are more susceptible to SAD than others.

In general, SAD is a better-recognized disorder in adults because so many children's mental health disorders emerge over time. Diagnosing SAD in a child is not easy, because determining the pattern of depression takes time. A doctor will typically attempt to determine whether a child is suffering from depression or anxiety first, then look at the pattern over time. The diagnosis of SAD is made only if a person meets criteria for a diagnosis of depression and if a seasonal pattern of symptoms has been present for at least 2 years.

In order to diagnose SAD, doctors need to perform a medical exam to rule out other possible causes of the symptoms. They may also administer questionnaires to determine mood and look for seasonal patterns.

Treating SAD

Several effective treatments can help ease the symptoms of SAD, including:

  • Opening the window shades in your home. Simply bringing more sunlight into your life can treat mild cases.

  • Spending time outdoors every day, even on cloudy days.

  • Exercising regularly and eating a healthy diet, one low in carbohydrates and high in vegetables, fruit, and whole grains.

  • Using a "dawn simulator," which gradually turns on the bedroom light, tricking the body into thinking it's an earlier sunrise.

  • Planning a mid-winter family vacation to a sunny climate.

  • Light therapy - sitting in front of a strong light box or wearing light visors, with UV rays filtered out. However, light therapy may have risks when used for children. Talk to your child's doctor before considering this treatment option.

If none of these treatments work, prescription antidepressants​ may help regulate the balance of serotonin and other neurotransmitters that affect mood. Antidepressants, however, come with a "black box" warning about the risk of suicidal thoughts and behavior. Parents with children on antidepressants need to be vigilant in watching for agitation, anxiety, or insomnia and make sure they continue to see their physician on a regular basis.

​Working through it together

Whether noticing symptoms of SAD in yourself or in your child, take it seriously. Treating this disorder early and diligently can turn the dark days of winter into a pleasant time of togetherness for your family. ​

Additional information:


 
Last Updated
1/24/2020
Source
American Academy of Pediatrics (Copyright © 2020)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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