Seasonal affective disorder (SAD) is a form of depression that appears at the same time each year, typically as winter approaches. A person with SAD may start to show symptoms when daylight hours are shorter, but when spring returns and the days lengthen, they will experience relief from their symptoms.
What causes seasonal affective disorder?
While the exact cause of SAD is not yet known, experts believe that this type of depression is triggered by the brain’s response to decreased daylight. They believe that the brain may produce an imbalanced level of melatonin and serotonin.
Melatonin and serotonin help regulate a person’s sleep-wake cycles, energy and mood. Shorter days and longer darkness hours in the fall and winter may lead to increased melatonin and decreased serotonin, creating the biological conditions of depression.
What are the symptoms of seasonal affective disorder?
As winter approaches, someone with SAD will often show several changes in personality. These changes will generally present in a predictable, seasonal pattern. These symptoms can affect a child’s self-esteem and leave them feeling disappointed, isolated or lonely, especially if they do not realize what is causing them. Just like with other forms of depression, the symptoms of SAD can be mild, severe or anywhere in between.
Changes in mood
A person affected by SAD may be in an irritable mood or feel sad most or all of the time for at least two weeks during a specific time of year. They may also feel a sense of hopelessness or worthlessness. As part of this mood change, they may also be self-critical and more sensitive to criticism. They may also cry or get upset more easily.
Less time socializing and lack of enjoyment
Someone with SAD may lose interest in things they usually like to do. They may also feel like they can no longer complete tasks as well as they used to, and feel dissatisfied or guilty. It’s also possible that they will appear to lose interest in friends and may stop participating in social activities or extracurricular activities.
Low energy and changes in sleep
Unusual tiredness or unexplained fatigue are also symptoms of SAD. As a result of having low energy, someone with SAD may sleep a lot more than usual. This can make it really difficult for students to get up for school in the morning, stay awake during school or even partake in after-school activities.
Changes in eating
Appetite and diet changes can also be related to SAD. This can include cravings for simple carbohydrates (comfort foods and sugary foods) or the tendency to overeat. Because of this change, SAD can result in weight gain during winter months. Gaining weight can affect a child and make them feel depressed or self-critical. Children and teens are hyper-critical of their bodies and a slight change in their weight can lead to increased sadness or depression.
Difficulty concentrating
The inability to concentrate as normal can interfere with a child’s school performance and grades. A student may have trouble completing assignments on time or may seem to lack their usual motivation. It’s possible that their grades will drop, and teachers may comment that the student seems less motivated or is not trying in school.
How is seasonal affective disorder diagnosed?
Medical and mental health professionals can make a diagnosis of SAD after careful evaluation of the patient. A medical check up is an important part of the diagnosis to ensure that the symptoms aren’t due to an underlying medical condition. Tiredness, fatigue and low energy could be a sign of medical conditions like hypothyroidism, hypoglycemia, or mononucleosis. Other medical conditions can cause appetite changes, sleep changes, or extreme fatigue which makes diagnosing SAD a little tricky. However, medical and mental health professionals can test for certain medical conditions to cross them off the list.
How is seasonal affective disorder treated?
Once a person has been diagnosed with SAD, doctors may recommend one of several treatments:
Increased light exposure
Because symptoms of SAD are triggered by a lack of light exposure, and tend to go away when available light increases, treatment often involves more light exposure during winter months. For someone with mild symptoms, something as simple as taking a walk or exercising outdoors daily may be enough. Another way to accomplish this is to use full spectrum (daylight) lightbulbs that fit in regular lamps because they can help bring more daylight into your home.
Light therapy
Stronger symptoms of SAD may be treated with phototherapy (light therapy). This involves using a special light to simulate daylight. A special light box or panel is placed on a tabletop or desk and the person experiencing symptoms will sit in front of the light for about 45 minutes each day. The person should occasionally glance at the light to allow the light to absorb into the retinas, but should not stare into it for long periods of time. Symptoms will usually improve within a few days to a few weeks, depending on the severity of the symptoms.
Like with any medical treatment, light therapy should only be used when recommended by their pediatrician.
Talk therapy
Psychotherapy (talk therapy) can also be used to help people with symptoms of SAD. Talk therapy focuses on revising the negative thoughts and feelings associated with depression in order to ease the sense of isolation or loneliness. It can also help someone learn about and understand their condition, as well as teach them what to do to prevent or minimize future bouts of seasonal depression.
Medication
Medication may also be prescribed for kids and teens with SAD. Antidepressant medications can help regulate the balance of serotonin and other neurotransmitters in the brain that affect mood and energy.
Can families deal with seasonal affective disorder at home?
In addition to medical interventions, there are lots of things that kids and families can do at home to relieve and prevent symptoms of seasonal depression.
- Learn about the condition and explain it to friends and family so they can understand your child better.
- Get plenty of exercise, and exercise outside when possible. It can be a mood booster!
- Spend time with friends and loved ones who understand what your child is going through. They can help provide a sense of connection.
- Be patient and don’t expect symptoms to go away immediately.
- Help your child with homework and other assignments when needed. If they are having trouble concentrating, talk to your child’s teacher to work on a plan to help your child complete assignments at home.
- Eat a balanced diet. While it may be difficult, avoiding simple carbohydrates and sugary snacks can help kids feel better in the long run. Focus on getting lots of wholegrains, vegetables and fruits.
- Develop a sleep routine. Following a regular bedtime can help kids reap the mental health benefits of daytime hours.
Depression of any kind can be serious. If you think your child is experiencing symptoms of depression, seasonal or otherwise, please reach out to medical and mental health professionals.
Children’s Minnesota can help
At Children’s Minnesota, we understand that being a kid isn’t always fun and games. Sometimes there are obstacles along the way. Our behavioral pediatrics professionals are here to help children navigate those obstacles.
We understand that mental health issues don’t just affect your child — they affect your whole family. And we’re here to help.
Inpatient mental health center at our St. Paul hospital
We plan to open an inpatient mental health center at our St. Paul hospital in the latter half of 2022. The new inpatient center will be the first in the east metro to treat kids under 12 years old and will be able to serve children with other complex medical conditions. Annually, the center is expected to care for more than 1,000 children and adolescents, meeting the urgent mental health needs of the most vulnerable kids in Minnesota and the region.
Our Lakeville specialty center offers behavioral health services
In June 2021, our specialty center in Lakeville started offering an adolescent partial hospitalization program (also called a mental health day-program) designed to meet the needs of each individual child. Patients will have hours of therapy each day, but will return home with their families each night.
To learn more about our adolescent partial hospitalization program or to learn about enrolling your child, call 952-992-6750.