Boston Children's Health Physicians | Seasonal Affective Disorder

Julia Miller, LMSW – Briarcliff Pediatrics, Caring Pediatrics

Tara Navarra, LMSW – Branch Pediatrics

Ryan Ramsey, LMSW – Washingtonville Pediatrics

Chelsea Lopez, LMSW – Herbert Kania Pediatrics, Pediatric Care of the Hudson Valley

Seasonal Affective Disorder: When winter makes your child SAD, and what to do about it

Do the winter months make your child feel sad? If so, and if the sadness is deep and persists for the entire season, it could be caused by Seasonal Affective Disorder (SAD). This is a condition that causes major depression to occur during specific seasons of the year and typically reoccurs.

Exploring the cause of SAD

While it’s normal for everyone to feel sad sometimes, SAD symptoms can be deeper and may include: feelings of sadness, hopelessness, lethargy, unexplained fatigue, change in appetite, disrupted sleep and/or difficulty concentrating. SAD is most common as winter approaches and daylight hours become shorter. When spring returns and days become longer, people with SAD experience relief from their symptoms, returning to their usual mood and energy level.

Experts have been researching this condition for decades, yet there is no known cause for SAD. Theories center on the interaction between the body and sunlight, exploring how exposure to light affects a part of the brain called the hypothalamus and its production of melatonin and serotonin. Light might also impact the body’s circadian rhythms (biological clock). Many have theorized that SAD may be caused by the body’s difficulty to regulate serotonin, overproduction of melatonin or low vitamin D production.

Risk factors for SAD include: age, gender (females are higher risk), having a history of depression, having a family history of SAD, and having a geographic location further from the equator.

How SAD impacts children and teens

SAD usually develops in adulthood, but it can also affect children and teens. Therefore, it’s important to recognize that depression symptoms may look very different in young people. Children and adolescents with SAD may have:

• The presence of irritability. When we think of depression, sadness often comes to mind. However, depression in adolescents can also present anger, frustration, or general irritability.
• Changes in sleep. While insomnia tends to be a symptom of depression in adults, children and teens may sleep more than usual or sleep at unusual hours of the day.
• Feelings of low self-worth. For example, children with depression struggle to concentrate on their school work. Their grades may drop, which can harm their self-esteem.

Signs parents should look for

If you’re worried your child or teen could have SAD, there are some clues to look for. For instance, look for a pattern of symptoms. Does your child’s behavior or mood seem to change every fall or winter? Second, what does that change look like? Does your child appear sad, tearful, or irritable? Have they lost interest in the activities they usually enjoy? Are there any changes in eating/sleeping patterns? Are they socializing less with friends, or have they changed peer groups? Is your child more sensitive to critiques? Are they feeling tired or have less energy? Have they expressed any thoughts of hurting themselves or others? It is also important to be mindful of physical complaints such as frequent headaches or stomach aches as these can be signs of depression in younger children.

How to address SAD

The good news is that SAD can effectively be treated and managed. The first step is recognizing the symptoms and seeking help from a behavioral health consultant, pediatrician, or another trusted mental health professional. In some cases, medications are an option.

Here are some other steps to address SAD:

• Keep communication open. When your child feels safe and comfortable expressing their feelings to you, they are more likely to open up about their struggles as well.
• Encourage your child to set small goals each day. This helps with motivation and provides self-esteem boosts.
• Encourage as much time outdoors as much as possible. When winter weather doesn’t permit, open the blinds to allow as much natural light in as possible. Or, try “lightbox therapy,” using "natural light" bulbs and lamps that offer a helpful alternative to sunshine.
• Have your child utilize a journal to keep track of some of his/her thoughts and feelings. This can be anything from a physical notebook to a note on their iPad.
• Research has shown that physical exercise significantly improves depressive symptoms. However, the compacting effect of SAD symptoms and cold/inclement weather can be a barrier to physical exercise for many people. Consider joining a gym, or bundle up and take a family walk.
• A behavioral health consultant can screen for SAD and other behavioral/mental health concerns and offer help with coping strategies and symptom management.

When depression symptoms are severe

If your child is exhibiting more severe symptoms of depression or talking about self-harm, always contact 911 or go to your local emergency room.