Children’s health: Seasonal affective disorder can also affect adolescents

As winter approaches, some of us may experience the “winter blues” – feeling sad from shortened days, climbing into bed earlier and resenting waking up on dark mornings. That’s different from seasonal affective disorder (SAD), a term used to describe a type of depression that follows a seasonal pattern.

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

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

When experiencing seasonal affective disorder, a person may withdraw from social situations, lose interest in things they previously enjoyed, have trouble sleeping, experience decreased appetite, or crave comfort foods such as simple carbs like pasta, breads, and sugar. Those excess calories and lack of healthier food options can lead to increased fatigue and weight gain.

Those living with the disorder may also feel anxious, irritable, or have trouble sleeping, but these symptoms are more prominent in those who experience the spring/summer form.

Researchers have not determined what causes seasonal affective disorder, but 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 the disorder than others.

In general, seasonal affective disorder is a better-recognized disorder in adults because so many children's mental health disorders emerge over time. This makes diagnosing the disorder in a child more difficult.

A doctor will typically try to determine whether a child is suffering from depression or anxiety first, then look at the pattern over time. The diagnosis 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 two years.

In order to diagnose seasonal affective disorder, 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.

Several effective treatments can help ease the symptoms of seasonal affective disorder, but most include increased exposure to sunlight either via open window shades, time spent outdoors, light therapy, or a dawn simulator that gradually turns on the bedroom light, tricking the body into thinking it's an earlier sunrise. Other treatments can include regular exercise, a healthy diet, or even a mid-winter vacation to a sunny climate.

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.

Whether you notice symptoms of seasonal affective disorder 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. If symptoms persist or interfere with daily life, families should talk with their child’s pediatrician, who can help guide next steps and determine whether additional support is needed,

• Children's health is a continuing series. This column was provided by the American Academy of Pediatrics. See more at www.healthychildren.org.