Sarah started off her junior year of high school with great energy. She had no trouble keeping up with her schoolwork and was involved in several after-school activities. But after the Thanksgiving break she began to have trouble getting through her assigned reading and had to work harder to apply herself. She couldn't concentrate in class, and after school all she wanted to do was sleep. Her grades began to drop, and she rarely felt like socializing anymore. Even though Sarah was always punctual before, she began to have trouble getting up on time for school and was absent or late many days during the winter.
At first, Sarah's mom & dad thought she was slacking off. They were upset with her, but they figured it was just a phase — especially because her energy finally seemed to return in the spring. But when the same thing happened the following November, and Sarah's mood and her grades plummeted again, they took her to the doctor, who diagnosed her with a type of depression called seasonal affective disorder, or SAD.
What Is Seasonal Affective Disorder?
A form of depression that follows a seasonal pattern, SEASONAL AFFECTIVE DISORDER appears and disappears at the same times each year. People with SEASONAL AFFECTIVE DISORDER typically experience symptoms of depression as winter approaches and daylight hours become shorter. When spring returns and the days become longer again, they experience relief from the symptoms and a return to a normal mood and energy level.
Signs and Symptoms—
Like other forms of depression, the symptoms of SEASONAL AFFECTIVE DISORDER can be mild, severe, or anywhere in between. Milder symptoms minimally interfere with someone's ability to participate in everyday activities, while more severe symptoms can interfere much more.
The symptoms of SEASONAL AFFECTIVE DISORDER are the same as those of depression, but simply occur during a specific time of year. It's the seasonal pattern of SEASONAL AFFECTIVE DISORDER — the fact that symptoms occur only for a few months each winter (for at least 2 years in a row) but not during other seasons — that distinguishes SEASONAL AFFECTIVE DISORDER from other forms of depression.
Symptoms of SEASONAL AFFECTIVE DISORDER may include:
· Low energy: unusual tiredness or unexplained fatigue
· Less time socializing: spending less time with friends in social or extracurricular activities
· Lack of enjoyment: loss of interest in things that are normally enjoyable; feeling like tasks can't be accomplished as well as before; feelings of dissatisfaction or guilt
· Difficulty concentrating: more trouble than usual completing assignments on time; lack of usual motivation (which can affect school performance and grades)
· Changes in sleep: sleeping much more than usual (which can make it difficult for kids with SEASONAL AFFECTIVE DISORDER to get up and get ready for school in the morning)
· Changes in mood: seasonal affective disorderness, irritability, and/or feelings of hopelessness or worthlessness most of the time for at least 2 weeks; tendency to be more self-critical and more sensitive than usual to criticism; crying or getting upset more often or more easily
· Changes in eating: craving simple carbohydrates (i.e., comfort foods and sugary foods); tendency to overeat (which could result in weight gain during the winter months)
The problems caused by SEASONAL AFFECTIVE DISORDER — such as lower-than-usual grades or less energy for socializing with friends — can affect self-esteem and leave people feeling disappointed, isolated, and lonely, especially if they don't realize what's causing the changes in energy, mood, and motivation.
What Causes SEASONAL AFFECTIVE DISORDER?
It's believed that with SEASONAL AFFECTIVE DISORDER, depression is somehow triggered by the brain's response to decreased daylight exposure. How and why this happens isn't yet fully understood. Current theories about what causes SEASONAL AFFECTIVE DISORDER focus on the role of sunlight in the brain's production of certain key hormones that help regulate sleep-wake cycles, energy, and mood. Two naturally occurring chemicals in the body, melatonin and serotonin, are currently thought to be involved in SEASONAL AFFECTIVE DISORDER.
Melatonin, which is linked to sleep, is produced in greater quantities when it's dark or when days are shorter. Increased production of melatonin can cause sleepiness and lethargy. Serotonin production increases with exposure to sunlight. Low levels of serotonin are associated with depression, so increasing the availability of serotonin helps to combat depression. Shorter days and longer hours of darkness in fall and winter may cause increased levels of melatonin and decreased levels of serotonin, the combination of which may create the biological conditions for depression.
Who Gets SEASONAL AFFECTIVE DISORDER?
About 6 in every 100 people (6%) experience SEASONAL AFFECTIVE DISORDER. Although SEASONAL AFFECTIVE DISORDER can affect kids and young teens, it's most common in older teens and young adults, usually starting in the early twenties. Like other forms of depression, females are about four times more likely than males to develop SEASONAL AFFECTIVE DISORDER, as are people with relatives who have experienced depression. Individual biology, brain chemistry, family history, environment, and life experiences may also make certain individuals more prone to SEASONAL AFFECTIVE DISORDER and other forms of depression.
The prevalence of SEASONAL AFFECTIVE DISORDER varies from region to region, and it's far more abundant among people who live in higher latitudes. For instance, one study found the rates of SEASONAL AFFECTIVE DISORDER were seven times higher among people in New Hampshire than in Florida, suggesting that the farther someone lives from the equator, the more likely they are to develop SEASONAL AFFECTIVE DISORDER. Interestingly, when people who get SEASONAL AFFECTIVE DISORDER travel to lower latitude areas during winter where there is more daylight, they don't experience their seasonal symptoms.
However, most people don't experience seasonal depression, even if they live in areas where days are shorter during winter months. Why certain individuals are more likely to experience SEASONAL AFFECTIVE DISORDER isn't yet fully understood. It may be that they are more sensitive than others to the variations in light, and therefore may experience more dramatic shifts in hormone production depending on their exposure to light. Research into the causes and mechanisms of SEASONAL AFFECTIVE DISORDER continues, as does research into why some people are more likely than others to experience SEASONAL AFFECTIVE DISORDER.
Treatment—
Treatment for SEASONAL AFFECTIVE DISORDER, which varies depending on the severity of the symptoms, includes:
· Talk Therapy (Psychotherapy). Helping to ease the sense of isolation or loneliness, talk therapy focuses on revising the negative thoughts and feelings associated with depression. Talk therapy can also help people with SEASONAL AFFECTIVE DISORDER to learn about and understand their condition as well as learn what to do to prevent or minimize future bouts of seasonal depression.
· Medication (Pharmacotherapy). Medications, which might be used in combination with talk therapy and light therapy, may be prescribed for a youngster or teen with SEASONAL AFFECTIVE DISORDER and should be monitored by a doctor. Antidepressant medications help to regulate the balance of serotonin and other neurotransmitters in the brain that affect mood and energy. Be sure to let your doctor know about any other medications your youngster takes, including over-the-counter or herbal medicines, which could interfere with prescription medications.
· Light Therapy (Phototherapy). Stronger symptoms may be treated with light therapy involving the use of a special stronger light that simulates daylight. A special light box or panel is placed on a tabletop or desk, and the person sits in front of the light for a short period of time every day (45 minutes a day or so, usually in the morning) with their eyes open, glancing — not staring — occasionally at the light (to work, the light has to be absorbed through the retinas). Symptoms tend to improve within a few days or weeks. Generally, light therapy is used until enough sunlight is available outdoors. Some mild side effects of phototherapy might include headache or eyestrain. Lights that are used for SEASONAL AFFECTIVE DISORDER phototherapy must filter out harmful UV rays. Tanning beds or booths should not be used to alleviate symptoms of SEASONAL AFFECTIVE DISORDER. The ultraviolet rays emitted by tanning beds can damage skin and cause wrinkles, age spots, and even lead to skin cancer such as melanoma. Phototherapy should be used with caution if your youngster has: another type of depressive disorder, skin that's sensitive to light, or medical conditions that may make his or her eyes vulnerable to light damage. Be sure to discuss any of these situations with your doctor. Like any treatment, phototherapy should be used under a doctor's supervision.
· Increased Light Exposure. Because the symptoms of SEASONAL AFFECTIVE DISORDER are triggered by lack of exposure to light and tend to go away on their own when available light increases, treatment for SEASONAL AFFECTIVE DISORDER often involves increased exposure to light during winter months. For someone with mild symptoms, it may be enough to spend more time outside during the daylight hours, perhaps by exercising outdoors or taking a daily walk. Full spectrum (daylight) light bulbs that fit in regular lamps can help bring a bit more daylight into your home in winter months and might help with mild symptoms.
What Moms & dads Can Do—
Talk to your doctor if you suspect your youngster has SEASONAL AFFECTIVE DISORDER. Doctors and mental health professionals make a diagnosis of SEASONAL AFFECTIVE DISORDER after a careful evaluation and a checkup to ensure that symptoms aren't due to a medical condition that needs treatment. Tiredness, fatigue, changes in appetite and sleep, and low energy can be signs of other medical problems, such as hypothyroidism, hypoglycemia, or mononucleosis.
When symptoms of SEASONAL AFFECTIVE DISORDER first develop, it's not uncommon for moms & dads to attribute low motivation, energy, and interest to an intentional poor attitude. Learning about SEASONAL AFFECTIVE DISORDER can help them understand another possible reason for the changes, easing feelings of blame or impatience with their youngster or teen.
Moms & dads sometimes are unsure about how to discuss their concerns and observations. The best approach is usually one that's supportive and nonjudgmental. Try opening the discussion saying something like, "You haven't seemed yourself lately — you've been so seasonal affective disorder and grouchy and tired, and you don't seem to be having much fun. It seems like you've been feeling kind of worn out and exhausted — like you just can't get enough sleep. So, I've made an appointment for you to get a checkup. I want to help you to feel better and get back to doing your best and enjoying yourself again."
Here are a few things you can do if your youngster or teen has been diagnosed with SEASONAL AFFECTIVE DISORDER:
· Be patient. Don't expect symptoms to go away immediately. Remember that low motivation, low energy, and low mood are part of SEASONAL AFFECTIVE DISORDER — it's unlikely that your youngster will respond cheerfully to your efforts to help.
· Encourage your youngster to get plenty of exercise and to spend time outdoors. Take a daily walk together.
· Establish a sleep routine. Encourage your youngster to stick to a regular bedtime every day to reap the mental health benefits of daytime light.
· Find quality time. Spend a little extra time with your youngster — nothing special, just something low-key that doesn't require much energy. Bring home a movie you might enjoy or share a snack together. Your company and caring are important and provide personal contact and a sense of connection.
· Help with homework. You may have to temporarily provide hands-on assistance to help your youngster organize assignments or complete work. Explain that concentration problems are part of SEASONAL AFFECTIVE DISORDER and that things will get better again. Kids and teens with SEASONAL AFFECTIVE DISORDER may not realize this and worry that they're incapable of doing the schoolwork. You may also want to talk to the teachers and ask for extensions on assignments until things get better with treatment.
· Help your youngster to eat right. Encourage your youngster to avoid loading up on simple carbohydrates and sugary snacks. Provide plenty of whole grains, vegetables, and fruits.
· Help your youngster understand SEASONAL AFFECTIVE DISORDER. Learn about the disorder and provide simple explanations. Remember, concentration might be difficult, so it's unlikely your youngster will want to read or study much about SEASONAL AFFECTIVE DISORDER — if so, just recap the main points.
· Participate in your youngster's treatment. Ask the doctor how you can best help your youngster.
· Take it seriously. Don't put off evaluation if you suspect your youngster has SEASONAL AFFECTIVE DISORDER. If diagnosed, your youngster should learn about the seasonal pattern of the depression. Talk often about what's happening, and offer reassurance that things will get better, even though that may seem impossible right now.
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