Leah has watched her 13-year-old daughter struggle with symptoms of anxiety and depression for nearly seven years, but it was only in the past several months that she and her daughter have realized that the symptoms seem to come and go with the seasons.
“As the days get colder and shorter, she starts to become really withdrawn and stops doing a lot of the things she typically enjoys,” says Leah, who asked to be identified by first name only to protect her daughter’s privacy. “She also tends to retreat to her room and seems to want to sleep much more in the winter time than she does during the spring and summer months.”
Leah is not alone in making the connection between her daughter’s depression and the changing seasons. Seasonal affective disorder is a subtype of major depressive disorder that displays a seasonal pattern. For most individuals living with SAD, this means that their major depressive symptoms arrive in late fall and tend to taper off in the spring when the weather begins to warm up and daylight starts to last longer.
In older children and adolescents, signs of depression — seasonal or otherwise — can include losing interest in things they liked before, a change in appetite or weight, changes in sleep patterns, low energy, feelings of hopelessness or worthlessness, and difficulty concentrating. With younger kids, who are less able to communicate their feelings verbally, symptoms of depression are often characterized by behavioral changes.
“Behavior is a communication tool for kids,” says Kamilah Jackson, a physician and the medical director at AmeriHealth Caritas, a national health-care provider for underserved populations. “Depression in younger kids often appears as irritability or snappiness rather than sadness, although some kids may seem sad or express loneliness.”
While an official diagnosis of seasonal affective disorder can take years to obtain, parents and practitioners can be on the lookout for specific symptoms that point to the fact that a child’s depression may be seasonal. In addition to noticing that symptoms arrive in late fall, Mylien Duong, a clinical child psychologist and social-emotional learning researcher at Committee for Children, says that there are some specific characteristics that parents can look out for that indicate the issue could be seasonal. While depression often causes changes in sleep and appetite, SAD is characterized specifically by an increase in sleep and an increase in appetite.
“Cravings for comfort food, carbs, weight gain and a loss of energy can all be specific symptoms of SAD,” Duong says.
Experts also say that the social climate of 2020 might make it particularly challenging to accurately diagnose seasonal affective disorder or even major depression in children and adolescents. Because widespread school shutdowns are causing strife for a lot of children, it’s likely that some who are struggling with underlying depression may have their symptoms misdiagnosed as issues with virtual learning, isolation or loneliness related to the pandemic.
If parents are noticing a behavioral shift in their children, or their kids are telling them that something is wrong, it’s important to listen.
“Older kids and adolescents can often communicate their feelings verbally,” says Jackson, though parents may have to be intentional about raising the subject of mental health. Jackson suggests parents share a neutral observation, such as, “I’ve noticed you spending time in your room more often and that you’re having trouble sleeping.” Then ask the child what that might mean: “I’m wondering if you’re feeling sadder than usual?” It can also be helpful for parents to take notes or keep a journal of their observations. Jotting down simple information about when symptoms occur can help parents provide accurate information to a mental health care provider and, hopefully, get an accurate diagnosis — and effective treatment — sooner.
While a child who is diagnosed with major depression is likely to be referred for treatment that will improve their symptoms, if the seasonal aspect of their depression is not recognized, they may miss out on therapies that could provide particular benefit. Talk therapy is typically considered the first line of treatment for kids with depression, and many families decide to explore medication next. In addition to these options, seasonal affective disorder tends to respond well to other targeted treatments, such as daylight exposure, artificial light therapy and vitamin supplements.
“A lot of the science points to the impact that shorter daylight hours can have on hormones, which can lead to increases in melatonin and decreases in serotonin,” Duong says. This shift in the hormones that regulate sleep and mood can increase depressive symptoms. Another option is artificial light therapy, an at-home practice in which individuals spend time sitting near a special light box that gives off sunlight-mimicking bright light. And vitamin D supplements can also provide some relief. While these options can be very effective and are often affordable and accessible, experts recommend that parents consult with their child’s pediatrician or mental health team before exploring a new therapy.
And remember: just because a child is feeling down or is voicing frustration about missing their normal winter activities does not mean they are experiencing major depression. “Winter blues are common and generally represent subclinical symptoms of depression,” Duong says.
If your child is experiencing symptoms that get in the way of their relationships, or are making it difficult for them to complete the things they need to do each day, experts recommend reaching out to your pediatrician for additional guidance, while also reflecting on whether, and when, these symptoms have occurred in the past. Because wait lists for appointments with mental health practitioners can be long, Duong also recommends making the call sooner rather than later: “Call before you think you need it. You can always cancel if things get better naturally.”
Whether a child is currently experiencing diagnosable mental health challenges or not, there are some important steps parents can take to boost the whole family’s mental health. “Getting into and staying in a regular routine, spending time outdoors, exercising, eating a well balanced diet and helping kids maintain connections with family, friends and things they find pleasurable can all be helpful in preventing or lessening the symptoms of depression,” Duong says.