What Is Seasonal Affective Disorder?
How it can affect kids, and how parents can help
As we all hunker down for a uniquely challenging winter, it’s no surprise that lots of children and teenagers are having a tough time coping. Short tempers, bad moods, low energy — parents are seeing it all, even from kids who are ordinarily cheerful.
If you’ve noticed a shift in your child’s mood or behavior as the season changes, you might have wondered if seasonal affective disorder (sometimes abbreviated SAD) could be involved. But what exactly is seasonal affective disorder, and how do you know if your child is experiencing it? Read on for help understanding this sometimes-confusing diagnosis, plus tips to help your child thrive this winter, whether or not they’re experiencing SAD.
What is seasonal affective disorder?
Despite its name, SAD isn’t a distinct disorder, according to the DSM-5 (which classifies psychiatric disorders). Rather, it’s a specific form of major depressive disorder that comes and goes according to changes in seasons.
“In terms of symptoms, seasonal affective disorder and depression are one and the same,” says Heather Bernstein, PsyD, a clinical psychologist at the Child Mind Institute. “Seasonal affective disorder is essentially major depressive disorder that occurs during specific months of the year.”
Most people affected by SAD experience episodes of depression during the fall and winter, as the days get shorter in many parts of the world. When the season changes again, the depression goes away until the following year. However, a smaller number of people experience depression during the spring and summer instead. Women are more likely to be affected than men, and symptoms usually start to show up in older teenagers or young adults, though younger children can experience SAD too.
Experts aren’t certain what causes SAD, but one theory is that decreased sunlight in the winter months may affect the levels of melatonin and serotonin in our brains, which can in turn affect our mood and energy level.
What are the signs of seasonal affective disorder?
The symptoms of SAD match those of other kinds of depression, including:
- Feeling unusually sad or irritable, even when there’s no obvious reason
- Losing interest in things that used to be enjoyable
- Low energy levels
- Changes in weight or eating habits
- Sleeping too much or too little
- Being very self-critical
- Engaging in self-harming behaviors, like cutting
- Feeling hopeless, worthless or numb
- Thoughts of or attempts at suicide
As in other kinds of depression, a diagnosis is only made if several of these symptoms are present for at least two weeks. Additionally, the pattern of depression coming and going with the seasons must occur for at least two years to be considered SAD.
It’s also important to rule out other sources of stress. “One of the criteria for this particular diagnosis is that it’s not associated with a seasonal pattern where there’s always a stressor,” says Dr. Bernstein. For example, a child who participates in a stressful winter sport and always get depressed when it starts would not be diagnosed with SAD, because their change in mood was not caused by the change in season itself.
How is seasonal affective disorder treated?
In many cases, the recommended treatment for seasonal affective disorder is cognitive behavioral therapy (CBT).
Because energy levels and motivation decrease when individuals are depressed, CBT for this diagnosis often focuses on what’s called behavioral activation. “There’s going to be a lot of behavioral intervention to engage in the opposite action of what your body is pulling you to do,” says Dr. Bernstein. “Treatment can focus on questions like: How are we setting a schedule? How are we doing things even though we don’t necessarily want to be doing things?” This can include support developing and sticking to routines for sleep schedules, eating habits, screen time and social connection.
Especially in regions that get much colder and darker in the winter, behavioral activation can also target staying active and getting outside in the daylight, even when doing so isn’t appealing. “The more we can pull our access to sunlight into balance, the more beneficial that’s going to be,” Dr. Bernstein says. “Regular physical activity and a balanced diet have also been found to be beneficial,” she adds.
In some cases, SAD is also treated using antidepressant medications, including SSRIs. Light therapy, which involves looking at specialized lamps that mimic sunlight, is also an option that some people with SAD have found to be helpful in reducing symptoms.
When should parents worry about seasonal affective disorder?
With kids everywhere having an unusually tough time coping, it can be hard to tell whether your child’s moodiness and irritability are something to worry about or normal reactions to a hard situation.
Dr. Bernstein recommends thinking in terms of changes from your child’s normal behavior, whatever “normal” means for them right now. Maybe your child loved posting TikTok videos early in the pandemic, but now they say that it’s not fun anymore. Or maybe they’ve been feeling frustrated the whole time, but only now are they refusing to do schoolwork. If your child seems to be losing motivation or having a harder time enjoying things, those might be signs of depression, whether or not it technically qualifies as seasonal affective disorder.
Looking for patterns of change is key, says Dr. Bernstein. “We’re not talking about a kid who’s active all week and then has a hard time getting out of bed on Friday,” she says. “We’re talking about at least two weeks of not responding to friends, of not coming to the dinner table, of not doing schoolwork. When you see a persistent pattern is the time to reach out for help.”
It’s also important to remember that you can always consult a professional, even if you’re not certain there’s a problem. “Listen to that parental twinge that says, ‘This doesn’t feel right,’” Dr. Bernstein says. “Reach out to a pediatrician, therapist or general practitioner. It’s better to ask whether something is normal as soon as you start wondering, rather than waiting until it’s clear that it’s a problem.”
Tips for coping with a difficult winter
It’s hard to say whether this particularly hard winter will come with an increase in cases of seasonal affective disorder. But diagnosis or no, it’s clear that keeping yourself and your family mentally healthy this winter could be harder than normal.
“We have to be more aware of, how do we take care of ourselves?” notes Dr. Bernstein. “How do we take care of our kids? How do we maintain the healthy habits, even when it gets harder?”
To that end, she recommends getting ahead of the season’s challenges by putting a few strategies in place now, whether or not you’re dealing with seasonal affective disorder.
- Stick to routines. By now you’ve heard it a thousand times, but it’s still true: routines help kids and adults alike. Having a consistent schedule for sleep, meals, work and family activities can provide some stability in uncertain times and keep everyone’s spirits up.
- Prioritize healthy habits. Ask kids for their own ideas for healthy activities that they’d be excited to do on a regular basis. Maybe that’s an after-school trip to the park (even in the cold!) or a weekly look through cooking blogs for fun new recipes.
- Set realistic expectations. “It’s really challenging when we come up with solutions that are not within our grasp,” says Dr. Bernstein. For instance, you might think that exercising every day is the only way for your family to stay healthy, but work and school schedules get in the way. Try getting together as a family and looking for doable alternatives: What about a game of basketball in the driveway twice a week, or taking turns choosing music for a weekend family dance party?
Whatever you choose to do, a team effort can make it easier to stay on track. “It’s not going to be just the individual who’s dealing with depression or a pattern of challenges,” Dr. Bernstein says. If your child is having a hard time, think about what would be helpful for them and use that to create some practices that the whole family can follow together.