As we enter the cold, dark winter months, there are those among us who become S.A.D. And this isn’t just a passing episode of mild winter blues: Thousands of Americans suffer from Seasonal Affective Disorder, a condition in which people become depressed and lethargic between late fall and spring.
“SAD starts to set in late in the fall, when the days are shorter and the sun’s rays are not as bright as in the summer,” says Dr. Adelita Segovia, a child and adolescent psychiatrist with Clayton Behavioral. “Usually the symptoms are worse in the winter months, with remission of symptoms in the spring and summer months. It is also worse in the northern latitudes, areas farther away from the equator.” The condition affects both adults and children, she notes.
Although kids can be S.A.D., diagnosis in children is more difficult than it is in adults. “Common sense tells us that time of year probably impacts children, teens and adults about equally, but the first obstacle is making an accurate diagnosis of depression in a child when children don’t always exhibit depression in the same ways that adults do,” says Dr. James Feinberg, a child clinical psychologist in Kirkwood. For instance, depressed adults tend to exhibit more lethargy than children.
Feinberg notes that a clinical diagnosis of S.A.D. requires a prior history of depression and an obvious resolution of symptoms when days lengthen, followed by a relapse when daylight again diminishes in autumn. A history of at least two years of this cycle is required for diagnosis, which is defined by the Diagnostic and Statistical Manual of Mental Disorders as a subtype of major depression.
“Kids haven’t really been alive long enough to make that diagnosis accurately and then get a two-year pattern,” Feinberg says. “But by the time they get to the age of 15, it’s much easier to diagnose. By then, they look a lot more like adults who are depressed.” Diagnosis in young children is typically dependent on the observations and concerns reported by parents and teachers. However, Feinberg also recognizes ‘school affective disorder,’ his term for the depressive symptoms some children and adolescents express due to the stress and demands of the academic year.
Lethargy, irritability, changes in appetite, a decrease in academic performance, and disinterest in friends and activities can be signs of psychological distress in children and teenagers.
If a person is S.A.D., there are treatments that can help alleviate depression and listlessness. “Light therapy is an effective form of treatment and usually with less adverse effects than medications,” Segovia says. “It requires a special type of lamp that emits light resembling the brighter summer sun rays. The standard dose for treatment is 10,000 lux of white, fluorescent light for 30 minutes per day.” Antidepressant medications may be used in conjunction with light therapy.
Feinberg advises clients who have been diagnosed with S.A.D. to begin light therapy in early October as a preventive strategy. Bathing in the light during breakfast is often the best plan, he says. He also encourages children, adolescents and adults to spend as much time outdoors as possible when autumn arrives.