What is SAD?
Seasonal Affective Disorder is a type of depression that tends to show up in the fall and winter when there are fewer hours of daylight, then lifts in the spring as sunlight returns. "We don't know the exact cause of Seasonal Affective Disorder, but it probably has something to do with the neurochemicals melatonin and serotonin," says Jeffrey Borenstein, M.D., acting president and CEO at the Brain & Behavior Research Foundation in Great Neck, New York. Serotonin, which regulates mood, decreases when there are fewer hours of daylight, and melatonin, responsible for regulating sleep, increases, and these fluctuations can be associated with depression. SAD is more likely to affect people who have a family history of depression, as well as those who live at high altitudes because seasonal changes in those areas are more extreme, adds Dr. Borenstein.
Symptoms and Signs
It's sometimes easy for parents to overlook symptoms of SAD, or dismiss them as normal mood swings. Aside from feeling sad or depressed, your child may be irritable, feel tired, have difficulty concentrating, experience changes in school performance, or have decreased interest in things he usually enjoys. Your child's eating habits may also be affected: Some people with SAD have changes in their appetite or crave carbohydrates, says Cathryn Galanter, M.D., a child and adolescent psychiatrist and visiting associate professor of psychiatry at SUNY Downstate Medical Center and King's County Hospital Center, both in Brooklyn, New York. But even if your child is showing a few of these symptoms, it doesn't necessarily mean he has SAD. "It's not uncommon for people to want to stay in during the winter or to feel more tired," points out Dr. Galanter. The timeframe and severity of symptoms are the biggest telltale signs that your kid is experiencing more than the normal winter blahs. If symptoms persist for two weeks, or they're so severe your child is having difficulty functioning, contact your pediatrician or a licensed mental health professional who has expertise working with children.
Prevention and Treatment
There's no known way to avoid SAD, but practicing general healthy habits may be helpful. That means having your child spend time outside during daylight hours, making sure she gets at least an hour of exercise every day, offering her healthy foods, like fruits, vegetables, whole grains, and lean protein, and encouraging her to get enough sleep, says Dr. Borenstein.
Staying connected with your child may be beneficial, too. Talking with your child about her day and letting her know she can come to you to talk about her feelings or any problems she might be having may help her reduce stress, which has been found to increase symptoms. Tuning in to your child will also keep you alert to any changes in her behavior, so you can address them more quickly.
The Most Helpful Treatments
Unfortunately, there isn't a lot of research about treating SAD in children. The same healthy habits that may help prevent the disorder -- spending time outside during daylight hours, eating healthy, and getting enough sleep and exercise -- may treat very mild cases. Others may require medication, such as antidepressants, psychotherapy, to help your child express his feelings and learn coping strategies to use when he is stressed, or a combination of these options.
Your doctor may suggest light therapy, in which a device called a light therapy box mimics natural light. It can be performed in a medical facility, but most people use a small, portable box at home (some insurance companies will cover the cost of the light unit with a doctor's prescription), says Dr. Borenstein. For this treatment, your child would do his usual activities, like reading or playing with toys, while sitting near the box for a specific amount of time, usually 20 minutes. The light tricks the body into thinking it's receiving extra hours of daylight, thereby reducing SAD symptoms. This therapy is less common in children because, although it's been successful in treating adults suffering from the disorder, there hasn't been much research on its effectiveness in kids.
With treatment, symptoms can improve in as little as a few days, though some cases may take a few weeks, says Dr. Borenstein. However, the difference between SAD and other types of depression is that your child's mood should brighten as the sun starts to stick around longer in the spring and summer. Unfortunately, SAD tends to return during following fall and winter seasons. But being proactive and making sure your child sticks with the healthy habits mentioned above may help lessen symptoms or even prevent it altogether.
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