Seasonal affective disorder in kids

Seasonal Affective Disorder (SAD), known colloquially as seasonal depression and winter blues, has become more widely discussed in recent years. Despite this increase in awareness, the discussion about SAD, its symptoms, and how to deal with it primarily focuses on adults. Children and adolescents can also be affected by SAD, and while the presenting symptoms can be different, dealing with SAD is no less difficult for children.

The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses the following criteria to identify or diagnose depression with a seasonal pattern:

• Depression that begins during a specific season every year for at least two years
• Depression that ends during a specific season every year for at least two years
• No episodes of depression during the season in which you experience a normal mood for at least two years
• Many more seasons of depression than seasons without depression over the lifetime of your illness

When most people think of depression in general, they think of how it presents in adults: depressed mood, tearfulness, lack of pleasure in activities, low energy, feelings of worthlessness, etc. In children and adolescents, however, the symptoms of depression may look a little different.

For instance, rather than overt feelings of sadness or observed tearfulness, children and adolescents may be irritable or aggressive. Rather than being identified as fatigued, children or adolescents experiencing a depressive episode may be pegged as “lazy” by their parents or teachers. The diminished ability to think or concentrate or indecisiveness we see in adults with depression may be viewed as being off-task and disruptive at school in children and adolescents.

This misidentification of children and adolescents with SAD as being lazy, disruptive, or irritable may be even more common. If a child is displaying these symptoms year-round, parents and teachers may find it easier to identify depression as the underlying cause. On the other hand, a child who only displays these symptoms from November to March may be seen as a child who just doesn’t like school and isn’t putting in the effort.

Some studies suggest that between 1.7 percent and 5.5 percent of 9–19-year-old children may have SAD (Swedo et al, 1995), while others estimate that 10–20 percent of adult recurrent depression cases follow a seasonal pattern (Magnusson, 2000). What causes some people to develop symptoms of depression only during certain times of the year?

The specific cause of SAD has not been identified, but several factors are theorized to be at play, including one’s own biological clock (circadian rhythm), serotonin levels, and melatonin levels.