The cold temperatures and darker, shorter days of winter lead people to stay indoors more often. Month after month, we begin to feel cooped up and complain of cabin fever. People react to the cold weather in many different ways, ranging from a love of snuggling up under warm blankets in front of the fireplace to feeling sad and depressed.
Seasonal Affective Disorder (SAD) is a form of depression that follows a predictable course and correlates with a particular time of year. (1) "Winter Depression" is typically triggered during the fall and remits once springtime arrives. (2) Research shows that approximately 6 percent of the population suffers from SAD. (3) While the disorder appears to be more common among young adults (4) preliminary data suggests that children and adolescents can suffer from this mood disorder as well.
For example, a 1995 study surveyed children ages 9 to 19 and estimated the prevalence of SAD to be 3.3 percent (5). Research conducted in 1993 estimated that 4.2 percent of children ages 9 through 12 in the United States met criteria for SAD (6). In 1984, researchers found that 42 percent of their adult sample reported that their depressive symptoms first started in childhood.
Similar to episodes of major depression, SAD can range from mild to moderate or severe, and can consist of a number of different symptoms. Due to the limited amount of research with children and adolescents, its exact symptom presentation is unknown at this time. Professionals suggest that symptoms of child and adolescent SAD are consistent with traditional episodes of depression and may include:
- Changes in mood, such as irritability and sadness
- Increased crying
- Fatigue or loss of energy
- Increased sleep and difficulty waking in the morning
- Increased appetite and ingestion of more carbohydrates
- Difficulty concentrating
- Withdrawal from activities that are usually found to be enjoyable. (2)
Such changes can impact a child's self-esteem, interfere with extracurricular activities, and impair social and academic functioning.
So what causes this particular form of depression? Several theories have been suggested and described within the research literature, however few focus specifically on child and adolescent SAD. Some theories connect it to factors in the environment, including research that has linked SAD to changes in the brain caused by light. Studies have found that the prevalence of SAD varies by geographical region, with higher rates among individuals living in more northern latitudes. (2) Other studies have shown that levels of serotonin — a neurotransmitter linked to major depression and other mood disorders — can change during different seasons of the year. (7, 8) Thus, it is not uncommon to read about preliminary evidence in support of phototherapy (treatment with bright lights) for SAD.
If you are a parent and have noticed changes in your child's mood, how do you determine if your child is truly suffering from SAD, a milder form of the "Winter Blues" (which might include some symptoms described above, but is less debilitating than SAD) or just a situational case of cabin fever?
- Remember that SAD includes a distinct change in mood lasting a number of weeks and correlating with a change in seasons.
- Moreover, look for other changes in behavior related to school, attitude and social functioning. Notice if your child is showing changes in the way they eat, sleep or dress.
- Keep in mind that SAD consists of a number of symptoms at once and is not related to a particular situational stressor.
If you are concerned or suspect your child may have SAD, it is best to consult with a medical professional, such as a pediatrician, psychiatrist, psychologist, or licensed therapist. Ask this person to assess the changes you are observing in your child and provide guidance about how to approach the situation and whether treatment is indicated.
There are a number of evidenced-based treatments for depression. Determining which is the most suitable for your child should be based on professional judgment.
Talking to your child about your concerns is often challenging. Invite your child to sit down and talk during a more low-key part of the day. Approach him or her in an open and supportive manner. Make sure you listen and provide reassurance that what he or she says will not be judged.
It is also important to remember that some variations in mood triggered by certain situations or events are normal. It is reasonable that having to stay indoors day after day because of the cold and dreary weather can cause temporary irritability or crankiness. If you find yourself or your children suffering from a case of the winter blues or cabin fever, here are some suggestions to help elevate everyone's mood and cope with the wrath of winter.
- As snow piles up, temperatures drop, or chilly wind and rain beat down, it's not surprising that we find ourselves being more sedentary, staying indoors under cozy blankets. However, research shows that exercise increases the amount of serotonin in the brain and can help to improve mood. You may not be able to get outside to the local park, but there are plenty of ways to get active indoors and raise your heart rate. Pick a fun exercise video to do with your kids or challenge the family to a tournament on Wii Sports. Turn on the radio or play your favorite iPod playlist and throw a dance party in your living room.
- After getting active, designate a time for rest and relaxation. Listen to calming music or read a good book. If you and your family have experience with meditation, engage in some meditative breathing or visualization.
- Research also shows that engaging in pleasurable activities can boost our moods. Create a list of fun things your family can do together, such as playing board games, doing arts-and-crafts projects, or baking. Watch a funny movie or take turns telling jokes. Let each member of the family choose an item from the list to do on the next rainy or snowy day.
- Fun activities can be enjoyable by ourselves, but are often even more pleasurable when done with other people. Plan a lunch or dinner party with your neighbors or your children's friends.
- Being productive and accomplishing goals can also elevate our mood. Take advantage of having to stay indoors by tackling projects you never have time for. Make sure to find a way to make chores fun for your family, such as adding rewards at the end for participation.
- Finally, when the snowplow comes or there is a break in the weather, take full advantage and get out of the house while you can. Bundle up and take a brisk walk around the block to get some fresh air and maybe even a little sunlight. Find indoor activities outside your home that you can get to safely. Look in your local paper for entertaining and educational activities that fit your child's interests. For example, go to a movie, the library, or a museum. Get a day pass to a local gym where your children can go swimming or play basketball. Not only will it be fun, it will give you a taste of spring and warm weather activities to keep you going during the final days of winter!
Dr. Carrie Spindel is a Clinical Assistant Professor of Child and Adolescent Psychiatry at the NYU School of Medicine and Clinical Director of the Anita Saltz Institute of Anxiety and Mood Disorders at the NYU Child Study Center. She sees patients at the Child Study Center as part of our Faculty Group Practice.
1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
2. Glod, CA & Baisden, N (1999). Seasonal Affective Disorder in Children and Adolescents. Journal of the American Psychiatric Nurses Association, 5 (29): 29-33.
3. Rosenthal, NE, Carpenter, CJ, James, CP, Parry, BL, Rogers, SLB, & Wehr, TA (1986). Seasonal Affective disorder in children and adolescents. American Journal of Psychiatry, 143, 356-358.
4. KidsHealth by Nemours. (2010, October). Seasonal Affective Disorder, Retrieved February 14, 2011 from http://kidshealth.org/parent/emotions/feelings/sad.html.
5. Swedo, SE, Pleeter, JD, Richter, DM, Hoffman, CL, Allen, AJ, Hamburger, SD, Turner, EH, Yamada, EM, & Rosenthal, NE (1995). Rates of seasonal affective disorder in children and adolescents. American Journal of Psychiatry, 152: 1016-1019.
6. Carskadon, MA & Acebo, C (1993). Parental reports of seasonal mood and behavior changes in children. Journal of the American Academy of Child and Adolescent Psychiatry, 32: 264-269.
7. Lingjaerde, O., Bratlid, T., Hansen, T., & Gøtestam, K. (1986). Seasonal affective disorder and mid-winter insomnia in the far north: studies of two related chronobiological disorders in Norway. Clinical Neuropharmacology, 9(suppl 4):189.
8. Potkin, SG, Zetin, M, Stamenkovic, V, Kripke, D, & Bunney, WE Jr. (1986). Seasonal affective disorder: prevalence varies with latitude and climate. Clinical Nueropharmacology, 9(suppl 4): 181-183.