For many people, the winter season is a time of joy and happiness – the holidays, scenic winter resorts and villages, snow-days from work/school – but for many, this time of year brings the opposite type of feelings. Darker mornings and longer nights where we are not seeing as much sunlight can leave us with what is commonly called ‘the winter blues’. If it is dark when we get up and go to school/work, it is feasible that we may live most of our waking hours in winter without direct contact with sunlight and being in the fresh outdoor air. Weekends may be the only time we have an opportunity to get outdoors and get our fill of vitamin D from the sunlight and some cold air on our face. This can result in subdued emotions that for some can be as severe as depression. Seasonal Affective Disorder (SAD) is a recognized condition that is a subset of Major Depressive Disorder (MDD), and which carries many of the same symptoms as MDD, including:
• Feeling depressed most of the day, nearly every day
• Feeling hopeless or worthless
• Having low energy
• Losing interest in activities you once enjoyed
• Having problems with sleeping (too much/little)
• Experiencing changes in your appetite or weight
• Feeling sluggish or agitated
• Having difficulty concentrating
• Having frequent thoughts of death or suicide
(www.mayoclinic.org)
SAD can also cause depression in the spring or early summer, though this is rare and affects less than 1% of the American population (Flaskerud, 2012). SAD symptoms primarily center on sad mood and low energy. Those most at risk are female, are younger, live far from the equator, and have family histories of depression, bipolar disorder, or SAD (Melrose, 2015). For many people, the winter begins to take its toll early, and then the turn of the year initiates further emotional stress. The mere prospect of a new year repeating old habits/chores, working in the same job and facing the same challenges as the past year can prove too much to handle. For certain populations, the winter/holidays season can bring additional stressors that can lead to an emotional slump. Workers who exist in seasonal jobs, or jobs where their workload is more fruitful for the other months of the year, may feel significant financial stress in the winter. This, combined with commercial and family pressures of Christmas, Hanukkah etc., can leave people in a poor emotional state.
The Diagnostic and Statistical Manual of Mental Disorders DSM-5, asserts that the criteria for depression with a seasonal pattern includes depressive symptoms that consistently begin and end at the same time/season every year, and that the individual has full remittance during other seasons, for at least two years. It further states that an individual would have more seasons with depression than without over the course of a lifetime. This can lead to a delay in an individual actually recognizing that they may be suffering with this and observing these patterns over a period of multiple seasons. The actual cause of SAD remains unknown though it is believed that factors such as sleep cycles, and changes in brain chemicals such as serotonin (a neurotransmitter that affects mood) and melatonin (responsible for sleep patterns and mood) play a major role, either independently or collectively. SAD has even been known to have significant depressive effects on people with visual impairments. As background light plays a key role in our mood state, a lack of sunlight can compound visual issues into mental and emotional ones (Madsen, 2016).
Children and Adolescents
There is a general lack of research and data on children and SAD. What is known, however, is that children and adolescents can be equally as vulnerable to seasonal changes and children are at higher risk than adults of developing winter SAD. As with adults, a lack of daylight, and in some cases a lack of productivity, can have adverse effects on a child/young person’s emotional state. Females are also at greater risk of all types of SAD. SAD usually shows itself in children and adolescents as fall approaches and the impending start of school term gets nearer. The condition often becomes progressively worse (for children and adults) as fall turns into winter and the weather becomes bleaker. Obviously geographical location plays a party in this with darker, colder locations creating greater risk of SAD for its inhabitants. As with other forms of depression, people often increase their quantity of sleep with SAD, and are also known to increase their weight, often exponentially. While diagnosis in children and adolescents should always be approached cautiously and with constant consideration of normal developmental changes, significantly increased sleep or weight gain can be a sign that a child is suffering with SAD. SAD has also frequently been known to be triggered or exacerbated by stress. So if a child is facing academic or other challenges at school (social, bullying, athletic etc.) – or as noted above, has stress in January/February such as in the form of exams – this can cause the start, or worsening, of SAD symptoms.
Treatment
Treatment options often include counseling, light therapy, medications (usually anti-depressants). However, it is important to note that if there are other mental/emotional issues in addition to SAD, then the treatment prescribed may be different. Bi-polar disorders are an example of a common-co-occurring disorder with SAD and treatment options for these individuals may vary slightly. A person who suspects they may be suffering with SAD should always tell their practitioner if they have other conditions or disorders. Due to commonly co-occurring issues, counseling is often a preferred option as it affords the individual the opportunity to address multiple concerns at once. It can also help the individual to learn and develop new coping skills and strategies for dealing with their various feelings and behaviors.
If you feel depressed, fatigued, or notice any changes that seem to occur around the same time each year, you may be experiencing a form of SAD. Call us at Crossroads Family Counseling Center to schedule an appointment so we can help you immediately.
Dave Edwards is the clinical intern at Crossroads Family Counseling Center in Fairfax, VA. He is a student in the M.A. in Clinical Mental Health Counseling program at Marymount University in Arlington, VA. He is also a full-time professional soccer coach and has been working with youth for 27 years.