Kids with seasonal affective disorder, depression go largely undiagnosed

Even though the new school year is in full swing, kids still have plenty of time to play outside in the sunshine before dinner.

Yet as the sun starts to set earlier each night and daylight savings time ends in November, a sneaky form of depression called seasonal affective disorder, or SAD, can become a problem for some children.

Left untreated, kids with SAD may be prone to depression throughout their lives. Even more troubling is that experts say many children with SAD aren’t being diagnosed.

The good news is that if you know the risk factors and the symptoms, and where to turn for treatment, you can help your child feel better.

What is seasonal affective disorder?
Seasonal affective disorder (SAD), or what is now called major depressive disorder recurrent with seasonal pattern, is a form of depression that affects both adults and children. Unlike depressive episodes that can happen at any time of the year, SAD is one that returns each year, usually during the fall and winter months, said Dr. Adelle Cadieux, a child psychologist at Helen DeVos Children’s Hospital in Grand Rapids, Mich.

More On This...

Approximately 3 percent of kids ages 9 to 17 have SAD, according to Dr. Norman E. Rosenthal, a world-renowned psychiatrist based in Rockville, Maryland and author of “Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder.”

In fact, some studies show the prevalence rate can be as high as 5 percent.

SAD is more common in older teens and in girls.

“After puberty, the percentage of girls affected increases three-fold,” Rosenthal said.

Plus, children who are already at risk for depression have a higher chance of being affected by SAD.

Kids are slipping under the radar.
SAD is largely undiagnosed in kids and one of the reasons may be because they’re not  frequently screened for it. The American Academy of Pediatrics has recommendations for identifying behavioral and emotional problems in kids and guidelines for screening depression in teens, but chances are, SAD isn’t something your pediatrician is going to ask about during a well visit.

One of the challenges with making a diagnosis is that kids have specific stressors during the fall and winter months that they don’t have during summer, like school, athletics and new social situations. So if those factors alone are what is triggering your child’s symptoms, it’s more likely a depressive episode, not SAD.

“We have to look at: Is there a seasonal trigger as opposed to a change in season that is triggering it,” Cadieux said.

Schools may not identify a problem either since SAD can often mimic attention deficit hyperactivity disorder (ADHD). Unlike their ADHD peers who are hyperactive, kids with SAD are usually withdrawn.

“They’re often quietly sitting at their desks, sometimes putting their heads down or staring out of the window and not concentrating on their work,” Rosenthal said.

It can also be hard to identify the disorder in teens who are defiant or rude, since teens tend to have these normal behaviors anyway. Nevertheless, what you should look for is a change in your child’s behavior or mood that seems unusual for him.

The most common signs of SAD
• Blaming parents, teachers and friends for being demanding or causing problems
• Changes in appetite, overeating and weight gain
• Changes in school performance
• Decreased energy
• Defiance
• Difficulty with concentration
• Irritability
• Lack of interest in friends, hobbies and sports.
• Lack of motivation
• Sleepiness, changes in sleep patterns or irregular sleep schedule
• Trouble coping
• Trouble getting out of bed in the morning

Plus, if you notice that your child was happy when the days were longer or when he’s playing outside, but gets upset when it gets dark, it’s a good indication that he has SAD.

If you suspect your child may have SAD, here is what you can do:

Make a doctor’s appointment.
To rule out other medical conditions, it’s a good idea to have your child checked out by his pediatrician. If he thinks your child has SAD, he can determine the severity and refer you to a mental health expert if necessary.

Get sunlight.
Encourage your child to get as much sunlight as possible by playing outside after school, helping with outdoor chores like raking the leaves, taking a family bike ride or joining after-school sports.

Focus on healthy habits.
Making your child’s overall health and well-being a priority can help SAD, regardless of the severity. Do the best you can to make sure your child eats a healthy diet, exercises at least 60 minutes a day, cuts down on screen time and sticks to a consistent sleep schedule, even on the weekends.

Let light in.
Full spectrum light bulbs can give a daylight effect in your house. Open the blinds in the morning to let sunshine in and put her bedside lamp on a timer to turn on 30 minutes before she wakes up.

Try phototherapy, counseling and medication.
For kids with a severe form of SAD that’s impacting their functioning, phototherapy— sitting in front of a light box for about 30 minutes each day— can help.

Anti-depressants and psychotherapy, cognitive behavioral therapy (CBT) in particular, are effective as well. CBT can give kids strategies that will help them get their homework done, build their self confidence and prepare them for next year, should SAD rear its ugly head again.

“It’s really helping them to gain some coping strategies, challenging a lot of those negative thoughts they’re having and helping them reframe things and focus more on the positives,” Cadieux said.