Depression Dangers in the Winter

The holidays are upon us. The decorations, the lights, memories made with family and oh yea…holiday stress, anxiety, and depression. From January through December, everyone is dealing with events and “obligations” that bring with them higher levels of emotional distress than any other time of the year. The remaining winter months consist of short days, cold weather, and changes in day to day routines, which can lead to symptoms of depression and anxiety as well. These experiences are not limited to adults; teens and young adults can experience similar (and in some cases) more severe stress than adults during this time of year.

There are various reasons for teens to experience higher levels of emotional friction during the holiday and winter seasons. The holidays can be challenging when it comes to the social circles and activities your teen is part of. The social settings your teen finds themselves in can involve a broad mix of individuals from all walks of life, including vastly different economic positions. It is easy to see how one teen hearing about a friend’s family trip to Hawaii for Christmas or watching his friend roll up to school in his new car courtesy of his parents; could increase anxiety and depression levels. Especially if your teen is already in a fragile emotional state before the season even arrives.

As an adult, you have grown to accept, sometimes begrudgingly, that winter and the holiday season just bring with it a certain level of abnormality. You remind yourself that by the end of January, most of the crazy is over, and by March, things don’t seem so bad. The weather is improving, and the days are longer. But, if your teen already struggles with the emotional highs and lows of the day, they may not be able to rise to the challenges of the season quite as well as their friends and other family members. Winter depression (or seasonal affective disorder) is a real and challenging thing, and for some, it returns every year; some years are worse than others.

Short term stress is usually easily managed by most people, but these stressors are not short term. Extended, longer-term stressors like those that come with the holiday months and continue through the duration of winter can wear people down and make them more susceptible to illness, exhaustion, anxiety, and depression. The holidays are a time of high expectations. Unfortunately, sometimes those expectations are much higher than what the holiday itself can bring. Refer to the car scenario in the opening paragraph. Rejection, emotional instability, and feeling unworthy or out of place are not uncommon feelings for your teen to experience this time of year. Some will say the season cannot be enjoyed or fully experienced when a loved one such as your child is experiencing issues such as these. This is not true; at all. It is essential to consider their needs and try some of the following ideas for managing the emotions that come with the holidays and the winter season.

Seasonal Affective Disorder

Seasonal affective disorder (SAD) is a form of depression that appears at the same time each year. With SAD, a person typically has symptoms of depression and unexplained fatigue as winter approaches and daylight hours become shorter. When spring returns and days become longer again, people with SAD experience relief from their symptoms, returning to their usual mood and energy level. For those who experience SAD, their depression symptoms are somehow triggered by how the brain responds to decreased daylight exposure during the winter months. The reduction in exposure to daylight impacts how the brain produces two essential chemicals, Melatonin and Serotonin.

Both chemicals help to regulate the sleep-wake cycles in the body, along with energy levels and mood. The shorter days and less sunlight exposure that come with the winter months may increase the levels of melatonin and decrease serotonin, which, chemically, increases the conditions for depression.

What Are the Symptoms of SAD?

The symptoms of SAD are very similar to other types of depression; however, they do not manifest with the same frequency. Changes in how your teen feels and acts will occur in a more predictable, seasonal pattern. If your teen is experiencing SAD, you may notice some or all the symptoms below:

Changes in mood:

You may see your teen seems sadder or seems to be in an irritable mood most of the time. This will likely occur during a specific time each year as the months begin to change, and days get shorter. During that time, they may feel a sense of hopelessness or worthlessness that generally isn’t there. As part of the changes in mood that come with SAD, people can be more self-critical and more sensitive to criticism, so they get upset more often and are more emotional.

Lack of enjoyment:

You may notice your teen is losing interest in the things he or she usually likes to do. People with SAD often feel as though they no longer do certain tasks as well as usual, even if this is an inaccurate feeling. They may have increased feelings of dissatisfaction or guilt. They may begin to lose interest in friends and cease their participation in social activities.

Low energy:

Unusual tiredness or unexplained fatigue is also part of SAD and can cause people to feel low on energy.

Changes in sleep:

A person may sleep much more than usual. Excessive sleeping can make it impossible for a student to get up and get ready for school in the morning, and poor grades or feelings of failure may be increased.

Changes in eating:

Changes in diet and appetite related to SAD may include cravings for simple carbohydrates (think comfort foods and sugary foods) and the tendency to overeat. Because of this change in eating, SAD can result in weight gain during the winter months. For female teens (and some males) this could add to the feelings of inadequacy as they “compare” themselves to other individuals in their social circles.

Difficulty concentrating:

In addition to feelings of lethargy and exhaustion, SAD can cause difficulty concentration. This, too, can interfere with your teen’s school performance and grades. A student may have more trouble than usual, completing assignments on time or seem to lack his or her usual motivation. Someone with SAD may notice that his or her grades may drop, and teachers may comment that the student seems less motivated or is making less effort in school.

Less time socializing:

People with SAD may spend less time with friends, social activities, or extracurricular activities. They also may indicate they feel out of place or feel as though they do not belong as a part of their typical social groups.

The problems caused by SAD, such as lower-than-usual grades or less energy for socializing with friends, can affect self-esteem and leave a teen feeling disappointed, isolated, and lonely. This is even truer if they are new to the symptoms and do not realize or understand what is causing the changes in their energy levels, motivation, and desires.  As with other forms of depression, the symptoms of SAD can range considerably. Where it may impact one person very minimally, it may be crippling for another. SAD has a seasonal pattern, which is what separates it from other forms of depression.

Who Gets SAD?

SAD can affect anyone. Children, teens, adults, senior citizens; age does not matter. The number of people with SAD will vary from region to region and will increase in locations where there are more days with less sunlight. There have been some interesting studies that show people who live further from the equator are more likely to develop SAD than those who live closer. However, if those who live further away visit warmer climates south of the equator that have longer, warmer winter days, they are less likely to develop their symptoms. This provides some confirmation of the theory that SAD is related to light exposure.

SAD does not affect everyone. It is estimated that approximately 6 out of every 100 people will experience symptoms. Like other forms of depression, SAD is more likely to occur in females (around four times as likely) and those who have a family history of the illness. Individual traits related to hormone production, biology, brain chemistry, environment, and life experiences may also play a role.  There is a lot of research still being done on SAD to be able to explain better the causes and why some people will experience it when others won’t.

Diagnosis and Treatment

A diagnosis of SAD requires careful evaluation by both mental health and medical professionals. This is due to the nature of the symptom reported by those who experience SAD. Many of the symptoms could be the result of other medical conditions that require treatment. For example, tiredness, fatigue, and low energy could be a sign of mononucleosis or hypoglycemia. Other symptoms, such as sleep changes and changes in appetite, can also have medical roots that require medical intervention.

Once it has been determined a person has SAD there are a variety of possible treatments which could include one of or a combination of the following:

Increased Light Exposure

It is believed that SAD and its associated symptoms are triggered by a lack of or reduced exposure to light. These symptoms often go away on their own when exposure to light is increased. One common treatment for SAD involves increased exposure to light during the winter months when symptoms are most likely to occur. In mild cases, simply increasing time spent outside may be sufficient. This could involve taking a walk or doing some type of outdoor activity. If outdoor activity is not an option, full-spectrum (or daylight) lightbulbs can bring more daylight into your home during the winter. This may also help with mild symptoms.

Light Therapy

For cases of SAD where symptoms are stronger, light therapy or phototherapy may be used. This process involves the use of a special light which simulates daylight. A person sits in front of a special box containing this light for a short period (approximately 45 minutes) every day, usually in the morning. The person is instructed to look at the light occasionally (but not stare into it the entire time) as the light must be absorbed into the retinas for the process to work. Symptoms tend to improve within a few days to a few weeks for most people. Generally, once enough natural light is available outdoors, it is recommended that natural light be used instead.

Light therapy is a medical treatment and should only be used under the supervision of and guidance of a doctor. If someone has certain medical conditions, light therapy should not be used. Tanning beds are not a substitute or treatment for SAD as they do not filter out the harmful UV rays in the same way the lights used for phototherapy do.

Talk Therapy

Talk therapy (psychotherapy) is also used to treat people with SAD. Talk therapy focuses on revising the negative thoughts and feelings associated with depression and helps ease the sense of isolation or loneliness that people with depression often feel. These sessions can be individual or in a group depending on the comfort level and needs of the individual. Talk therapy can also help someone who is experiencing SAD learn about and understand their condition as well as what they can do to prevent or reduce the occurrence of symptoms in the future.

Medication

Doctors may also prescribe medications for teens with SAD. Antidepressant medications help to regulate the balance of serotonin and other neurotransmitters in the brain that affect mood and energy. Medications need to be prescribed and monitored by a doctor.

When symptoms of SAD first develop, it can be confusing, both for the person with SAD as well as their family and friends. Some parents or teachers may mistakenly think that teens with SAD are slacking off or not trying their best. As a parent, you may notice your teen is struggling and experiencing emotions you are not used to seeing. If you think your teen is struggling with the symptoms of SAD, take a moment to talk to them. Learn what they are experiencing and open the doors to communication. Ask how you can help or encourage them to reach out to teachers or guidance counselors they may be comfortable talking to. Talking about what they are feeling and understanding what is wrong is the first step in seeking help.

If you have a teen who is struggling to cope with SAD, you have options when it comes to treatment. Here at Hillcrest, we know how to work with teenagers to help them understand and work through the symptoms they are experiencing.  Reach out to Hillcrest today to find out how our facility can help your teen work through the emotions and challenges associated with Seasonal Affective Disorder.