Evo Terra (Host): Feeling a little down this time of year? You are not alone. To help us understand why we're a little or a lot, gloomy this time of year, I'll chat with Psychologist Dr. Colby Butzon with Le Bonheur Children's Hospital. This is The Peds Pod by Le Bonheur Children's Hospital. I'm Evo Terra. Dr. Butzon, thank you very much for joining me on the program today.

Colby Butzon, PhD: Thank you for having me.

Host: So let's start at the beginning. What is this thing called Seasonal Affective Disorder, and why does it make us sad?

Colby Butzon, PhD: So seasonal affective disorder is a depressive disorder or a mood disorder. But unlike other depressive disorders, it tends to only happen during certain times of the year. And it's most common to happen in the fall or the winter months. So we're getting right into that time of year when we start to look for that seasonal affective disorder.

Host: And, does that have to do with the light? Does that have to do with other things? Why does it happen?

Colby Butzon, PhD: You're right on target there. Light is a big factor. So during this time of the year, our hours of daylight get shorter and shorter. And we're also spending more time indoors to stay out of the weather. So that limits our exposure to natural light even more. Also, we think about the rhythms of our life and the rhythms of the seasons.

And all animals tend to have seasonal differences in their activity levels and their behavior patterns. So we as humans tend to do more indoor activities, take things slower, do slower things during this time of year. And that is absolutely a factor that can impact our mood. Our moods are impacted by our exposure to natural light. And so since we're staying indoors more, the hours of daylight are shorter; those factors contribute to us having an impact on our mood that can be elevated with more exposure to light.

Host: Right, right. Thanks for that. Now, the acronym is SAD and clearly one of the behaviors associated with SAD is sadness, but are there other types of behaviors we should be thinking about?

Colby Butzon, PhD: There definitely are, and especially in kids and adolescents, sometimes what we think of as sadness can look different. So it might be traditional sadness, moodiness, but it might be increased crankiness, increased negativity in general, could be more acting out behaviors and grumpiness. In addition, we might see people losing interest in activities they used to enjoy. We might see changes in patterns of sleep, sleeping a whole lot more, having a lot harder time getting up in the morning. Also we might have people who have difficulty with falling asleep at night. They may have a hard time adjusting to that natural change in their body rhythm. And so they might be staying up later too, which can reduce sleep and make you cranky too.

We might see in kids and adolescents, behavior or performance changes in school. So their grades might go down. They might be getting in trouble more often. They might be having more difficulty paying attention and focusing. We might also see some changes in eating habits. So eating more or eating more of like those simple carbohydrates and sweets, sometimes people also eat less. They get less interested in eating and meals and they sort of reduce how much they're eating. And one of the most concerning symptoms that we really want to be sure we pay attention to is that sometimes we see those thoughts about self harm or suicidal thoughts, and we definitely want to be aware of those and respond to those if we're seeing those symptoms.

Host: Yeah, definitely. So, a lot of this sounds to me as a lay person, very similar to other sorts of depression or mood disorders, but this is different, right?

Colby Butzon, PhD: Right, and it is very similar to depression or mood disorder. It's just a depression or mood disorder that happens within a specific period of time during the year. So we tend to see the symptoms come on during the fall and winter months, and they tend to resolve in the spring and summer months.

So sometimes you'll be able to differentiate whether it's a depressive disorder or specifically, a seasonal affective disorder if you're seeing that pattern happen season after season.

Host: Alright, well this has all been fascinating, but let's talk about how do we get better? What treatment options are available? And let's talk about kids, teens, children first.

Colby Butzon, PhD: So, some of the things that families can do just on their own is try to increase light exposure, exposure to natural light during the day. So, getting outside, especially in the morning hours when you can get more exposure to that natural light, that's going to be helpful no matter what. There is also in cases where the mood is not really lifting or this is really causing an impact on daily functioning; we can use other treatments that we would normally use for depressive disorders like talk therapy, like cognitive behavioral therapy or CBT. For younger kids, sometimes play therapy can be helpful. Medications are also effective at treating seasonal affective disorder just as they can be effective at treating other depressive disorders. And there's also special light boxes and light therapy that you can purchase and use in your home.

So depending on where you live in the world, if going outside is just really not an option, you can bring that light exposure into your home and have some time during the day that you spend in front of that light box.

Host: Yeah, those are great options for you know, I know people that live in the Pacific Northwest. Not a great time to be outside. Because it's rainy and cloudy the entire time. Yeah. So if you can bring light inside would be a good idea. And that's good advice, but any other advice for parents of children who are suffering from SAD?

Colby Butzon, PhD: So if we're talking about kind of a dip in feelings, a dip in mood; I encourage families to live in the season as much as they can. So we can't go outside and go to the playground the way we normally love to do when the weather is nice. So what can we do indoors that make it special and we're not just sitting around looking at, at each other trying to wonder what we're going to do.

Some things that can be really helpful with young kids, especially that sometimes people don't think about; we can bring the playtime like into the bathtub. So we don't have to just have a bath at the end of the day. We could run a bath in the middle of the afternoon and have water toys and play and that can be a way to kind of have an activity that's a little fun a little bit out of the norm, but is not going outside to play.

Also, I encourage as much as possible, let's get outside, bundle up, use those umbrellas, whatever we can do, so that we can get outside and have some of that activity so we don't get that cabin fever kind of situation going on indoors. Engaging in activities that are still enjoyable, but are possible to do during this lower time of the year.

So that might be cuddling and reading on the couch instead of, you know, going and running around outside. Or it might be working on a puzzle together as a family or playing a board game together as a family. Sometimes that can seem like pulling teeth for our adolescents. They don't really want to play those board games or engage in puzzles.

But sometimes something that's a little bit enough out of the norm, it might actually get them involved and engaged. And definitely if everything you're trying is not working and your child is just not behaving the way that they used to and you're really concerned about them; that's the time to contact your pediatrician, contact a mental health professional to see if there's anything else that can be done.

Do we need to go with some of those treatments that I've mentioned with the talk therapy or light therapy or even medications to help get us out of those really down in the dumps seasonal blues so that we're able to still enjoy life.

Host: Do you have any additional comments about this disorder in children and teens, and maybe how to fix them at school, and their relationship, playing sports?

Colby Butzon, PhD: So it can definitely affect teens when there are changes in like a sport season. So they might be reaching the end of a sport that they really enjoyed in the fall. And so they have a lot more time on their hands. They don't have that volleyball practice or they don't have that football practice and games anymore.

And so now they have more time on their hands and nowhere to put that energy. So I do encourage parents to talk with their kids and try to help them think of other things they could do with that time. Do we want to use that time to be more involved in activities at school or in the community?

 Could this be an opportunity for some volunteer work or helping others? That can often help elevate somebody's mood by helping another person can be a huge factor as well. Also, when our kids maybe are spending a lot more time online; online can be a whole nother topic for a whole nother show.

But engaging in relationships online through social media is not necessarily a good thing or a bad thing. It depends on how it's done. So, when there's bullying happening on social media or there's a lot of comparison happening, that can be not so healthy. But if there is a lot of positive interaction and our teens or children are getting that social environment that they might not get in their community or might not get at school, might not get from their peers because of the changes in the season; that's a good opportunity to have that as well. But just encouraging your kids to continue to find things that are enjoyable to them. If it is the end of a sports season or an event or an activity, seeing if we can help them put that energy into something else so they don't feel isolated or without that support system that they've had previously.

Host: This has all been exceptional advice. Anything you'd like to add before we wrap things up?

Colby Butzon, PhD: I do want to encourage families as well, if your children are expressing any thoughts of harming themselves, or thoughts of suicide, please reach out to the National Suicide Lifeline. You can call or text 988 anytime, day or night. Please share that information with your children as well, so that they don't necessarily have to come to you to get that information, but know that there is help out there. And if you're in the most difficult downtime, there is help and there is hope. And not only are the pediatricians and the behavioral health specialists at Le Bonheur and in our community available to help you, there's also the National Suicide Crisis Line that can be accessed anytime by anyone.

Host: Dr. Butzon, thank you very much for your time today.

Colby Butzon, PhD: Of course. Thank you for having me.

Host: Once again that was Psychologist Dr. Colby Butzon, and for more information about The Peds Pod please visit lebonheur.org/podcast. That's L-E-B-O-N-H-E-U-R.org/podcast. And if you found this episode helpful, please share it on your social channels. I'm Evo Terra, and this has been The Peds Pod by Le Bonheur Children's Hospital. Thanks for listening.