In this episode of The Pediatric Pharmacist Review, we explore the phenomenon of seasonal affective disorder (SAD) and its relevance to children, adolescents, and families. Our guest, Tim Horton, is a seasoned psychiatric nurse‑practitioner (APRN, CNP) and founder of PeopleFirst Clinic in Woodbury, Minnesota, where he specializes in holistic, medication‑management and therapy‑integrated care for youth and adults. With his unique background in pediatric mental health, patient‑centered approaches, and collaborative provider work, Tim brings deep insight into how biological and environmental factors converge in seasonal depression—and what practical actions caregivers and clinicians can take to mitigate its impact.Key Discussion Points:Biological & Environmental Contributors: We unpack how changes in daylight exposure, circadian rhythm shifts, neurotransmitter variations (serotonin, melatonin), and geographic/seasonal factors contribute to SAD in children and teens.Lifestyle & Environmental Interventions: Tim and I discuss actionable strategies such as structured light‑exposure (dawn simulators, 10,000 lux boxes), daily outdoor activity, consistent sleep schedules, and nutritional supports (timing of meals, nutrient‑dense foods, healthy fats) to reduce symptom severity.Treatment Options & Efficacy: We review standard of care for SAD—starting with behavioral and lifestyle measures, then progressing to light therapy and pharmacologic treatment (SSRIs, SNRIs, augmentation) when needed, including considerations unique to pediatric populations.Vitamin D and Seasonal Depression: We examine the evidence linking vitamin D deficiency with increased SAD risk, discuss screening thresholds in younger patients, supplementation strategies, and how this fits into a broader preventive mindset.Preventive Measures Ahead of Winter: Tim outlines a pre‑winter readiness plan—adjusting indoor lighting, optimizing outdoor daylight exposure, establishing routine exercise, reinforcing healthy diet patterns, and monitoring early warning signs for a proactive response.Misconceptions and Under‑Recognition: We address common myths—such as SAD only occurring in extreme northern latitudes, or that “it’s just the blues” and will self‑resolve—highlighting how under‑recognition in pediatric settings can delay helpful intervention.Resources & Links:Tim Horton LinkedIn: https://www.linkedin.com/in/tim-horton-248858359/PeopleFirst Clinic: https://www.peoplefirstmn.com/
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