There are certainly a lot of things going on in the winter.
There are more viral infections and many of these have headaches associated with them, especially if they turn into sinusitis.
Dry, stale indoor air is sometimes a problem, especially if your son has dust allergies.
Migraines seem worse whenever our usual routines are disrupted, and if timetables are off, for whatever reason, this could also be a problem.
But there is another condition that shows up every winter: the winter blues caused by not enough light.
When this is severe enough, we call it seasonal affective disorder, or SAD.
I have noticed this tendency among my patients, especially adolescents, to become "out of sorts" come January.
We attribute this to cabin fever. Actually, cabin fever may actually be, in part, SAD or a milder version of this. Most everyone gets better in the spring.
People need light, apparently, like they need other nutrients.
What light does is set our nervous system and allows us to have a normal circadian rhythm (i.e., day-night cycle).
We don't know all of the mechanisms, but it appears that melatonin is important.
Melatonin does a few odd things like change our carbohydrate metabolism and lower our body temperature. Melatonin also makes us drowsy. It peaks just before we go to bed.
Without enough light stimulation, the cycles are kind of sluggish. Melatonin release is also related to serotonin release. So, being as simplistic as we can, not enough light means not enough serotonin, which means depressive symptoms.
What can we do about this? As a therapy, people have used light boxes, giving off relatively intense light that is more like sunlight. (Most artificial lights lack the full spectrum of sunlight.) This works but, for most of us there is something a bit simpler.
Get outside.
Our lives are busy and chaotic, and it can be tough to get outside, just like it can be hard to eat all your fruits and vegetables.
The best advice for getting enough nutrients is to follow a balanced diet.
Yet people like the shortcut - the assurance of a vitamin pill.
We like it because then we don't have to think about whether we are eating all the right things. The same is true for light exposure. Light boxes are the vitamin pill of light.
I have always liked simple solutions to what seem like complicated problems.
Take the TV out of the bedroom, read to your child, etc. Here's another good one: Walk in the morning.
If you can rearrange your schedule so that you can walk your child to school, then do that. It seems that morning light is better than afternoon light.
Remember that even on cloudy days in the winter, there is a lot of light energy. Don't worry about the wind chill. Bundle up.
As a wise person once told me: There is no such thing as bad weather, only bad clothes.
The benefit of sunlight in preventing SAD or the milder "winter blues" comes from what our eyes perceive.
Skin exposure is not important. So all you skiers, continue to use your sunscreen.
One of the reasons that skiers feel such exhilaration is the great amount of sunshine they get.
What do blind people do however? It is interesting that blind people, with no exposure of light to their retinas, develop a circadian rhythm of 25 hours. Left to their own devices, they go to bed later and later and get up later and later. This, of course, does not work well when others follow a 24-hour schedule.
Nowadays, we routinely give blind people a dose of melatonin about one hour before their desired bedtime. This retrains their day-night cycle. Sometimes that works for teenagers who stay up late as well. But don't get your hopes up.
But back to the original question. We often see frequent headaches and stomachaches as signs of depression of all types, including SAD. A little enlightenment may be what your child needs.
(1/14/07)
