ADHD Symptoms Worsen in the Winter

ADHD can definitely worsen in some patients during the winter months.   You might feel like you are succumbing to old wives tales and folk wisdom when you start to feel that January (or February or December) is getting to you.  However, many clinical studies point to the mental health of people with ADHD being worsened by winter.  Adults with ADHD are known to have a higher prevalence of Seasonal Affective Disorder (or SAD) than the general population (27% vs. 5%).  They also report more ADHD symptoms in the winter.   Although most of the research in this area has focused on adults, we do know that children with ADHD tend to seek fewer prescriptions during the summer and may see the doctor less for ADHD during the summer as well.  While these behaviors may reflect seasonal school attendance, the studies do not rule out other seasonal influences on ADHD.

The main causes for greater winter symptoms in ADHD adults seem to be SAD and delayed circadian phase sleep disorder.  SAD is mainly characterized by depressed mood and irritability, which is usually worse in the winter.  The person might even wake up earlier and be unable to get back to sleep, although some people with SAD sleep too much.   Other symptoms include worsened concentration, carb craving, fatigue, and feeling inappropriately guilty.

The main symptoms of delayed circadian phase sleep disorder are having a hard time waking up in the morning and having a tough time falling asleep at night because you don’t feel sleepy yet.  A person with a delayed circadian phase will usually not get enough sleep if they have to wake up in the morning for a job or school.  They are typical night owls, but as their sleep debt accumulates, they might start to be grouchy and feel down on themselves for being unable to get up in the morning and being late all day. 

In children, seasonal worsening may also have a social component to it.  The winter season typically brings a rise in holiday celebrations with accompanying over-stimulation, dietary disruptions, and schedule changes, as well as midterm examinations which can lead to a perfect storm for children, in addition to issues of SAD and circadian phase disruption.

Treatment for seasonal worsening of ADHD depends on the cause.  People with SAD are known to respond to bright morning light from full spectrum lighting.  Some health insurances will pay for special therapeutic lamps.  Antidepressants also are a possibility.  Circadian phase delay is treated with strict sleep hygiene, bright morning lights and possibly evening melatonin.

References:

Moses, MD Scott. "Delayed Sleep Phase." Family Practice Notebook. Family Practice Notebook, LLC, 05 Feb. 2017. Web. 05 Feb. 2017.

Moses, MD Scott. "Seasonal Depression." Family Practice Notebook. Family Practice Notebook, LLC, 05 Feb. 2017. Web. 05 Feb. 2017

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