Tips for Dealing with the Holiday Blues and when to Seek Help for Depression
By Jamie Criswell, MD, LMFT
For most people, the approaching holidays bring thoughts of family get-togethers, shopping for gifts, twinkling lights, and an overall sense of goodwill and cheer. However, for those who are struggling with depression, the holidays can be an especially tough time. The family get-togethers are cumbersome and exhausting, the thought of braving the malls creates stress, the twinkling lights aren’t quite as bright, and the goodwill and cheer is downright non-existent. It is not that these individuals don’t want to enjoy the holidays but that depression seems to suck all the joy out of this time of year – making it a difficult season for the person with depression as well as their loved ones.
It is not unusual to feel a bit melancholy around the holidays. If your support system is small, seeing others with their family and friends can be tough. Feeling pressured to buy expensive gifts is stressful when you have recently lost your job or had a pay cut. For those who are grieving the loss of a loved one, enjoying what is supposed to be the happiest time of the year can seem impossible. Even having unrealistic expectations of creating the “perfect” holiday can make it difficult to get out of bed in the morning. But how do you know when holiday sadness, which we can all experience for one reason or another, crosses the line into depression?
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, depression is characterized by, at least, 5 specific symptoms being present during a consecutive 2-week period. Ask yourself the following questions: Do you feel sad, empty, or hopeless for most of the day, every day? Have you lost interest in activities that you normally enjoy? Have you lost or gained a significant amount of weight in a short period of time or had a drastic appetite change? Are you sleeping more or less than normal? Do you feel sluggish or restless? Are you tired for most of the day? Do you find yourself feeling worthless or excessively guilty? Is it difficult to concentrate or make decisions? Are you having frequent thoughts about death or suicide? If you answered “yes” to five or more questions, it is possible that your holiday blues could be the result of depression, and you should to seek consultation with your medical doctor, psychiatrist or therapist.
If you are feeling down, overwhelmed or stressed there are ways that you can intervene and improve your mood. Limiting alcohol intake can be especially tough at the holidays but use of any substances can worsen depressive symptoms. Feeling depressed can also make it more difficult to control how much you drink, resulting in overconsumption. Additionally, feeling down often makes it difficult to want to be around others, and many people turn to alcohol to cope with being in group settings such as holiday parties or dinners. This can, in turn, result in drinking more than you desired, becoming drunk, and often turns into arguments, accidents and relational difficulties.
Similarly, with cookies, cakes, and other goodies at our finger tips, eating healthy seems unthinkable at the holidays. However, the “everything in moderation” guideline is a good rule of thumb at the holidays and especially if you are battling a depressed mood. The foods we eat can play a large role in how we feel, physically and emotionally. Processed foods and foods with added sugars often contribute to fatigue, low energy, and mood instability (think “sugar crashes”). With an abundance of holiday treats at every party, restaurant and coffee shop, try to be intentional with your choices and serving sizes, so you don’t feel like you are completely missing out on your holiday favorites. In the same realm as alcohol and foods, caffeine can be another culprit in mood changes. With the hustle and bustle of the holiday season, we often turn to those holiday-themed caffeinated beverages to help us push through another hour of work, shopping, or gift wrapping. But be careful, because much like sugar, caffeine can cause a quick elevation in energy and a subsequent crash resulting in fatigue. Caffeine use can also be associated with increased anxiety, edginess, and irritability. We love a good “red cup of cheer” as much as the next person, but maybe opt for a decaffeinated version or one with sugar-free syrup to help keep your mood stable while you’re caroling through the stores searching for the perfect gift.
Some additional tips for combating holiday stress and sadness include: getting adequate rest, exercise, talking to a friend, and taking time out for yourself. While getting adequate rest is always important, it becomes even more important when your resources are taxed. It is easy to become so overwhelmed with shopping, wrapping and attending functions that we sacrifice sleep. This can lead to irritability, depressed mood, weight gain, and an overall increase in fatigue. Ensuring that you try to get as close to the average number of hours of sleep that you normally get will help you feel better and be more productive. Trying to work in some moderate exercise can also boost your mood. Exercise has a positive impact on our overall well-being, physically and emotionally, it releases “feel good” chemicals, as well as makes us feel better about all of that hot cocoa we drank the night before. Taking a time out for yourself, or having a chat with a friend or confidant can help you release tension and get a new perspective on things that you are worried about.
Taking 5- 10 minutes to find a quiet space to practice meditation or yoga or even just sit alone with your thoughts can increase your mental focus, awareness, clear your mind when you’re feeling overwhelmed and give your mood a boost. However, when you are feeling down, it is common to isolate yourself from others. It is important that you make a point to engage with other people, even if it’s just getting out and walking around a store or going to a coffee shop where other people are around. Being in close proximity to others is important to help you feel connected and less alone. Finding someone you can talk with and share some of your stresses and feelings with can greatly improve your outlook and mood. Finally, the nature of the holiday season – parties, dinners, shopping, wrapping, traveling – can make it a very stressful time of the year. While the things we fill our schedules with are often enjoyable, they are still stressful (even good stress is stress). To combat the mental fatigue and decreased mood that comes along with being overwhelmed, it is a good idea to make lists (Santa does it, after all), prioritize your schedule, and don’t over commit. Being organized and having some margin in your schedule will keep you feeling less stressed, especially when unexpected events or visitors pop up.
Even if you are singing “deck the halls” before you clean up the last of Thanksgiving dinner because the holidays are your favorite time of the year, these tips can help you ensure your mood stays jolly. While it is wonderful to spread holiday cheer, keep in mind that the holidays are often hard on others. Be sure to check in on friends and family that may be feeling a little more “bah humbug”. If you notice a friend or family member that may be struggling with depression around the holidays, reach out to them, offer to talk or bring them a meal; don’t let them isolate and be alone. If you become concerned with their behaviors (increasingly down or sad, crying spells, increased irritability, overeating or no appetite) offer to get them to someone that they can talk to, such as a medical doctor, pastor, or therapist. If you or someone you know is feeling so down that thoughts of suicide are occurring, seek medical assistance promptly. Sometimes, the “holiday blues” are more than just a passing feeling around the holidays and medical treatment may be deemed necessary to help get you or a family member back to feeling well.
If the “Holiday Blues” seem to linger beyond the holidays, or if you answered “yes” to 5 or more of the questions above, it may be time to reach out for professional help. In addition to Major Depressive Disorder, Seasonal Affective Disorder can also impact many people during the holiday season, due to the changes in temperature and light cycles. If this describes you or a loved one, you are not alone. According to dbsalliance.org, Major Depressive Disorder affects 14.8 million American adults (or 6.7 % of the population) each year (Archives of General Psychiatry, 2005 Jun; 62(6): 617-27). The recommended treatment for mild to moderate depression is Cognitive Behavioral Therapy (CBT). It is best to find a licensed therapist that has experience and training using CBT to treat depressive symptoms. Sometimes, medication in conjunction with psychotherapy is needed to minimize the symptoms of depression so that the person can regain functioning and fully engage in therapy. Persons diagnosed with severe or chronic Major Depressive Disorder often need medication to help regulate the chemical imbalance that occurs in the brain, as well as psychotherapy to assist them with cognitive behavioral techniques for coping with symptoms. Most people find that therapy is helpful in relieving and often resolving their symptoms of mild to moderate or situational depression.
Whether you are decking the halls or feeling “bah humbug”, you are not alone. Everyone experiences changes in moods throughout the year, but it is especially common to feel down around the holidays. Holidays often bring a lot of memories (happy and sad), expectations, and stress, and everyone adjusts in different ways. Practicing some of the tips above can help keep your mood lifted during the season and keep you aware of when to seek help for yourself or a loved one. Focus on the positives of each day, and give yourself a much needed break. Before you know it, the ball will be dropping to signal the beginning of a brand new year.
Jamie Criswell is a licenced therapist with Foundations Family Therapy in Fuquay-Varina.
