Beating the Holiday Blues

Rosemary Black

Reviewed by QualityHealth's Medical Advisory Board

Christmas trees sparkle, festive carols fill the air, and cups overflow with rum-spiked eggnog. With the abundant good cheer and the prevalence of loving families on TV, it seems like it should be the happiest time of year. Yet for many, the holiday season is a trigger for depression.

"Depression is prevalent at holiday time," says Victor Fornari, MD, director of the division of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, New York. An estimated 10% of the population suffers from major or mild depression at any time of the year, he says. And holidays can exacerbate the symptoms in those who are depressed as well as bring out symptoms in others who may be at risk.

Causes of Holiday Depression

The holidays can be especially difficult for individuals who are suffering from a loss, according to Fornari: "The holidays highlight the loss of a loved one, and this is true for people who don’t face depression as well as those who do." To complicate matters, he adds, the holidays occur during the winter months, when many people are already feeling the effects of Seasonal Affective Disorder, a form of depression that occurs seasonally—usually during the winter.

Other factors that can contribute to depression include financial worries, especially if you’ve over-extended yourself by buying too many expensive gifts for loved ones, and feelings of displacement [being out of place] in individuals who are torn between which side of the family they should be spending the holidays with.

The holidays "can be especially hard on people whose parents are divorced," notes Scott Krakower, DO, of Zucker Hillside Hospital. When an individual is pressured by both parents to spend the holidays with them, depression can surface.

Depression can also settle in when you’ve had a change of circumstances, such as the loss of a job or a serious illness, says Mary A. Fristad, PhD, ABPP, vice chair in Research & Academic Affairs in the Department of Psychiatry and Behavioral Health at Ohio State University Wexner Medical Center, in Columbus. Depression can also occur when people "have unrealistic expectations of a picture-perfect holiday in the midst of financial, family, or work troubles, or other tension," she adds.

Are You Depressed? Know the Symptoms

While many people think of depression in terms of a low mood or sadness, Fornari notes you should also be aware of the following signs:

Sleep disturbances (sleeping more or less than usual)
Changes in appetite (eating more or less than usual)
Irritability
Feelings of helplessness
Suicidal thoughts

In additional, holiday depression can also cause you to feel guilty over not having a "perfect" holiday, not enjoy events that are usually pleasurable, and have trouble concentrating, Fristad points out.

Dealing with Holiday Depression

If you are feeling really down around the holidays, it’s important to get help. Discuss your feelings with your primary care physician, Fornari suggests. You may be referred to a psychologist or a social worker, and "Psychotherapy can be very helpful for holiday depression."

Here are some other strategies that can help you manage these feelings of sadness and depression and help you reclaim some holiday joy.

Be sure to schedule a little down time just for you. Allow yourself to relax, pray, meditate, or laugh, Fristad says. This time should be exclusively for you.
If family tensions are making you feel low and you can’t decide where to go to spend the holidays, be easy on yourself and go where you feel the most comfortable. In addition, "Don’t ruminate and dwell on it," Krakower advises.
Start some new holiday traditions. "There is so much emphasis placed on memories of the past during the holidays," says Julie Szempruch, RN, a mental health expert with Eskenazi Health Midtown Community Mental Health in Indianapolis. "Try to sit down and think about some other things you could do around the holidays that would be fun for everyone."
Plan ahead. This can help prevent the feeling that the holiday season is spinning out of your control Szempruch says. "Sit down and think about what you want to accomplish during this time of year," she says. "Do some serious planning on the front end."
Get enough sleep. "When we are sleep deprived, we crave sugar and fat, tend to overeat, and are low on energy and irritable," Fristad says. "With enough sleep, it’s easier to eat healthfully, exercise regularly, and maintain a positive outlook on life."
Volunteer. “It makes you feel better, and helping others can help you,” Krakower says.
If you’re feeling depressed because of the loss of someone close to you, make a "gift" for that person. This advice comes from Jeanette Raymond, PhD, a clinical psychologist with a private practice in Los Angeles. She explains, "Make a scrapbook that shares your year, your life, and your family. This is a way for you to understand and appreciate that you have lived well enough without them."
Celebrate a loved one who’s no longer with you by creating a meaningful ritual. "This could be lighting a candle by the person’s picture, writing a letter to the loved person, or gathering family and friends together to share special memories of that person," Fristad says.
When you’re feeling down, wear cozy, warm, comforting clothes. This sounds like it might not have much effect, but "Sometimes just feeling blanketed by warmly textured fabrics can be uplifting," Krakower says.