DEC. 15, 2005 | The idea of “the holiday blues” has been accepted as a common occurrence, but stress from the holidays and true depression are very different and should be treated in different ways, according to Robert Jarvis, M.D., director of the Mood Disorders Clinic at the University of Arkansas for Medical Sciences (UAMS) and an assistant professor in the Department of Psychiatry in the UAMS College of Medicine.

His clinic is part of the UAMS Psychiatry Programs for Adults.

The idea of the existence of the holiday blues is largely based upon anecdotal evidence and has been perpetuated in the popular media and by pop-psychology, Jarvis said. The notion that the holiday season is associated with an increase in psychopathology has not been supported by research. The majority of studies on this subject have consistently shown a decrease in the number of psychiatric emergencies, outpatient visits, hospital admissions and suicides in the days and weeks before Christmas, and a proportional increase afterwards. People may experience dysphoria (blue mood) and anxiety, but increased emotional support (family and peers) during the holidays may counterbalance this.

Jarvis said the holidays are often stressful because of the expectations people put upon themselves. “We’re supposed to be happy and joyous. We’re supposed to feel love towards others, to be generous with our time, energy and resources. We’re supposed to spend time with our grandparents, cousins, aunts and uncles, and friends,” he said.

“We scurry around our homes and towns cleaning, preparing, decorating, shopping, spending, waiting in line to buy, waiting in line to return!  And it’s tiring. We push ourselves to the limit, and the effort takes a toll.  And when it’s over, what’s left?  The support and hope of the holiday season dwindle, or worse, suddenly drop off. As a result, sometimes we are despondent, resentful, or demoralized.”

So how do you differentiate depression from transient holiday-related mood changes? Jarvis said most cases of holiday-related depression are likely to be normal reactions to stress. Some might meet criteria for an adjustment reaction with depressed mood or anxiety, and fewer for major depression. You must consider the duration of the episode, the severity and degree of social and occupational dysfunction.

One in six Americans will experience depression in their lifetime. As many as 20 million Americans experience depression each year. Research has proven that depression strikes women more than men, and that genetics plays a role. If a close family member has experienced depression, the likelihood that you will goes up dramatically. Once a person experiences a depressive episode, the likelihood of a re-occurrence also increases. If the holiday blues continue several weeks into the new year, it is best to visit with a psychiatrist to determine if the cause is more than seasonal stress.

Tips

These tips may help take the stress out of the holidays and keep depression from taking over the spirit of the season:

• Get some rest. Sleep deprivation or sleep habit changes can lead to mood changes.
• Limit caffeine and alcohol, as both affect sleep, and alcohol is a depressant.
• Moderate your eating. Significant changes can lead to guilty feelings and weight change.
• Maintain already-established exercise routines

If you are lonely, don’t let yourself be alone. Lonely plus alone is a bad combination. If you are grieving, increase your contact with friends and family. Talking about departed loved ones helps one to feel supported.

Think about when to shop, and consider shopping and wrapping gifts with others. Plan ahead. Don’t postpone shopping or planning for meals. Pace yourself. Shoot for somewhere between a social marathon and a self-centered retreat.

Remember that it is within the normal range of experience to experience some sadness, disappointment, anxiety or other emotional pain during the holidays. If you already have a depressive or anxious condition, take extra precautions.

Know yourself and your own expectations. What do you want out of the holiday season?  Be honest with yourself about how much you can realistically afford to give in terms of your time, energy and resources. Know your loved ones, and try to understand them and their hopes and expectations. Make a realistic appraisal of social and familial expectations.

Avoid the tyranny of expectations by looking at your and other’s expectations, considering affordability, and by looking carefully at what you want and respecting the needs and feelings of others. Consider drawing names and setting a dollar limit on gifts to be exchanged within a group. Be aware, however, that this can cause stress if there is disagreement about the dollar limit.

Remember – you don’t have to be happy every minute of every day, Jarvis said.  It’s OK to feel down. Give yourself permission not to feel euphoric all the time. Have a wonderful and peaceful holiday season!