Health Care and Holiday Blues

Have you ever heard Elvis Presley's recording of "Blue Christmas", or any of the countless other songs during the Holiday Season that refer to being blue for one reason or another? Many people suffer depression and dark times during November and December, and this time frame has the highest suicide rate than any other during the year. There is something about these months that make people sad or cause them to be depressed.

According to the University of Maryland Medical Center (UMMC), the holidays are a time for festive partying with friends and family, sharing gifts and laughter -- and getting depressed. That's right. For many people, the holidays bring on feelings of sadness and anxiety that can be hard to shake. According to the National Mental Health Association, reasons for feeling blue around the holidays are numerous. They range from fatigue -- a result of all of the increased holiday activity -- to financial limitations and family tensions.

Experts say one of the fastest routes to holiday depression is unrealistic expectations. People often hold on to what they remember as an ideal holiday from years gone by, and are unable to reproduce it. There are also expectations around the holidays that 'everything must be perfect', and perfection is, of course, rarely obtainable. Other factors that can contribute to feelings of sadness around the holidays are memories of deceased loved ones and strained family dynamics. The holidays are associated with family and togetherness. In today's world of high divorce rates and fragmented family units, stress is commonly experienced as family members attempt to find some compromise in defining shared time.

According to MedicineNet.com, sadness is a truly personal feeling. What makes one person feel sad may not affect another person. Here are some examples of what may cause you to experience sadness, stress, or depression during the Holidays, and how to deal with it:

1.) A number of factors, including unrealistic expectations, financial pressures, and too many commitments can cause stress at holiday time.

2.) Certain people may feel depressed around the winter holidays due to seasonal affective disorder (SAD), sometimes referred to as seasonal depression.

3.) Headaches, excessive drinking, overeating, and insomnia are some of the possible consequences of poorly managed holiday stress.

4.) Those suffering from any type of holiday depression or stress can benefit from increased social support during this time of year. Counseling or support groups can also be beneficial.

5.) In addition to being an important step in preventing the symptoms of seasonal affective disorder, regular exposure to light that is bright, particularly fluorescent lights, significantly improves depression in people with SAD during the fall and winter.

6.) Setting realistic goals and expectations, reaching out to friends, sharing tasks with family members, finding inexpensive ways to enjoy yourself, and helping others are all ways to help beat holiday stress.

The holidays cause many people to feel anxious and depressed in a general sense; but for some, holiday tensions can lead to full-blown clinical depression. According to the National Institute of Mental Health, about 19 million American adults suffer from depressive illnesses every year. Unfortunately, many people with clinical depression don't seek help, even though depression is a treatable condition. Some people still look at mental illness as a character flaw, but the truth is that it is no different from any other kind of illness. If your body couldn't produce enough insulin, no one would tell you to 'get over it'. You'd need to go to the doctor and get treated for your insulin deficiency. It is the same with mental illness.

Below are a list of depressive symptoms compiled by the National Institute of Mental Health. NIMH experts suggest that you seek professional help if you experience five or more of these symptoms every day for two weeks. If you have recurring thoughts of death or suicide, you should get help immediately from professional sources. Depression may exhibit itself in the following ways:

•Persistent sad, anxious, or "empty" mood.
•Feelings of hopelessness, pessimism.
•Feelings of guilt, worthlessness, helplessness.
•Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex.
•Decreased energy, fatigue, being "slowed down".
•Difficulty concentrating, remembering, making decisions.
•Insomnia, early-morning awakening, or oversleeping.
•Appetite and/or weight loss or overeating and weight gain.
•Restlessness, or irritability.
•Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

According to MedicineNet, a simple history and physical exam may be all that is needed to diagnose a case of the holiday blues. Your health-care professional may perform lab tests or other tests to rule out any medical conditions that may be causing your symptoms. Likewise, a full history of your symptoms is likely to provide clues that can help distinguish a mild case of the holiday blues from SAD or a more serious and chronic depressive disorder. Those suffering from any type of holiday depression or stress may benefit from increased social support during this time of year. For uncomplicated holiday blues, improvement may be found by finding ways to reduce the stresses associated with the holiday, either by limiting commitments and outside activities, making arrangements to share family responsibilities such as gift shopping and meal preparation, agreeing upon financial limits for purchases, or taking extra time to rest and rejuvenate.

Counseling or support groups are another way to relieve some of the burdens of holiday stress or sadness. Knowing that others feel the same way and sharing your thoughts and experiences can help you manage your troubling feelings. Support groups also provide a further layer of social support during this vulnerable time period.

In addition to being an important step in preventing the symptoms of seasonal affective disorder, regular exposure to light that is bright, particularly fluorescent lights, significantly improves depression in people with SAD during the fall and winter. Phototherapy is commercially available in the form of light boxes, which are used for approximately 30 minutes daily. The light required must be of sufficient brightness, approximately 25 times as bright as a normal living room light. The light treatment is used daily in the morning and evening for best results. Visiting other areas of the world that are characterized by more bright light (such as the Caribbean) can also improve the symptoms of SAD.

For extreme conditions, Antidepressant medications, particularly serotonin selective reuptake inhibitor (SSRI) medications, can be an effective treatment for seasonal affective disorder. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa).

In addition to relationship problems, according to CBN, another source of sadness at at the holidays is the belief that happiness depends on how much money you spend. And with unemployment in double digits, there may be lots of people who feel inadequate. Here are 9 great ways to help beat the holiday blues:

--Plan ahead. Make a budget for gifts, travel, food and donations. Schedule tasks such as holiday shopping, baking, decorating so they are less stressful.

--Reach Out. Focusing on someone else tends to lift your spirit and theirs. Churches, hospitals and nursing homes all need volunteers this time of year.

--Let Go of Grievances. In other words, bury the hatchet.

--Be With People. Schedule get-togethers well in advance, attend meetings, parties, church services, etc. Don't get caught alone. Isolation can lead to depression.

--Get Creative. If you can't be with your loved ones find new ways to celebrate together such as sharing pictures, e-mails or videos.

--Exercise. It's a powerful mood booster because during exercise the body releases endorphins, neurotransmitters that have euphoric and pain-relieving properties similar to morphine.

--Eat Healthy. Overindulgence leads to feelings of guilt and lethargy.

--Get Plenty of Rest. You'll need a good night's sleep to tackle the emotional demands of the holidays and to prevent getting sick when you can least afford to be side-lined.

--Pray Daily. Prayer helps to center  you--it's important to make time to get your life in focus.


By taking spiritual and practical steps, you can enjoy good emotional health throughout the holidays. Find help professionally and with family and friends you trust to help you through any challenging issues relative to depression and sadness. There are plenty of resources to help you if you are dealing with problems around the Holidays. Seek help, and then work on your mood to get back to where you belong--happy and healthy.

Until next time.