How to combat depression during the holidays

With the holiday season upon us, many people are gearing up to spend time with loved ones and indulge in holiday meals. But for some, the holidays might not be so merry. It's not uncommon for people to experience depression during the holidays for many different reasons, and for those who are struggling or have loved ones who are struggling, it's important to recognize the signs of depression to help combat it.

Why do some people feel depressed during the holidays?

Previous studies have shown that 38% of people say their stress levels increase during the holidays, and 64% of people with a preexisting mental illness said the holidays make their condition worse. However, sometimes people start to feel depressed during the holidays, even though they do not experience depression at other times of the year. This can happen for several reasons.

Many traditional holidays — including Thanksgiving, Christmas, Hanukkah and New Year's Eve — take place during a time of year when the days are shorter, which can be difficult for people with seasonal affective disorder (SAD), explains Dr. Frank Drummond, HCA Healthcare's national medical director of Behavioral Health. SAD is a type of depression with symptoms that last about four to five months per year. It's characterized by a recurrent seasonal pattern that can occur during the winter (winter-pattern SAD) or summer (summer-pattern SAD). The likelihood that you'll experience this type of depression can also depend on where you live.

"The percentage of people who experience seasonal affective disorder in south Florida, for example, is 1 in 100. But in the northeast, it's 1 in 10," says Dr. Drummond.

Others might experience "winter blues," which isn't a medical diagnosis but rather a general term for sadness or lack of interest during the fall and winter months. The winter blues are typically less severe than SAD and can usually be managed with lifestyle modifications. Still, it's important to not brush off those feelings in case they develop into something more serious.

For people who do not have SAD, the stress of the holidays can lead to depression. "Some people feel pressured to feel the holiday spirit. This pressure comes from not just social media, but also the popular media and marketing," Dr. Drummond says.

"There's also the stress of spending money, and the final biggest stressor is the disruption in time," he adds. "The high commitment to holiday get-togethers, the commitment to taking time off from work, the change in childcare. These are all things that can be celebrated, but they can also introduce stress to people at different times."

What are the signs and symptoms of depression?

Depression, also known as major depressive disorder or clinical depression, is a serious mood disorder that affects nearly 17.3 million American adults. Symptoms of depression include:

• Feelings of hopelessness or pessimism
• Feelings of frustration, irritability or restlessness
• Feeling of helplessness, guilt or worthlessness
• Decreased energy or fatigue
• Trouble sleeping, waking up or oversleeping
• Changes in appetite or unplanned weight changes

During the holidays, people might feel guilty about not being able to participate in festivities as they would like to, or they may feel guilty about not being able to give the presents that friends and family were expecting, says Dr. Drummond. Others might feel guilty about not being close to their family during a time when family is in such sharp focus. It's important for people to be aware of their individual triggers, whether those factors relate to gift giving, cooking meals or social gatherings.

Holiday depression can also stem from exposure to holiday marketing in stores or on TV, Dr. Drummond says. "There is a correlation between the inflated pressure to have a wonderful holiday season that starts as early as September now," he says. "I think that speaks to creating the holidays that are meaningful to you and the people you care about, versus the holidays that are meaningful to people who are trying to sell us things."

How to combat depression during the holidays

Dr. Drummond emphasizes the need to be aware of personal triggers to combat depression during the holidays. Whether they are tied to spending time with family members you don't normally see or traveling to and from other people's homes, it's important to consider which events may trigger stress and depression, and why they might do so.

He suggests exploring your feelings with questions like these: "Is it the stress of getting there and all of the unknowns, or dealing with interpersonal relationships that you don't enjoy? Is the trigger financial? And how can you recognize that for what it is, not let it get to you so much, and feel some sense of control over it?"

Practicing self-care can help with managing the symptoms of stress and depression, Dr. Drummond says. "As you're making all these plans and building out your schedule, make sure that you take time for yourself, whether that's walking, exercise or meditation. Don't overbook yourself."

It's also important to avoid overindulging, which can sometimes be difficult during the holidays. "Don't overdo it. That includes overspending, overeating, overdrinking and not sleeping enough," Dr. Drummond notes.

If a loved one is struggling, it can help to have an open conversation with them about how they're feeling and decrease the stigma around not feeling the holiday spirit. "Help them talk through it and understand what is manageable and what they might do to help themselves," Dr. Drummond says. "And if it's serious or life-changing, then talk about how to get help."

If you know the holidays are going to be difficult for you, remember that it's OK to set boundaries. Don't be afraid to turn down events and invitations that are triggering, and say "yes" to the things that make you feel good and happy.

Find information about the mental health resources offered at TriStar Health.

Keep an eye out for next month's article on how to deal with post-holiday blues.