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Holiday depression, anxiety, and stress facts

The winter holiday season, including Christmas, Hanukkah, and Thanksgiving, for most people is a fun time of the year filled with parties, celebrations, and social gatherings with family and friends. But for many people, it is a time filled with sadness, self-reflection, loneliness, and anxiety.

What causes the holiday blues?

Sadness is a truly personal feeling. What makes one person feel sad may not affect another person. Typical sources of holiday sadness include

Is the environment and reduced daylight a factor in wintertime sadness?

Nonhuman animals react to the changing season with changes in mood and behavior. People change behaviors, as well, when there is less sunlight. Most people find they eat and sleep slightly more in wintertime and dislike the dark mornings and short days. For some, however, other symptoms are severe enough to disrupt their lives and cause considerable distress.

Sadness or depression at holiday time can be a reaction to the stresses and demands of the season. In other cases, people may feel depressed around the winter holidays due to a condition known as seasonal affective disorder (SAD), sometimes referred to as seasonal depression. This is a type of depression that tends to occur (and recur) as the days grow shorter in the fall and winter. It is believed that affected people react to the decreasing amounts of sunlight and the colder temperatures as the fall and winter progress, resulting in feelings of depression. Although this disorder usually occurs in the fall and winter, there are those who suffer from this condition during the summer instead of, or in addition to, during the fall or winter. The incidence of seasonal affective disorder increases in people who are living farther away from the equator.

What are symptoms and signs of holiday depression, anxiety, and stress?

Balancing the demands of shopping, parties, family obligations, and house guests may contribute to feelings of being overwhelmed and increased tension. People who do not view themselves as depressed may develop stress responses and may experience a number of physical and emotional symptoms including

areas-affected-by-stress

Image of areas of the body that are affected by stress
Others may experience post-holiday sadness after New Year's/Jan. 1. This can result from built-up expectations and disappointments from the previous year, coupled with stress and fatigue.

In the case of seasonal affective disorder or a true depressive disorder, symptoms may persist beyond the holidays or may be more severe. The symptoms of seasonal affective disorder include tiredness, fatigue, depression, crying spells and mood swings, irritability, trouble concentrating, body aches, loss of sex drive, insomnia, decreased activity level, and overeating (especially of carbohydrates) with associated weight gain.

How is holiday anxiety, stress, and depression diagnosed?

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.

What is the treatment for holiday depression, anxiety, and stress?

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.

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).

Can holiday anxiety, stress, and depression be prevented?

The following tips can help prevent stress, anxiety, and mild depression associated with the holiday season:

Holiday depression and stress, fortunately, can be managed well by following the tips listed above and by seeking out social support. Counseling and support groups can be of benefit if the symptoms are too much to bear alone.

Seasonal affective disorder generally responds well to bright light therapy (phototherapy). For some patients, medications may be used to help relieve symptoms.

Medically reviewed by Martin E Zipser, MD; American board of Surgery

REFERENCES:

Dryden-Edwards, Roxanne. "What Is Seasonal Affective Disorder (SAD)?" MedicineNet.com. Apr. 29, 2010. <http://www.medicinenet.com/seasonal_affective_disorder_sad/article.htm>.

Golden, R.N., B.N. Gaynes, R.D. Ekstrom, et al. "The Efficacy of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-analysis of the Evidence." Am J Psychiatry 162 (2005): 656-662.

Medically Reviewed by a Doctor on 12/4/2014