In the midst of the holiday season, not all people feel merry, especially those living with mental health issues.
Thanksgiving to New Year’s Day for some can be filled with loneliness and stress. According to the National Alliance on Mental Illness, 64% of people with mental illness report holidays make their conditions worse.
Sharp Grossmont Hospital for Behavioral Health Psychotherapist Mary Heineke, LMFT said that 45% of Americans dread the holiday season. Women are more likely than men to be negatively affected during the holiday season, and holiday stress has a larger impact on lower middle-income individuals. Heineke said “holiday blues” is different for everyone. She said the American Psychological Association indicated that 88% of Americans feel stressed over the holidays.
“Over money, over family, being overcommitted, overtired, struggling to feel rested, and having over realistic expectations on how everything is supposed to be,” she said. “Some people must travel, and many have trouble just dealing with the traditional demands this time of year.”
Heineke said for some, the holidays are difficult due to personal loss and grief.
“The first year of losing persons can be the worst year,” she said. “Not only loss of people, but loss of health, a job, all those losses become more impactful as the holidays come around,” adding that it seems like everyone else is having fun, but you just do not feel that joy.
“Some of the things that we encourage people to do is just learn to say no,” she said. “Set realistic expectations of what you can do and what you cannot do. It is okay to let people know that you cannot do things that you have done in the past. When you feel like that it becomes more about doing than being. It is important to take that step back.”
Heineke said it is important to pay attention and know your budget during holidays because shopping can be stressful, especially if you shop during the holiday season only to have to pay it off the rest of the year.
“It is important that we lower our expectations,” she said. “Keep in mind what this holiday is about for you and your family. Do not try and do it all. Some people have the tendency to just shut down, maybe drink more alcohol to comfort themselves. Being aware of things that you might do to comfort yourself are probably not going to be in your best interest. Some of these things are a way of suppressing your emotions, or that is what makes them happy when they feel stressed. But the effect does not last very long.”
Heineke said at Sharp, they mostly help people in its programs to be more mindful.
“Do not compare yourself to past Christmases, or your neighbors,” she said. “Be in today and stop looking at the future. Ensure that what you are doing today is impactful and it feels like you have accomplished something in a way that gives your heart some joy.”
Heineke said the holidays can be extremely difficult for people with a major depressive disorder. She said you must have five or more symptoms lasting more than two weeks. Trouble concentrating, remembering details, making decisions, feelings of guilt, helplessness, hopelessness, separating everything, irritability, insomnia, loss of interests in things you find pleasure in, overeating, loss of appetite, digestive problems, and feelings of death or suicide.
“These are extreme symptoms of depression, and you need to see a professional,” she said.
Heineke said if you notice a family member or friend that seems depressed, many times if you bring it up, they will refute the question.
“But being able to sit down with them and say that you have noticed some changes with their behavior and asking them what you can do to help them, can you take something off their plate, asking if they have talked with a therapist, or their primary physician,” she said.
“Being a friend to somebody is trying to direct them to a professional. It is great to sit with your friends and talk about your feelings, but sometimes we need more professional help.”
Heineke said many times during the holidays, you are surrounded by people, so those suffering with depression may reflect discussions by saying this is not the right time, they do not want to talk about it now, and it is important to pick a time to have a one-on-one conversation. Let them know that you care about them, they are important to you, and ask them how you can help.
“Ask them how you can help. Do not just show up with food or something else,” she said.
“Some people are not being as helpful as the could be if they are not just asking how they can help.”
Heineke said support groups are extremely helpful, especially if you have lost a loved one, she said. “Depression can be extremely powerful this time of year. We encourage people who have lost someone, how can you honor them during the holidays. What can you do to ensure what you are doing is validated that this person is important to you. Perhaps having a picture of that person somewhere in the room where you are celebrating. Being able to tell the stories about your holidays with that person.”
Heineke said if the holiday blues last beyond the holidays, it is important to see your primary physician.
“Your primary care physician can direct you to see a psychiatrist,” she said.
“Sometimes our moods get worse after the holidays. January and February can be very difficult times. Get an appointment with a psychiatrist, talk with a therapist. Talk with your priest, minister, rabbi, or join a support group.”
Heineke said the outpatient program at Sharp Grossmont, the groups specialize in different things. Problems with drugs and alcohol, mood problems for those suffering with depression and anxiety, and senior programs because seniors have a different set of issues.
“Seniors suffer from anxiety and depression, but also loneliness,” she said. “The change that they have had to incorporate in their lives may increase these feelings. Here, we try to get seniors connected. Maybe by getting them to volunteer, attend a class, become more connected in their community.”
For those suffering from the holiday blues, Heineke said the following strategies during the holidays may help. Start a new tradition, change the celebration, express your needs, help someone else, and give yourself time. She said for anyone who struggles during the holidays, consider making new traditions. Look for new holiday recipes, volunteer, donate things you no longer need, visit a neighboring house of worship, donate to a charity as a gift for someone in their name, visit a museum or zoo, or take a holiday walk on the beach.
