Understanding Holiday Depression: What Providers Should Know

The festive period has come round again. Stores are playing jolly music, friends are making plans, and families are getting together. It seems like everyone loves the holidays, but you notice that some of your clients are feeling more anxious, sad, or tense than they were before.

The holiday blues can be an isolating experience when everyone else seems to be joyful and in good spirits. However, feeling down throughout the festive period is a common experience. Many people are impacted by loneliness, stressful family dynamics, a lack of sunlight, and an excess of alcohol.^[1][2]

While many possible stressors could be underlying a client’s holiday blues, there are also several ways to manage these. This blog aims to help providers understand how they can support clients through holiday depression by exploring:

• What the holiday blues are.
• Possible reasons for feeling sad during the holidays.
• How to help clients cope with feelings of depression at Christmas time.

What Are the Holiday Blues?

The holiday blues meaning centers around feelings of sadness, depression, or anxiety during festivities, such as Christmas or New Year’s Eve.

While these annual events are typically spoken about as joyous times, many people find it hard to cope with their mental health before, during, and after this season.^[1]

Having low mood, anxiety, or worsened symptoms of other mental health conditions can be particularly isolating during holidays because of widespread expectations to be happy.

Messaging from the media, music, work colleagues, and family members can center around enjoyment, relaxation, and quality time. These sorts of messages can create additional pressure to be positive, but many people don’t feel excited about festive occasions. Instead, they may feel like they have to hide that they’re finding it hard to cope.

Experiencing the holiday blues doesn’t equate to a diagnosis of mental illness. It simply describes how some people may be more likely to have emotional difficulties during these times or see a worsening of their pre-existing condition.^[1] There are several reasons why the holidays can do this, which we’ll explore next.

What Does Research on Holiday Blues Tell Us?

If a client finds the holidays depressing, they’re certainly not alone. A lot of research has been done on the holiday blues, and it has found some significant trends. Here are the highlights:^[1][3]

• People with depression are more likely to never send Christmas cards.
• 60% of people with a mental health condition report worsened daily symptoms throughout the holiday season.
• There are fewer visits to psychiatric emergency services before Christmas but a corresponding increase after Christmas.
• Psychiatric hospitals report higher levels of illness (with greater aggression, alcohol misuse, and self-harm) in the patients who remain hospitalized over Christmastime.
• There are more deaths caused by alcohol poisoning during Christmastime than other times of the year.
• Suicide rates drop around Christmas but then rebound after and during the New Year’s holidays.

These different studies show two important trends:

The first is that many people do feel worse around Christmas, highlighting the need for extra support from themselves, family, friends, and mental healthcare professionals during this time.

Secondly, the research shows that festive periods may temporarily protect people from suicidal behaviors, even if alcohol use and mood disorders get worse.^[3] This underpins the importance of extra mental health support in the post-holiday period.

Reasons for Holiday Depression

The causes of holiday blues are broad, varied, and different for everyone. However, people do report some common underlying contributors.

So, if a client is finding it hard to cope with their mental health at Christmas, here’s what could be happening. They could be:^[2]

• Feeling the extra stress of plans, cooking, gift-buying, and social events.
• Having unrealistic expectations of holidays going entirely smoothly.
• Remembering happier times at this point in the year.
• Remembering sad events that happened at this time of year, such as a bereavement.
• Having a reduction in sunlight throughout winter.
• Experiencing significant changes to their routine and diet.
• Drinking an excess of alcohol or using other substances.
• Unable to see friends or family.

These factors can affect everyone differently. One person might feel lonely, isolated, or sad. But another may feel tense or frustrated, like they’re irritated all the time. Or others might feel fatigued and be battling a sense of loss.^[2]

Furthermore, the common depressive belief that everyone else is having a good time can be exacerbated during the holiday period. This can also create or worsen depressive feelings at this time.^[3]

Lastly, one major contributor to holiday depression is stress-inducing family dynamics, which we’ll explore next.

Stress-Inducing Family Dynamics

Another cause of the holiday blues is the family dynamic that some people return to over the Christmas period. A client’s awareness that this dynamic could be contributing to their low mood could help them manage triggers during this time.

Common stressful family dynamics include:

• Enmeshment: When families lack boundaries, it can seem like closeness. However, there might not be enough emotional separation between family members. For instance, a client may feel as though they’re not allowed to be independent or express negative feelings. Some enmeshed parents use guilt to feel reassured or in control, and their children are made to feel responsible for their parents’ happiness. For this reason, boundaries are important for people from enmeshed families during holidays.^[4]

• The “Drama Triangle”: Some families have high levels of conflict, and these frequently draw members into the roles of Victim, Rescuer, or Persecutor. The triangle keeps its members in these positions as people are compelled to be helpless and dependent (Victim), oppressive and authoritative (Persecutor), or helpful and focused on other people (Rescuer). The key to escaping the triangle over the holidays is to encompass values from each position: sensitivity, compassion, and responsibility.^[5]

• Avoidant dynamics: Some families will avoid conflict at all costs in order to maintain the illusion of peace and harmony. However, this often means that negative emotional experiences aren’t allowed to be expressed.

If these emotions are expressed, children may be met with the silent treatment or neglectful responses. Members may prioritize the needs of other family members but end up sitting alone with their own anger, disappointments, and sadness.^[6] People with avoidant families may benefit from relying on an external system throughout the holiday period and tending to their own emotional needs.

How to Help Clients Cope With Christmas Depression

Being sad over Christmas can feel incredibly isolating, but there are ways to help clients cope with the holiday blues. Some ways to manage these feelings are practical, such as going for sunlit walks and reducing alcohol consumption.

However, others require a bit more emotional investment, such as setting boundaries and seeking social support.

Here are some of the ways you can encourage clients to manage the holiday blues:

Raise Awareness of the Symptoms of SAD

As mentioned, some feelings of depression in the winter holidays can be attributed to the decrease in sunlight. This is known as “seasonal affective disorder” or “SAD.” Someone with SAD typically starts lacking energy, feeling less productive, and losing hope.^[7]

A client can tackle the symptoms of SAD by spending more time in front of bright light during winter, whether this is natural morning sunlight or light from a light therapy box. SAD symptoms can also be alleviated by starting a new hobby or eating more protein, whole grains, and vegetables.^[7]

Encourage Them to Drink Less Alcohol

Increased alcohol consumption is strongly associated with emotional difficulties at Christmastime.^[2][3] This is because it affects both mood and sleep, which can spiral into symptoms of depression and anxiety.^[7]

So, a client limiting how much they drink can be essential for coping during the festive period. This can be especially difficult at parties and other social events, but it is still possible. For example, they could limit themselves to one drink per event (or remain sober).

Promote a Trustworthy Support System

Research demonstrates why it’s so important to have a support system during the holidays. This is because the most common stressors reported by people in psychiatric emergency services at Christmas are loneliness and being without a family.^[3]

However, many may be cynical about increasing support because their so-called “support system” is the thing that’s giving them stress. However, it’s key that their support system is actually supportive.

While they may feel obliged to attend some social events that cause emotional pain, this doesn’t mean that they can’t see the people that bring them joy. Regardless of whether they choose to attend a stress-inducing family event, it’s still important to carve out time to see a particular friend, group of friends, or extended family. This can ensure they feel seen and loved during the holidays.

If they don’t have a family to see at Christmastime, they may need to be creative, brave, and anticipate their feelings. For instance, if they know that being with someone else’s family will feel too sad, they could plan a lavish and nostalgic day for themselves. Alternatively, it’s worth asking their friends if they can join them for the holidays; though this could be daunting, they may be surprised by people’s generosity.

And finally, volunteering at Christmastime can be a great way to feel connected and valued, even if it’s with people they’ve never met. Their local community is likely to have several volunteering opportunities at Christmas (and throughout the year), which can make them feel good while helping others.^[7]

Support Them in Setting Boundaries

Setting boundaries is one of the most powerful things a client can do for their well-being. They can be even more necessary during the festive period because it’s a time of plans, expectations, and seeing people who they may not encounter very often.

Boundaries are about preferences and what the person will tolerate. Without them, people can tend to say “yes” to everything despite being low on time or energy, feeling responsible for other people’s emotions.^[8]

For example, a client’s festive boundaries might sound like:

• “We’re having Thanksgiving dinner with just the children this year, but we’re free the day after.”
• “We’d love to see you on Christmas Day. We’ll cook dinner; could you bring the dessert?”
• “I’m not drinking alcohol this Christmas because I’m on a bit of a health kick.”
• “I’ll be leaving at 8 pm, but I’m looking forward to seeing everyone.”

Setting boundaries with family members at Christmas may feel scary to a client. This is because they’re disrupting patterns of relating and behaving that their family members are likely familiar with. So people may respond poorly to their boundaries, whether they feel abandoned by independence or are used to getting what they want.^[8]

Reactions to a client’s festive boundaries may cause them to feel guilty, but remind them that there’s nothing to feel guilty about. They’re simply doing what they have to do to protect their well-being. It can help to rely on other sources of support during this time, such as extra sessions.

Find Therapeutic Support for the Holiday Blues With AMFM Healthcare

At AMFM Healthcare, we provide compassionate, evidence-based mental health treatment focused on meaningful, lasting results. Our outpatient treatment program, Mission Connection, offers many types of therapy to address clients’ emotional difficulties at Christmas.

If the holidays have triggered issues with a client’s mental health, ongoing talking therapies can be helpful to address what’s underneath. For instance, they might like to explore CBT for anxiety, psychodynamic therapy for family dynamics, or humanistic therapy for self-discovery.

If you find that a client is experiencing holiday depression and you’re unsure of how to best support them, call us today at 844-690-0205. We can talk you through the best approach for your client and help you support them in reclaiming the holidays as a joyous experience.