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November 30, 2016

Infrequently Asked Questions: Are the 'holiday blues' real?

Elvis didn't croon about a "Blue Christmas" for nothing, folks.

But, curious to get the rundown on whether these seasonal blues are actually holiday-related, we reached out to Virginia O'Hayer, a clinical associate professor in the Department of Psychiatry at Drexel University. She'll host a "Holiday Survival Guide" workshop on Thursday, Dec. 15 from 11 a.m. to 1 p.m. -- a workshop for Drexel clients struggling to get through the season.

A good place to start: Are the 'holiday blues' a real thing? I imagine it goes hand in hand with seasonal affective disorder.

Yes, it's definitely an actual thing -- for multiple reasons. One is a lack of light, especially with daylight savings, and people get much more depressed around the holidays partly because of lack of sunlight but also because of a lot of pressures -- pressures to spend money they don't have on gifts. Especially around family, which some people find stressful. Not having family and having that loneliness really exacerbates [depression] during the holidays, when there's this fantasy everyone else is living out, of this hallmark holiday.

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And then also it can be a time of increase in relapses, for people with drug and alcohol problems. Because of those factors like depression and family and loneliness and all that, but if you think about it, a lot of celebrations in our culture involve food and alcohol. And so people with weight issues, or an eating disorder, the holidays are a big relapse time.

Why do you think depression is more likely for this season as opposed to another holiday, like Valentine's Day? Not that that holiday doesn't come with its own share of problems ...

I think for most faiths this is a bigger time of year, but even if you're not Christian or Jewish and don't have a holiday this time of year, this whole culture is more Christian-culture-oriented. It's impossible to walk into a store without the holidays being shoved down your throat. I think that also can be a reminder that everybody else is having fun with their family, everybody else is spending money on gifts, and for whatever reason, you're not or you should be or you're not doing what you should be, and that leads to depression. 

Does the mental health community tend to deploy more resources around this time of year, knowing all of this?

Yeah. So, at least in my clinic, we make sure we always have licensed providers on site all throughout the holidays. For example, I take every little time off during the holidays. Part of it's my family's local, but I usually miss zero work days over the holidays, just to be there for the patients. It's a time of year where everybody who shows up to therapy is someone who really needs it.

It has to be a challenge getting people to even recognize what they're feeling and why they're feeling it.

Yeah. We also have a holiday survival guide workshop. And I've noticed quite a lot of clinics have something like that as well, preparing in advance for the holidays, coping ahead, making the most of it, starting your own traditions, if money is a concern how can you think about giving gifts within your budget -- how to get the best out of the holidays. It's a two-part series. That's Part One. Part Two is, in the new year, we have revolutions and repairs, which is getting back on track after the holidays.

Any advice for people who celebrate from afar? Maybe they don't go home for Christmas because of work or something.

So our typical patient is somebody who might have drug and alcohol problems and has burned bridges with their family, so is essentially alone for the holidays even though they might have family nearby. And one thing that works for them that I think would work just as well for people who do have family and aren't going home to see them, is to find things to make the holidays meaningful such as volunteering. It'll make you feel great about yourself. If you're lonely and you're volunteering in a place, like serving at a soup kitchen or a volunteer animal shelter, you're bound to meet other people who are like-minded and also want to help out. It can be a great antidote for the holiday blues -- to get active. 

With depression and blues, the urge is to isolate, stay at home, sleep more, binge-watch Netflix, eat food that's bad for you, get drunk. That will just fuel more and more depression. And the therapy I do, behavior therapy with DBT, one of the central skills is 'opposite to emotion action.' So, acting opposite to the emotions urged in order to change the emotions. Instead of staying at home and isolating, doing the opposite. Getting out, being around people, doing exercises -- a 'fake it until you make it' situation.

Flipping perspectives, what would you recommend for someone who wants to help someone who may be facing depression this time of year?

I'm a big fan of things we do in our family: a toy drive, some people sponsor a family and get their wishlist to get them the things they really want. I think if people think friends of theirs might be depressed for the season, inviting them out is something you may want to do. But also low-key options, one-on-one, watching TV or something like that. I think it's also a hard time to be single because there are a lot of office holiday parties that involve bringing a date. It could mean a lot to somebody who's depressed to be brought out to a big party.

Anything to add? 

So here's another thing people can do: You can also get a light box or light therapy; that's a thing as well. Apparently, it has to be a certain brightness for it to work, and not all models are sufficiently bright. It's also, depending on your insurance, something you can get a prescription for. So, that's a good antidote. And also, making an effort to get out during the day into sunlight. Leave the office and be outside.