The Holidays & Depression

Most people associate the holidays with happiness, excitement, family, and joy. Unfortunately, not everyone is ushering in the holidays with the eagerness of a child waiting for Santa to drop down the chimney. For many people, the holidays are one of the most difficult times of the year. In my office at Fort Bend Psychiatry last week, one of my patients said "I can't stand the sound of Christmas music this year!" (Meanwhile, holiday tunes were playing in the waiting area.) For her, the holidays come with extra pressure to be happy, host family, and give from a tank that is already running on empty. Looking through the eyes of a depressed person, every day life is a burden, and the holidays may seem like climbing Mount Everest.

Holidays can be difficult for many reasons. Some individuals or families may have had a particularly difficult year, financially. Parents going through bankruptcy, for instance, may be unable to provide the gifts they would like to give to their children or other family members. This can lead to added anxiety about how to make the holidays special. Or, what about the families who are separated by several continents as a result of a spouse, parent, sibling, or child serving in the military or working overseas? Not only do loved ones at home worry on a daily basis, but the holidays are an exclamation point on the daily reminder of being separated. On another note, let us not forget that lives can be turned upside down in a matter of 365 days. Families that celebrated together during last holiday season may have lost someone during the past year. The absence of that person may be heart wrenching, leading to sorrow rather than joy. Families may have also been torn apart by divorce, leaving an obvious void in the minds of adults and children. Children may now have to balance spending holidays between two houses.

If someone you care has a tough time during the holidays, there are things you can do to help:

• Offer to help with whatever tasks may feel overwhelming to them; whether that means cooking, running errands, shopping, or cleaning up around the house
• Encourage them to get outside! Sunlight and fresh air naturally improve mood.
• Plan a coffee or lunch date. Just getting out of the house can help someone who is depressed to feel better. Isolation can perpetuate depression.
• Let them know you are concerned and are ready to listen. Many people feel better after having gotten their worries "off their chest." Check in with them frequently so they know you are concerned.

If YOU are feeling DEPRESSED:

• Exercise - Physical activity produces endorphins which naturally improve mood.
• Get some sunlight - Getting 15-20 minutes of direct sunlight a day can help boost mood. You can do this by sitting near a window, opening your blinds, or drinking your coffee outside in the morning.
• Stay connected to family and friends! Isolating yourself allows more time to dwell on things that are bothering you. 
• Eat healthy foods - Yes, even during the holidays, your body and brain need nutrients to function properly.
• Sleep - It is important to get 8 hours of sleep each night. Poor sleep can affect mood, lead to increased appetite, raise cortisol ("stress hormone") levels, and cause weight gain, irritability and, depression.
• If your depression or anxiety impairs your ability to function or affects your quality of life, it is time to consult a mental health professional. Counseling and/or medication management (psychopharmacotherapy) may be indicated. 

Psychiatrists and therapists can provide much help during this time of the year. Children and adults are susceptible to feeling down during the holidays. Another possible culprit is Seasonal Affective Disorder, which will be discussed in a future blog. In the meantime, Happy Holidays and Happy New Year!

Shannon Sniff, M.D., is a Board Certified General and Child & Adolescent Psychiatrist at Fort Bend Psychiatry in Missouri City, Texas.

Dr. Shannon Sniff: Psychiatric Diagnostic Changes

Dr. Shannon Sniff: Psychiatric Diagnostic Changes: The American Psychiatric Association has just approved the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders , also...

Psychiatric Diagnostic Changes

The American Psychiatric Association has just approved the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-V.  This project has been underway for years, and provides guidance for how all psychiatrists diagnose various conditions. Important changes include eliminating Asperger's Syndrome and adding a new disorder known as Disruptive Mood Dysregulation Disorder (DMDD).

Asperger's Syndrome has been a hot topic over the past several years, and is commonly known as a "mild" form of Autism among the lay population. The recent change involving eliminating Asperger's Syndrome actually moves toward creating an "Autism Spectrum." While this change will certainly cause some discord, it also allows professionals and patients to acknowledge that there is a group of common symptoms within Autism that can vary in degree among individuals.

Disruptive Mood Dysregulation Disorder is a new diagnosis that will be geared toward children. Previously, many children with disruptive behaviors and temper tantrums would prematurely or mistakenly be diagnosed with Bipolar Disorder. However, this diagnosis did not always follow the course of Bipolar Disorder diagnosed in adolescents and adults. This new Disruptive Mood Dysregulation Disorder serves as a separate diagnosis that can better identify mood problems in children without labeling them as "Bipolar."

These are a few highlights of the new DSM-V, but there are more changes slated to be revealed in the 2013 publication.