Helping Patients with Holiday Depression

For some individuals, the holidays are a time of excitement and joy — an opportunity to celebrate and spend precious time with loved ones. For others, however, the holidays can engender feelings of anxiety, depression and isolation. Colloquially known as “the holiday blues,” this form of seasonal-based depression often can be managed well with the assistance of a counselor.

It is important for counselors to keep in mind, however, that holiday depression, although similar, is not identical to clinical depression. Patients experiencing holiday depression may live with other depressive disorders, or they may not. Put another way, holiday depression is a unique condition that requires specific strategies for successful management.

Before an investigation into the kinds of approaches that counselors can use to help patients cope with this problem, it is important to take a closer look at what exactly constitutes holiday depression.

What is holiday depression?

Holiday depression usually is associated with the holiday season, which spans from November through early January and encompasses the major holidays of Thanksgiving, Christmas/Hanukkah, Kwanza and other cultural holidays. Common symptoms of holiday depression include stress, tiredness, sadness, loss of interest in activities and feelings of isolation. These symptoms and other related neuro-vegetative symptoms may indeed constitute a diagnosis of depression, but these symptoms alone and without a skilled professional’s ability for assessment and diagnosis, seasonal depressive-like symptoms, must not be conflated with depression.

Many variables during the holiday period may accompany depression-like symptoms in clients. As Healthline reported, some variables that correlate with seasonal depression include:

1. Feelings of inadequacy

If clients struggle with feelings of inadequacy and unfulfillment, these can be exacerbated by spending time with friends and family members who are perceived as being happier and more successful. Such feelings can be compounded by struggles with social anxiety, which often is heightened at the holidays.

2. Loneliness

People with few friends or family members may become acutely aware of their isolation during the holiday period, when many other people are spending time with loved ones.

3. Grief

For many people, the holidays can exacerbate grief for a loved one who is no longer there. Grief typically follows the death of a loved one, but feelings of grief also can be experienced after a relationship breakdown, divorce or other familial estrangement.

4. Stress and pressure

For some, the holiday blues may accompany the enormous stress and pressure of the season. For example, a client may have to remember to buy multiple gifts, host parties, decorate and so on. The burden of this responsibility can lead to feelings of fatigue and of depression. Stress in this scenario also is intensified if a client is struggling financially.

5. Major depressive disorder with seasonal pattern

This form of depression typically is — but not exclusively — observed in clients during the fall and winter months, when daylight becomes limited and the weather becomes colder and more inclement. Given that the holidays occur in the late fall and winter, it is common to find some people conflating major depressive disorder with seasonal pattern.

Effective counseling strategies

There are a number of approaches to helping clients cope with holiday depression. Some of the most effective include:

1. Identify accompanying events or experiences

Counselors must engage in comprehensive assessment strategies to understand what specific events or experiences may seem to be correlated with a client’s depression, to gauge a sense of how to move forward. Furthermore, a recent article in Counseling Today indicated that in many cases, counselors already may be
working with the client struggling with other issues that may be worsened at Thanksgiving or Christmas, and the counseling simply may be a continuation of the work that already is taking place.

2. Get to work early

Counselors should ensure that they begin to help clients prepare for the upcoming holiday season as early as possible. According to licensed professional counselor Lauren Ostrowski and family therapist Christian Billington, who were quoted by Counseling Today, a publication of the American Counseling Association, the sooner issues pertaining to holiday depression are dealt with, the more likely it is that clients will get through the holiday season with relative ease. Counselors, therefore, ask clients whether they experience holiday depression earlier in the autumn to allow time for the planning and implementation of coping strategies.

3. Develop a plan

Whether a client’s seasonal depression is the consequence of loneliness, feelings of low self-esteem or grief, one central challenge of the season is engaging with friends and family at social occasions — many of whom likely will be in high spirits. That is why counselors should focus on helping clients devise a plan for navigating various seasonal soirees and other get-togethers. Billington advised that counselors can help clients by having them work on non-offensive ways to leave a party — an “exit strategy,” as he named it. Additionally, Billington argued that counselors should help clients ascertain the kinds of things that make them uncomfortable at such events and then coach them on how to plan accordingly. If a client’s cousin is rude and dismissive, for example, a counselor can work with the client to think of positive ways to negotiate the family member’s negative behavior.

4. Promote self-care

Counselors should advise clients to find simple, everyday ways to manage symptoms of depression over the holiday period. As the American Occupational Therapy Association explained, the practice of “self-care” is multifaceted. To optimize self-care clients should:

• Maintain physical health by eating well, getting plenty of sleep, refraining from excessive alcohol consumption and exercising regularly.
• Take time away from “triggers” or “stressors” and make time for enjoyable activities and hobbies.
• Practice breathing exercises to reduce stress and preclude the risk of panic attacks.
• Enlist friends and family members to help with holiday-related chores such as shopping and meal preparation.

5. Focus on positive aspects of the season

While some clients experiencing holiday depression will want the season to pass as quickly as possible, others may have more ambivalent feelings. For example, if clients are experiencing grief-related depression, they may not be dreading holiday occasions per se but rather the mixed emotions associated with no longer having the missing person there. An effective way to help clients overcome this kind of sadness, according to Ostrowski, as quoted by Counseling Today, is to have clients make a note of or develop a plan for the kinds of festive activities that they find most enjoyable.

In summation

The holiday blues are a common problem, and with the right strategies in place, counselors can help clients navigate the emotional hurdles during the season.

Sources

http://ct.counseling.org/2014/12/unhappy-holidays-helping-clients-through-the-holiday-blues/

https://www.aota.org/~/media/Corporate/Files/AboutOT/consumers/MentalHealth/Blues/Blues.pdf

http://www.goodtherapy.org/blog/10-tips-for-beating-the-holiday-blues-1124144

http://www.healthline.com/health/depression/holidays#2