I was recently watching “Scrooge” with my 4-year-old son, and he asked, “Why does he hate Christmas?” I gave a generic answer, “He just doesn’t like it very much.” It was late, and he was bored with the movie and asked to watch something else.

When we think of the holidays, our minds go to decorations, presents, food, not unhappiness, dread and sadness. The disconnect between the holidays' societal image versus an individuals' reality is why I often refrain from assuming that everyone will have a merry Christmas or happy holidays. For some people, the holiday season's dread begins early in the fall and continues past the new year.

Why do people get depressed during the holidays?

• Grief: Grief reminds people that their loved ones are no longer alive. I often tell people that grief has no timeline, and it returns during important dates such as anniversaries or special occasions. As people get older, they often find that their circle can get smaller: parents, siblings and friends may no longer be alive. This can bring on sadness, feelings of loneliness and reflections of their mortality that cause depression.
• Geographical distances from loved ones: This one seems especially true this year as we are hit by the current pandemic, which has even separated us from people who are only minutes away. The holidays carry a visual image of gatherings and sharing time with family and friends. This also creates a sense of isolation and sadness that can lead to depression.
• Estrangement from family and friends: Disagreements between families are common. However, there are times that these differences can result in years of alienation that can leave people feeling alone or yearning for that relationship. Estrangement leads to feelings of loneliness and abandonment, contrary to the expectation of a harmonious gathering.
• Ill health: Unfortunately, illness, whether it be mental health problems such as depression/anxiety or physical conditions such as chronic pain or cancer, does not take a break during the holidays. The physical and emotional limitations of ill health can become more pronounced during the holidays when the person can't do all that they wish or feel that they should do during this time.
• Increase in obligations and responsibilities: Holiday parties (maybe not this year), Christmas shopping, holiday cooking, end of year work responsibilities and day-to-day family responsibilities can take a toll on a person. I find that not only is it “the most wonderful time of the year," but also the busiest time of the year. Again, there is a cognitive dissonance between enjoying the holidays and feeling harried and stressed. This can often lead to anxiety and mood changes, especially when the expectations don’t measure up to reality.
• Financial strain: Money is a significant source of stress during the holidays. The commercialization of the holidays is real. We have Black Friday right after the day that we give thanks to help businesses avoid being in the red. None the less, most of us are guilty of equating a good holiday season with presents and decorations which cost money. The holiday season is difficult, especially this year when many have lost employment due to the pandemic.
• Seasonal affective disorder: This is a real condition that occurs during the winter months. People experience depression during a specific time of the year, often having no particular trigger, and after the season is over, they slowly start to feel better. However, during that period when they are depressed, it can be debilitating and impair their ability to partake in day to day functioning, much less take part or enjoy holiday celebrations.
• Trauma: People who have post-traumatic stress disorder can often find themselves struggling during the holidays. For some, it comes down to cognitive dissonance. Some people find that the holidays may trigger their trauma symptoms such as flashbacks, isolation and hyperawareness (especially around crowds).

What can you do?

• Practice mindfulness: Acknowledge and be aware of your true feelings and emotions when it comes to the holidays. Often, trying to feel the opposite of what your mind and body are experiencing makes the problem worse. Allowing yourself to express your true feelings, even if it is just to yourself (although it helps to clue in others), may relieve some emotional distress. This is a simplistic explanation of mindfulness, but I encourage you to get a more in-depth understanding of this practice. A useful resource is a book called "Calming the Emotional Storm."
• Communication: If you have a good relationship with someone, it is often beneficial to discuss your feelings. I encourage you to seek professional help if your depression cripples you and you don’t feel that talking to family and friends is enough. Talk to your primary care doctor and make an appointment with a therapist. It's important to keep in mind you might need medications.
• Change the script: Instead of trying to live up to an image of what the holidays should be like, think about and describe what would make this time of the year better for you. Would you prefer to spend it with more immediate family? Would not having to do extensive shopping or decorating make things easier? Take out instead of cooking a full meal or just sitting at home doing a relaxing activity that brings comfort and joy?
• Practice Gratitude: We should not just practice gratitude on Thanksgiving. Listing the things that we are grateful for can help you feel better. I encourage you to start a gratitude journaling and the benefits that this practice can have in your daily life.

On behalf of the Ochsner Baton Rouge psychiatry department, I hope you can experience joy this holiday season. If you do find yourself struggling, I encourage you to reach out to others, including professionals. Remember, you are not alone. Help is available.