I remember feeling astonished at a patient of mine in the Denver veterans' hospital who, when I discussed discharging him home for the holidays, began sobbing and asked to be allowed to stay until after Christmas. The holidays were too stressful for him, he said. When I'd moonlight in emergency rooms as a doctor in training, the number of people overcome with grief and anxiety during the December holidays always increased. So I was thrilled when Dr. Neil Price, a psychiatrist at Lawrence and Memorial Hospital, offered to write the following piece on holiday stress:
Every holiday season you can expect to see a plethora of articles abut the “holiday blues” or “Christmas depression.” The content of these stories is as predictable as sidewalk Santas and noisemakers on New Year's Eve. What, if anything, should we take away from these depressing commentaries on the holiday scene? Are they simply a plot directed at us by the Scrooge society? After all, why aren't there any articles about Valentine's Day blues or Halloween depression? The focus is on the holiday season because at no other time of the year are so many of us subjected to so much stress. From Thanksgiving week to New Year's Day we attempt to cope with an increasing level of stress. By January it often has taken a significant toll on us both physically and emotionally. Let's examine ways of dealing with this stress.
There are two major classes of stress — biological and psychological. Biological stressors are those that directly affect our bodies. As the days get shorter in November and December (January February), many people are significantly affected by the decreasing availability of sunlight. This causes them to get out of sync with their normal biological rhythm. After several weeks of this, they feel increasingly fatigued, which may affect their ability to function.
In addition, the decreased sunlight causes an increased appetite with a pronounced craving for sweets, which can bring on undesirable weight gain. All of these changes are a part of what is called seasonal affective disorder, or SAD. SAD is particularly troublesome during the holiday season when there are increased demands on our time and energy.
Several ways to reduce these effects include getting out during the sunny days, avoiding sunglasses and keeping offices and homes well lit. If these fail, a psychiatrist can prescribe photo therapy (a specific type of artificial lighting), which can dramatically reverse the seasonal symptoms.
Another potent biological stressor is the increased intake of alcohol. It is common practice to give alcohol as a gift and alcohol can flow at the endless succession of holiday parties. Increased alcohol consumption may cause fatigue, weight gain and depression. If you are in a recovery program, work your program energetically during this season. For everyone else, moderation is the rule.
The most common biological stressor is the increased physical demands during the holidays. Already jam-packed daily schedules are stretched to the limit by the extra time and energy needed for shopping, partying and traveling. Try to maintain control of your schedule and get enough rest. This will probably mean saying no to some demands. If you haven't said no a few times by the end of December you're probably not protecting yourself enough.
Psychological stressors cause emotional conflict. For example, many people re-experience feelings of grief and sadness during the holidays for loved ones who are no longer with us. The holidays make us reminisce. Separation due to death, divorce or war makes us particularly sad. It is important to express feelings of grief and pain so that family and friends can offer support.
One especially potent psychological stressor is belief in the “Santa myth.” Some believe that Santa or someone else needs to give them exactly what they desire and, if not, they feel cheated and unhappy. Belief in this myth sets us up for unhappiness and creates other difficulties as well. We might use credit cards, for example, to make all of our holiday wishes come true. When the bills come due, however, stress levels may go through the ceiling. It is important to keep expectations realistic and keep in mind the true meaning of the celebration.
It might seem that significant numbers of people simply fall apart during the holiday season. This, however, is not the case. Even though people are subjected to more stress, they are helped by the “holiday spirit” or the “Christmas spirit.” This spirit of hope and peace and brotherhood provides a real sense of support.
When January arrives, however, that sense of support disappears, often leaving people depressed and anxious. It is then we see increased numbers seeking treatment. The key for avoiding January depression is to use good judgment during the holiday season.
Jon Gaudio is a cardiologist in New London. Neil Price is medical director at L&M Hospital's Counseling Center.
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