Journey of Hearts

It has taken me a while to get this section together on "The Blues," because for some reason this year, despite trying to 'talk myself out of it,' I found myself slipping into the Holiday Blues again.
Working on this section has helped to pull me out of it, along with several long brisk walks with reflecting on what I value in my life, remembering all that I have to be thankful for, and remembering to say "Good-Bye" to loved ones lost this year. (See We Remember Them, Remember Me and My Wish for You)

 Background Information
Blues vs. Depression
Factors that can contribute Holiday Blues
Symptoms of Holiday Blues
Assessing the Risk for Suicide
Finding Help for the Blues
Suggestions for Coping with the Blues
More Suggestions
Ways of Dealing with Old Unwanted Memories

Many people have a different experience of the Holidays. For many, it is time of joy, peace on earth and good will towards men and optimistic hope for the new year. But for others it is a time of self-evaluation and loneliness, to reflect on the past their accomplishments and failures. These feelings may result in a condition that has been termed the Holiday Blues or Holiday Depression. There are many different causes and many different contributors. When severe the symptoms may even mimic clinical depression.

In my own case for many years during my years of medical training, I would find myself slipping into the Blues before Thanksgiving, only to emerge sometime after Valentine's Day. With a Birthday over this time, and having spent many holidays being single, I found this a difficult time. There was often little to look forward to, working on the holidays, covering for those who had children or families. For me especially, it was a time for self reflection and for loneliness. Added to this was the media 'coverage' of the holiday season--in particular the images of happy couples and happy families all having the perfect holiday. These constant reminders only made things worse. Trying to rationalize and convince myself that other people had much more to be "blue" would help a bit, but didn't seem to alleviate the feelings. These Blue Holiday periods have lessened since getting married, and learning how to set realistic plans for the season. This year, however, the blues are career blues.

The feelings of Holiday Blues can be intense and unsettling, holiday blues are generally short-lived, lasting only a few days to a few weeks around the holiday season (prior to or just after). These seemingly contradictory emotions usually subside after the holiday season and a daily routine is resumed.

The key to coping with the Holiday Blues is understanding the Blues, what may be your triggers, knowing how to respond to these feelings and setting realistic expectations for the holiday season.

Blues
• Feelings may be intense and unsettling, especially if those around are full of holiday cheer.
• Short-lived - lasting only a few days to a few weeks around the holiday season (prior to or just after).
• Emotions usually subside after the holiday season and a daily routine is resumed.

Depression
• Duration - symptoms are present nearly every day, persist for most of the day for at least 2 weeks
• Pattern - the symptoms occur together during the same time frame
• Impairment - the symptoms cause a level of distress or impairment that interferes with important parts of daily functioning including:
• Work
• Self care
• Social activities.
In more mild cases, the level of functioning may appear to be normal, but it requires markedly increased effort to just maintain the normal level of activity.

The factors that can contribute to the Holiday Blues can be grouped into three major categories:

Psychological
• This may be the first holiday season without your spouse or a loved one. The first, or the umpteenth season without a loved one can cause great feelings of loneliness and sadness.
• Remembrances of Holidays past
• Remembrances of Loved ones lost.
• If you're already feeling depressed or isolated, seeing others having a good time often makes the situation worse. (Remember that misery loves company...)
• Family dynamics can create conflicts during the holidays. Problems can arise from
• Unable to be with one's Family members, because they have other plans
• Unable to be with one's Family, due to work, financial, time or travel restrictions.
• Pressures to be with one's Family when you really want to spend time alone (and they expect you to be there)
• Rekindling, resurrecting strained relationships between various family members, that surface when everyone gets together.
• Residue Stress from past experiences during the Holidays--old fights, memories, or conflicts that haven't been resolved.

(There were several years of uneasiness within our family, so I found it easier to stay home alone, than to deal with the 'hassle factor.' Now, I would prefer spending time with just my husband, without having to drive all over to 'please' both sets of parents)
• Unrealistic expectations--you may expect too much from the holidays,
• Trying to create the picture-perfect, Norman Rockwell Holiday celebration--the one you didn't get as a child, or the one you hope to create for your children.
• Disappointment can result when you don't hear from the long-lost friends and family, or the expensive gifts, tokens of affection, or proposals don't come.
(My long-standing Christmas wish for many years was for something tall, dark and handsome...he finally came, but I ended up with a "Blonde" Version, not the dark one as originally 'ordered.')

Financial

• The Holiday season brings along an extra financial burden--buying extra gifts, holiday clothing, attending social functions, or throwing holiday parties--within a short period of time there are many financial demands.
• This is particularly difficult if finances are limited normally.
• There may be financial pressures from friends, family, and children to keep up with everyone else, to have the latest toys or games, to have the most lights on the house, to have the latest party dress, or to throw the 'best parties.'
• The Over Commercilization of the holidays adds to this pressure, as we are bombarded with Christmas music, images and commercials of the latest toys and games since before Thanksgiving.
• The media tries to 'guilt' us into believing we need the latest 'hot item' toy for our children, or the latest celebrity endorsed item for our loved one as a token of our affection.
• Consider giving priority to gifts that can't be bought--such as time, support and sharing of memories.
• Donations to a worthy cause, instead of spending the money on a lot more unnecessary "stuff." My husband saw a statistic this year, that the estimate 40% of Christmas presents are in land-fills within 6 weeks of Christmas. Now this figure may seem a bit high, but none-the-less, even if  25% of gifts end up being tossed out--it does give one pause to think.

Donate -- Time, Blood, Tissue or Money.

Physical

• The pressures of the holiday season can be taxing physically particularly for those who's health is already strained.
• Feelings of stress and fatigue are common--just think about the extra time and energy demands from shopping, cooking, baking, cleaning, socializing, entertaining house guests, making presents, and sending Christmas Cards. It is no wonder that people get tired!!
• Too much food and drink during the holidays can also cause weight gain. There are pressures around to eat more than you need, especially sweet and fattening foods. This can be particularly frustrating if you are trying to lose weight.

(We recently read that some people put on 8-12 lbs over the holidays--although this was from a health club!!)
• Change in Diet, especially increasing sugar and sweets can lead to fatigue.
• Change in Daily routines (particularly decreasing the normal activity level) can increase stress and lead to fatigue.

Symptoms of the Holiday Blues, when severe, may mimic clinical depression. The keys to distinguishing are the length of time and and ability to find ways to ease the "Blues."

• Headaches
• Insomnia - inability to sleep
• Hypersomnia - sleeping too much
• Changes in appetite - weight loss or weight gain
• Agitation and anxiety
• Excessive or inappropriate feelings of guilt
• Diminished ability to think clearly or concentrate
• Decreased interest in activities that usually bring pleasure:
• Food
• Sex
• Work
• Friends
• Hobbies
• Entertainment

There are conflicting reports as to whether the suicide rate increases during the holiday, or afterwards. Whether or not there is an increased incidence of suicide, we know there is an increased incidence of depression, mental health visits and the blues, both during the holiday and up to three weeks after the holidays. Therefore, it is important to recognize the warning signs of suicide.

Anyone having suicidal thoughts should seek immediate care, either through their own doctor or through the nearest hospital emergency department.

Suicide Warning Signs

• Talk of death, suicide, or harming oneself.
• Chronic panic or anxiety
• Constant insomnia
• Altered personality or appearance
• Voicing feelings of hopelessness and worthlessness
• Changes in sleeping or eating habits
• Dropping grades (for those still in school)
• Giving away treasured possessions
• Becoming more isolated - pulling away from normal social activities
• Talk of depression, life is no longer worth living

If you suspect you may be depressed or know someone who may be depressed, then contact your health care provider or family physician. He/she may be able to help sort out if what you are experiencing is a transient case of the Holiday Blues or a more serious case of depression. You may also want to contact a counselor, social worker, or clergy member to help get the resources needed.

There are several quizzes (Self Assessment Quiz , Wakefield Questionnaire ) available on this site to help those visiting to assess their level of depression.

If you are feeling depressed-- CALL SOMEONE--a friend, or family member, your clergy or physician. Look in the Yellow pages under Counselors, Psychologists, Social Workers and Psychiatrists, if you feel you may need immediate professional assistance.

Anyone having suicidal thoughts should seek immediate care, either through their own doctor or through the nearest hospital emergency department. Call 911, your local suicide hot-line or Crisis Intervention Line, located in the Yellow Pages.

You can also contact the Samaritans via e-mail at:

For screens without frames http://www.samaritans.org.uk/textonly.html/texthome.html
For screens with frames http://www.samaritans.org.uk/sams.html/home2.html

The Samaritans is a UK charity, founded in 1953, which exists to provide confidential emotional support to any person, who is suicidal or despairing; and to increase public awareness of issues around suicide and depression. This service is provided 24 hours every day by trained volunteers, and relies upon public donations.

There are a variety of different coping strategies for dealing with the Holiday Blues. The list here and on the page for More Suggestions for Dealing with the Blues were compiled from a variety of different resources, common sense and brainstorming with friends and colleagues as to what helps us get out of the Blues. (If these suggestions don't work, then it is time to consider an assessment for depression)

Surround yourself with supportive people.
If you are feeling lonely, get out and get around people.
Consider volunteering for non-profit organizations or visiting a nursing home as a good way to remember the spirit of giving for the holidays.
Minimize the number of negative people (even if these are family members!).
Reach out and make new friends, especially if you will be alone during the holidays.
Connect with someone you have lost touch with.
If you are feeling grief or loss, acknowledge them. Recognize and accept that both positive and negative feelings may be experienced during the holidays, and that this is NORMAL.
Try to recognize and reframe unrealistic expectations.
Set limits--Try to maintain a balanced diet, eat and drink in moderation.
Get plenty of rest.
Exercise regularly.
Get involved with community service.
Go outdoors and get active.
Pace yourself.  Don't take on more activities, make more commitments, or try and do more than you can reasonably handle during the holidays.
Plan ahead. Set priorities and budgets before the holidays. Plan a calendar for shopping, baking, visiting and other events. Create a "To Do List" if things get overwhelming.
Give priority to gifts that can't be bought--such as time, support and sharing of memories. (Last year we visited my Grandmother, which I will be eternally grateful that my husband got a chance to meet her.)
 

The following list come from the website for the Fox Family Channel Home and Family show, now off the air. The article was from Marilyn Kagen (Therapist and Talk Show Hostess) from 1996, and can still be found on their website at: http://homeandfamily.com/features/relate/blues.html. Her suggestions seemed to include those who are facing the holiday season without loved ones, as well as the common-sense ones.
I thought many of these suggestions were worth including (slightly edited).

Create a box of old memories and traditions.
Include in this box, new traditions that you want to create.
Enlist your friends’ help before the holidays.
Keep the spirit of Christmas alive in your home.
Remind yourself of the festivity of the occasion.
Pay close attention to your finances.
Create a budget for yourself and don't go over.
Be realistic in your expectations.
If you haven't got along with your relatives in 15 years, it's not suddenly going to change.
Don't use Christmas as a time for family therapy, whether before, during or shortly after.
Do one good thing for someone outside of the family.
Don't pretend that feelings of loss are not there if you have them.
Say a special prayer, make a special ornament, reminisce and continue counseling.
Have a family gift of a toy and play with the children.
Remember Christmas is about children.
Write down positives about past Christmases.
Start a new tradition of a journal with just 2 or 3 happy thoughts every year.
Set up a holiday box where each family member puts a piece of paper in with their favorite holiday memory to be read while decorating or Christmas Eve.
To put things into perspective, try waking up very early and watch a sunrise with a cup of hot cocoa or coffee.
Make a list of the losses and the positives that have influenced the year.
Deal with the feelings that the list evokes.
Make pacts with friends to motivate each other.
Most of all, enjoy those who are around you.
Christmas is a time of sharing and giving.

Remember to try and spread a little Happiness in the Holiday Season:
 
Happiness is perfume,
you can't pour it on somebody else
without getting a few drops on yourself.
--James Van DerZee

For this season I would urge you to follow the words of Ralph Waldo Emerson and

"Scatter Joy...."