Dismal season

As much as people expect Thanksgiving, Christmas and New Year’s Eve to be joyous times spent with friends and family, it’s also widely acknowledged that, for some, they are just the opposite. Common wisdom holds that the prevalence of mental health conditions peaks over the holiday season in a phenomenon colloquially known as the “holiday blues.”

Two local mental health professionals say that’s not entirely accurate. Don Taylor, assistant director of clinical services at Butte County Behavioral Health, and Dr. Scott Nichols, a psychiatrist with Enloe Behavioral Health, agree that there’s a noticeable upswing in people seeking mental health services around this time of year. But it’s most acute after, not during, the holidays.

“You have people feeling let down,” Taylor explained. “Maybe they didn’t enjoy the holidays as much as they could have. They built it up in their head that it’s going to be this big thing, and if it’s not, it’s a big letdown.”

And for others who did enjoy the holiday season, there’s an abrupt shift back to everyday life. “The holidays are a very festive time with lots of lights, happy people, singing, the stores are bright and shiny,” Taylor said. “Then, suddenly, it’s just gone. New Year’s is over, and everything is back to normal.”

That’s why it’s common for people from all walks of life—not only those with diagnosed mental health conditions—to seek mental health treatment in January and February, Nichols said.

As a psychiatrist, Nichols’ works with six to 12 patients a day at Enloe Behavioral Health, helping them identify the root causes of mental health problems. That involves “working out the narrative,” he said.

“People always come in with a story explaining what’s going on,” he said. “One of the reasons people don’t get better is because their reason is plausible, but it’s not true.”

For example, in the past month, two patients who were experiencing depression “perked up after just a couple days with us,” Nichols said. While the patients attributed the change to taking new medication, Nichols suspected that they’d both been suffering from seasonal affective disorder—a condition triggered by a lack of sunlight and vitamin D—and that the clinic’s bright fluorescent lights had impacted them positively.

“We started talking about their work environments, and they’re working in places that are trying to conserve energy, and they don’t get outside much,” Nichols said. “That’s a better narrative: You need light therapy. Exploring why people are depressed is really important.”

So, when a patient tells Nichols that he or she is struggling over the holidays, he doesn’t doubt them. He just believes that labeling a condition as the “holiday blues” is generally false attribution.

“They say they’re depressed because it’s Christmas, but it’s actually because they’re drinking more, or they have seasonal affective disorder,” he said. “It could be because they’re a construction worker and they got laid off in December. It doesn’t really have anything to do with Christmas, does it?

“I don’t want to say that the holidays aren’t a difficult time, or mental health conditions aren’t caused by the holidays,” Nichols continued. “My message is that there are likely more factors.”

Both Taylor and Nichols elaborated on common holiday behaviors that may trigger periods of mental distress, including poor diets. Merrymaking often means overindulging at parties with family, friends and co-workers, and over the holidays people tend to drink more alcohol, eat less healthfully and slack off on their exercise routines.

Failing to turn those habits around, or get back into an exercise routine, once the holidays have passed also can be discouraging.

“People make New Year’s resolutions, which are often broken within the first 30 days,” Taylor said. “Then people say, ‘Wow, that didn’t last long. I must be a bad person.’ That may stir more depression.”

And, of course, the holidays often come with a burdensome price tag. “A lot of folks who are on limited income stretch it out to get presents for everyone,” Taylor said. “Then they’re in debt or spent money they shouldn’t have spent, and January isn’t looking so lovely.” And for someone with a pre-existing mental health condition, getting a big credit card bill “can be the last straw,” Nichols agreed.

“A lot of the serious suicide attempts are in January,” he said. “A lot of times, people kind of push through certain landmarks like the holidays; they’ll hold off until January.”

Additionally, the holidays are often used as a marker for tragedies, Nichols said. “If someone close has died in the past year, it’s the first Christmas since. They’re really overemphasized as markers for good and bad life events.”

How can one stay happy in the post-holiday doldrums of winter? Taylor suggests seeking out the company of other people, even if it’s just going to the mall or the movie theater—“anything where you might be interacting with other folks,” he said.

It’s also helpful to have something to look forward to, Taylor said. “Actively plan out things you can look forward to in February or March. You can plan for and actively participate in the process of, ‘OK, let’s prepare for this.’”

Nichols says its important not to dwell on uncontrollable circumstances, and to let go of the concept of the holiday blues.

“Thinking of it as the ‘holiday blues’ can really be counterproductive, because you cannot change that it’s the holidays,” he said. “You can change how much light you get, how much exercise you get. That breaks it down into things you can change, and things you can’t.”