Beating the Holiday Blues
Thanksgiving through New Years is the time for renewing old acquaintances, holiday parties, gathering around the table for feasts, buying gifts, singing Jingle Bells, and making New Year resolutions. Is this a happy time of the year? Sometimes. It can be great to meet with old friends, have sons and daughters home for the holidays, or to visit parents and grandparents. Giving can feel fulfilling. But the good feelings, revelry and joyous times portrayed in children’s stories and on the Television screen can be more of an illusion than a reality.
Many of us don’t like to think about bad times and misery around the traditional time for joy. But for some, this season is a nightmare. Alcoholic outbursts, family squabbles, shopping rages, disappoints, mid winter depressions, and sense of isolation stand in a stark contrast to an illusion of the wonders of the holiday season. Does describing this darker side to the holidays sound like a plot of the Grinch that Stole Christmas? Not if by recognizing the Grinch you can get the beast out of the holiday picture.
Holiday pressures can be the thief of joy and satisfaction. Practically everyone will add to their debt. There is often unexpected inconvenience, merging with crowds of aggressive shoppers, waiting in line for a desired child’s toy, or feeling frustrated that the instructions for assembling a toy seem written in an unfamiliar language. Rushing, too many responsibilities, and hassles can come like furies around holiday times.
As days shorten, a cloak of misery can make a melancholic descent. For many, shorter days are like a personal Grinch. About ten-percent of adults living where snow follows fallen leaves, experience a rather serious depression professionally labeled as seasonal affective disorder. Those who experience this seasonal depression tend to have a mixed sense of anxiety and depression and agitation. The ancients living on Scandinavian lands recognized this condition and broke up the winter with community festivities.
During this season, you may feel unusually saddened remembering people you lost whom you loved. Statistically, more than 25 percent of losses occur during this season of the year, and the anniversary of such losses can kindle a profound sense of sadness, and in some instances, a downward spiral of depression.
Fortunately, there are many effective ways to create conditions for more joyful times. Organizing your schedule to avoid predictably stressful situations is one practical solution. Recognizing and dealing with needlessly negative thinking can free the mind from a profound extra stress. The physical changes that link to bodily stress due to adjustments to less daylight can be addressed by taking in few extra hours of high intensity light after sundown.
Preventing and addressing holiday stresses and depressions can open opportunities for fulfillment and satisfaction over the holidays. If you want to learn how, read on!
The normal holiday blues and blahs rarely go beyond a temporary bad mood. Unlike depression, this state does not endure for long. You might feel gloomy, but then accidently catch yourself laughing at a classic Pink Panther comedy. You can feel uplifted hearing good news from a friend. You find yourself rebounding from a glum mood following a sound night sleep. A holiday depression is different. If a depressed mood lingers and deepens and you can see no exit in sight, you may be experiencing one of the many forms of depression.
How do you know if you are depressed to where your depression requires special attention? The simple answer is that depression is serious if you think it is. But you can find other conditions for deciding if you have a depression that merits action.
- Depression merits action if you experience a painful depressed mood that hangs on for weeks, and never seems to end. This intensely painful melancholic state practically always involves distressful thoughts about the past, present, and future that you can’t seem to shake. Therapies that focus on the ills of the past can deepen depression. Those that focus on dealing with contemporary problem issues, disconfirming needlessly negative thinking, and engaging in problem-related activities, are typically effective.
- Depression rarely comes in a pure form with just a depressed mood. This disability normally has complications. When you experience life as a continuation of one crisis after another, and where you can see no way out, you may have a depression that mixes with anxiety or anger. These and other complications commonly occur.
- When you experience depression, depressive thinking is common. These thoughts can promote and worsen a depressed mood. Immersed in depression, holiday stress situations typically get magnified when negative thinking colors perspective to intensify the distress. For example, some common depressive thoughts are, “I can’t control my life. I’m helpless. My life is hopeless.” Suicidal thoughts are common. (If you have serious suicidal thoughts, immediately get professional help. This is a highly preventable event. Most people want to kill off the depressive pain, and not themselves. There are many effective psychological and medical ways to arrest depression so you can get on with a sense of productive living.) Discharging depressive thinking correlates with a reduction in depression. The Cognitive Behavioral Book for Depression (Knaus, New Harbinger, November 2006) describes how to recognize and vanquish this form of Grinch.
- When depressed, you may have trouble getting started. The emotions that accompany depression are typically negative and include sadness, anxiety, anger, and an inappropriately low tolerance for the distress you feel. You can have trouble sleeping. Your appetite can be a problem. You can suffer from fatigue. Pleasure normally eludes you. You may have unexplained aches and pains, and sometimes feel like ending it all. If you experience a depressed mood, depressive thinking, and any other three of these signs of a depression, you are likely to be suffering from a depression.
- Some depressions come in disguise. You may not see yourself as depressed if you believe that difficult people and troublesome situations need to change for you to feel better, and anger mingles with a depressed mood to create an emotional muddle.
- When depressed, you may try ineffective and damaging ways to numb your troubles. Depression can be doused through drinking too much and drinking too often. Excess drinking can cause family problems, work problems, or trouble with the law. Through abstinence, you create an opportunity for yourself to productively experience depression and to overcome the depression cloaked through drinking.
- Some depressed people distract themselves by creating crises in their lives that can feel temporarily stimulating. This stimulus seeking behavior can sully the quality of significant relationships in a way that does not meaningfully address depression.
- If you are a woman, you are more likely to have complaints of physical symptoms. A man may be more prone to anger. But there is a significant overlap between the sexes in how they experience and react to depression.
If you know you are depressed, can you break the cycle? There is an encouraging statistic put out by the National Institute of Mental Heath. About 80 percent of those with depression can minimize or eliminate it. By learning and practicing antidepressant strategies, you can progressively defeat depression at any time of the year, including a depression that surfaces around the holiday season. As a byproduct of defeating depression, you may have more positive experiences around this holiday season and the years that follow.
IF DEPRESSED, YOU ARE NOT ALONE
For millions, depression can occur at any time of the year. About 9.5 percent of a 300,000,000 US population, or 28,500,000 people, are clinically depressed for a significant time in any twelve-month period. There are probably an equal or greater percentage of people suffering from milder but still painful but briefer forms of depression who manage to move sluggishly through life. If these numbers are reasonably accurate, about 57 million people each year suffer from depression that may last several weeks, months, or extend over the year. As some overcome depression, others take their place. In short, if you are depressed, you are not alone.
Currently depression is the number one disability for women. Women in their child bearing years are two to three times more likely to succumb to depression than men. The elderly are four times more likely to be depressed. By the year 2020, depression is expected to be the second most common disability for both genders behind coronary heart disease. But depression is not just a disability for adults. There is a reported 1000 percent increase in adolescent depression since the 1950s, possibly brought about because of urbanization and loss of a feeling of community support, earlier pubescence, and rapid cultural and social changes that can have a destabilizing effect and lead to depression among those vulnerable to such conditions. Children also are showing an increased prevalence for depression.
The economic costs for depression are staggering. In 2003, the estimated cost of this disability in the US was estimated at $83.1 billion. However, dry statistics on paper do not adequately tell the human tale of depression, which is measured in lost opportunities, degrees of misery, and pessimism.
Although depression is not as common as the common cold, this condition is common enough. Since this serious condition can affect many aspects of your life including how you relate to yourself, others, and the events around you, it is important to address. The good news is that mental health and medical specialists have many effective ways to help people curb depression, including professionally designed self-help manuals and books.
THOUGHT POWER TO DEFEAT DEPRESSION
As a species, we are suggestible. Believe that life is not worth living, and you’ll likely experience unpleasant emotions that fit with the idea. However, if you believed that a pill-even a sugar pill-would cause you to get relief from depression, your attitude is likely to change from negative to positive, and you will probably feel better. This placebo effect is common, and actual “medicative” changes can take place in the body as a result of this positive magical belief. This placebo effect is a type of rapid shift in beliefs from pessimism to positive, and may be more productive for people with milder forms of depression.
The placebo effect is a compelling example that by changing your thinking you can change how you feel. However, placebo shifts may not endure, especially when you respond to new challenging and disquieting events and no longer benefit from a placebo belief. In the area of depression, the placebo effect may prove slow in coming.
You don’t have to rely on a placebo suggestion to help yourself bring about a durable change in defeating depressive thinking and in preventing depression from coming back. There are multiple rational methods available to question, challenge and defeat depressive thinking. For example, if you think your life will always be bleak, can you prove that your future is permanently void of hope or change? If you can come to doubt depressive thoughts, you have established a disbelief that can give you a sense of inner command and control. Changes in thinking from pessimistic to optimistic, decrease the mood of depression. The skills learned through this process strongly helps prevent depression from coming back.
The founder of American psychology, William James, believed that the greatest discovery of the twentieth century was that by changing your thinking you can change your life. This was one of James’ most important insights. James was a veteran of many personal battles with depression who applied this insight to himself. To free himself from the grip of depression, James acted on the belief that despite being in a depressive state, he had free will. This is the ability to choose one course of action when he could have chosen another. He believed that with free will he could choose how he thought and what he did. James was able to manage his depression through assertions of free will.
By learning to recognize and separate out the exaggerated negative depressive thoughts that blend with a depressed mood, you can help yourself to gain relief and advance your enlightened interests. Practically anyone can learn to recognize and debunk depressive thinking. Even those who feel seriously depressed and without hope.
In the 1950s Psychologist Albert Ellis started a new form of psychotherapy that revolutionized the way we think about our thinking. He identified thoughts that were involved in irrational forms of anxiety, anger, depression, and other self-defeating emotional states. His Rational Emotive Behavioral Therapy system became the bedrock for allied approaches such as Aaron Beck’s Cognitive Therapy, which is famous for its effectiveness in combating depression. The popular forms of cognitive behavioral therapy place a significant reliance on Ellis’ methods.
Ellis showed that provocative events alone do not cause needless forms of stresses, as much as what we think about those events. For example, if you have helpless thoughts about getting over a depressed mood you are likely to experience double trouble, or having a depressed mood and an additional form of despondency over a perceived inability to change. Some have double troubles by depressing themselves over feeling depressed. Ellis found that by challenging this double-trouble thinking, one can decrease needless distress and open opportunities for developing a habitual, constructive perspective and complimentary actions that extend from this clear thinking.
When depressed, try Albert Ellis’ famous ABC method to defeat depressive thinking. List the “A,” which is the activating event. Identify the “B” or the depressive beliefs that link to the event. Dispute, question, challenge, and disconfirm these negative pronouncements. As a result you can bring about a different “C,” or thinking, emoting, and behavioral consequence that comes from more realistically positive thinking.
In Ellis’ system, the “B” is most significant when dominant and harmful. Changing erroneous beliefs can bring a welcomed relief: 1. If you think you have no hope, label the idea “overgeneralized,” and then challenge the overly generalized idea. For example, what do you mean by no hope? What are the exceptions to the meaning you ascribe? If you had the kind of infallible crystal ball that predicts no hope, would you not be able to predict all aspects of the future? This is hardly likely! 2. If you think you are helpless over your thoughts and life, and you blame yourself for the state you are in, how can you be helpless and still be blameworthy? Such conflicting ideas make no rational sense. Instead of focusing on helplessness and blame, you can learn to debunk this thinking through methods of reason and scientific inquiry.
There is an important extra value for addressing the psychological aspects of depression. People who learn rational cognitive and behavioral ways to address depressive thinking, are prone to make structural changes in the brain that link to clear thinking in the mind. This brain-mind enrichment connection strengthens with practice to reduce the risk of future depression and to increase opportunities for happiness. Thus, experiencing a serious depression can unexpectedly lead to a benefit for those who learn to challenge the negative thoughts of depression.
In a paradoxical way, without a depressive episode, one might not voluntarily and intentionally learn to build clear-thinking reserves that can serve many useful purposes beyond the time of depression. The Cognitive Behavioral Book for Depression shows how to effectively use this ABC method along with other cognitive behavioral approaches.
Expectations and Exasperation
Depression can link to patterns of unrequited, unrealistic, expectations. What you expect from the holidays can affect your mood, and your mood can affect what you expect. Recognizing and muting unrealistic expectations can dramatically reduce stresses associated with unrealistic expectations.
Expectations can lead to exasperation when lofty, perfectionistic, and normally unattainable. If you think you are obliged to make your friends and family happy around the holidays, you are probably going to be disappointed. If you believe that all people standing in line with you to buy a child’s toy should await their turn and act politely, you are likely to excessively frustrate yourself when you meet with people who play by different rules.
You won’t give many perfect parties, have perfect holiday meals, receive or give perfect gifts, say all the right things, hear only positive complements, and avoid distraction and frustration during this time of year. Patterns of these unrealistic expectations take a toll. Over time you can bank sufficient stresses to increase your vulnerability for depression.
Expectation thinking typically involves patterns of demands, requirements, shoulds, oughts, and musts. Here you have ideas about how you think that things ought to be, and then frustrate yourself when you, others, and life circumstances deviate from these inflexible rules. When demanding expectations are thwarted, the conditions are ripe for frustration, extending blame into criticism and criticism into condemnation, and condemnation into justification for punishment.
Changing expectation thinking involves more than changing the words that you use to describe reality. Showing yourself that you generally can produce better results for yourself often works better.
In contrast to expectation thinking, preferential thinking involves wanting, desiring, preferring, caring for, favoring, liking, and aspiring. This tougher-minded way of thinking takes human and situational variability into account, and can lead to a natural assertiveness of your preferences and a respect for realistic preferences of others. A preferential philosophy takes extra steps and effort to achieve but is ordinarily worth the effort.
Preferential thinking dovetails with Albert Ellis’s three dimensions of acceptance. The three dimensions of acceptance are that of unconditional acceptance of self, others, and life. The three dimensions of acceptance philosophy represents an ideal to strive for that you can self-apply to help sweep away defensive and distressful clutter associated with unrealistic expectation thinking.
Ellis’ three dimensions of acceptance represent an active, constructive, and positive state of mind. The process of developing acceptance thinking means that you are likely to experiencing less expectation-based stress and put yourself in a better position to free your mind from needlessly stressful thoughts and position yourself to operate as assertively, compassionately, and effectively as you can.
METHODS OF DEFEATING DEPRESSIVE THINKING AND BUILDING RESILIENCE
There are many ways to address depression. What works best for you may be different from what is effective for someone else to do. More often, it takes some combinations of methods to make a relatively permanent difference. Fortunately, you have a rich array of choices that you can use singly or in combination with other methods to bring about desired changes and relief from depression.
The Cognitive Behavioral Workbook for Depression describes multiple techniques for arresting depression and for preventing it from coming back. The technical manual that accompanies the book describes the research on what you can do to effectively address your depression. The book provides guidelines, examples, and exercises for how to overcome depression and to keep depression from coming back. A sampling of ideas and techniques from both sources follow in two parts: 1. Dealing with Holiday Stresses describes techniques that can help reduce the risk of a holiday depression. 2. General Techniques for overcoming depression describes ways to address depression at any time of the year.
Dealing with Holiday Stresses
Depression may be more than the holiday blues, but the holiday blues may be the start of a spiraling decline. When into this downward spiral, it is important to reassure yourself that you did not intentionally bring depression down upon yourself. So, if you are depressed, it’s not your fault. However, if you intend to do better in order to get better, it is your responsibility to do something to overcome this dark mood. Here are some ideas and techniques that you can use to structure your attack against holiday depressions:
- When it comes to shopping for gifts, decide how much you can afford to spend, and stick with that determination. This approach can help reduce worry over finances that can descend into depression.
- Space your holiday responsibilities and balance personal time with social times. Around the holidays, give thought to how to time and pace your actions. For example, you can reduce stress caused by shopping at off hours where there are more available parking and smaller crowds. Black Friday, the day after Thanksgiving, brings special bargains. But are these benefits worth the frustration of joining the shopping herd and then dealing with long lines? If you are stoic about such conditions, this type of experience is likely to be less stressful than for a person who “hates” crowds and believes they are obliged to shop on Black Friday. If you are with the later group, work on developing a stoic approach, or shop at off hours.
- If you tend to feel alone and lonely around the holidays, look for opportunities to avoid isolation by connecting with people. For example, eat out a few times a week. Make a point to speak to your server with brief small talk. Make brief small talk with a cashier at your local supermarket. Call acquaintances to inquire how they are doing. Talk about what you are looking forward to, and about what is happening to people you know where your listener is likely to have an interest.
- Use procrastination technology to get started and to maintain momentum. For example, if you procrastinate when faced with a challenging, boring, or uncomfortable activity, agree with yourself to start for five-minutes, then, at the end of that time, decide on doing another five-minutes or quitting until another time. It is typically easier to continue an activity you’ve started. To start a more positive momentum, press yourself into taking time-linked steps to start activities of daily living such as preparing for the day through showering brushing teeth, dressing, and so forth by setting a limited schedule for such activities, and by using the five-minute plan to get started. Your depressed sensations are likely to be there at the start of the five-minutes, but may start to lift once you are concentrating on what you are doing, rather than on the sensations. Once you get started, you may find it easier to continue. But even if depression continues through this process, the five-minute approach can help break a cycle of helplessness thinking. It is difficult to see yourself as helpless to act when you are acting! And you will have taken steps that can eventually help promote relief. Analogously, you don’t get in good physical shape by exercising once. You do so by establishing and maintaining an exercise habit, and by restarting the habit should you relapse into old patterns. Since practically everyone lapses into old patterns, it is useful to have a back up plan to restart your program. Part of this plan can involve recognizing and cutting through the procrastination barriers you may put in your way.
- Light-related seasonal depressions are common in northern climates in winter months. As the days get shorter, depression rises around November. As the days then lengthen, depression sets around April. If you are prone to this type of depression, expose yourself to an hour or so in the evening to a fluorescent light(s) of about 10,000 lux (10 to 20 times brighter than normal indoor lighting). This phototherapy correlates with a decrease in light-related seasonal depression. There is limited evidence that wearing a visor with a red tint to filter the light correlates with a reduction in seasonal depression. If you are susceptible to seasonal depression you can try light banking. This means taking in about one-half hour of noontime “rays” starting around September, and continuing this routine through the winter season. There is modest evidence that light banking can prove beneficial.
- Use your assertive abilities by asking for help when warranted, saying yes when this is in your interests, and saying no to activities you are likely to put off or begrudgingly do out of a false sense of obligation. This form of self-determination can give you a sense of greater control over you. If you view yourself as better able to command your thoughts, expression, and actions, you will likely find that you can better command events where your actions can make a difference.
General Techniques for Overcoming Depression
Holiday seasons bring a higher incidence of depression. If you are prone to depression, you can advantage yourself by learning to reduce the risk of depression, or to effectively address holiday-linked depressions that are already in process. But depression can erupt or evolve at any time of the year. Here are ideas and techniques for addressing depression at any time of the year.
- In dealing with depression, positive changes represent a process, and not an event. Antidepressant change techniques will rarely rid the mind and body of depression within hours or days. Usually, this result is accomplished over weeks or months. Recognizing this reality reduces the frustrations that can come from unrealistic expectations about rapid or miraculous change that can link to a sense of futility and despair. Spontaneous recovery is more the exception than the rule. Progressive mastery over depression is the normal path up from depression.
- However bleak you now see your future, look for a way that gives you the best chance of surviving and flourishing. This is the advice of psychiatrist Victor Frankl. As Frankl learned, the perspective you have or can develop about your life can make a big and positive difference. He discovered this in World War II when incarcerated in a Nazi death camp. He found that there was always something to grasp onto for hope, such as watching an ant carry a burden much greater than itself, and succeeding! This perspective helped keep him from depression and despair.
- Apply rational emotive and cognitive and behavioral techniques. Research shows that such methods are effective in getting rid of a depression, and preventing one from coming back. The Cognitive Behavioral Book for Depression shows many step-by-step examples to apply rational cognitive and behavioral change methods to defeat depression. Moreover, compared to an antidepressant medication approach, rational emotive and cognitive techniques produce a significantly lower depression relapse rate.
- When depressed, the last thing you may want to do is exercise. Exercise, dance, and other methods to boost physical activity levels have been prescribed since ancient times, and merit consideration. Numerous studies show that the ancients were largely right. For example, Duke University studies on depression and exercise show exercise to be as effective as antidepressants. This method helps stop depression from coming back. Local fitness clubs typically have scheduled aerobics classes, and exercising in such surroundings can also serve a double benefit when this exercise environment helps reduce a sense of isolation. As with most antidepressant methods, there is no quick fix. Exercise may take about 6 – 8 weeks to promote positive effects. It takes time for the body and mind to re-calibrate. However, exercise has a lower relapse rate than the antidepressant Zoloft and a combination of exercise and Zoloft. Exercise can help decrease the relapse rate of Zoloft. How do you start an exercise program that your low frustration tolerance thinking voice describes as too tough to start? Challenge the voice by forcing yourself to begin.
- Maintaining a nutritionally adequate diet can tip the odds in your favor. Changes in diet have been recommended since ancient times. There is merit to this approach. People living in cultures high in fish diets tend to be at a lower risk of depression. Omega-3 fatty acid increases found in fish oil appear to have an antidepressant effect for some forms of depression, but not for others, such as seasonal affective disorder. Deficiencies in folate, vitamin B12, iron, zinc, and selenium are common among people with depression. Taking such nutritional supplements may or may not make a material difference in reducing depression. In moderation, they are likely to cause no harm.
- Plan and structure your day for an antidepressant effect. Establish a predictable routine that you can work and that works for you. For example, plan to awaken at the same time each day, go to a local establishment to pick up your daily newspaper, eat an adequate morning meal, exercise a specific time span, go to bed each night at the same hour, and so forth. This systematic procedural approach may be especially helpful for people with bipolar depressions.
- Antidepressant medications are effective for a subgroup of people with depression. These medications can have a placebo effect as well as an actual medicative effect. However, the antidepressant approach can be counter indicated for people with dysthymic depression and depressive adjustment disorders. Antidepressants prescribed for people with bipolar forms of depression, with or without periods of elation, can cause a rapid recycling effect. However, for people who cycle between longer periods of depression and brief, troublesome, and costly forms of elation, the elation can be effectively addressed by medications such as lithium carbonate. (Talk to a medical authority with a specialty in psychopharmacology.) Antidepressants are presently hyped through drug company advertisements. Drugs are over prescribed to the detriment of effective self-initiated changes such as exercise and rational forms of cognitive and behavioral psychotherapy to promote a lower relapse rate. Many antidepressants carry a black box warning ordered by the Food and Drug Administration because they can increase suicidal risks among a sub-population of users. The antidepressants also carry an unacceptably high relapse rate, whereas the rational, cognitive, behavioral approaches serve as a buttress against relapse. Do the research and get professional support before deciding on this approach.
- European medical research shows that the herb Saint-Johns-wort is effective for mild, moderate, and some severe forms of depression. It’s priced at a fraction of the cost of the antidepressant medications. The European formula may be more consistent in quality that the more inconsistent and unregulated US variety. US research generally provides strong evidence that the herb may be effective for mild to moderate major depressions, equivocal for severe major depressions, and not effective for seasonal affective disorders. There are a few counter indicators for the use of the herb. Its use in combination with prescribed antidepressants is counter indicated. It can have serious side-effects when used with protease inhibitors for HIV/AIDS, when used with oral contraceptives, and the heart medication, digoxin. As a prudent caution, do the research. Talk to a knowledgeable professional before using the herb.
- About 90 percent of people who suffer from a serious depression have a sleep disorder such as a primary insomnia. This condition can precede depression by years. When having trouble falling back to sleep, try getting out of bed, turn on a light for a few seconds, then return to bed. This can sometimes set the stage for yawning followed by sleep. Some sleep medications and antidepressants have been found useful to improve sleep patterns.
- Bibliotherapy, or healing through reading, can prove beneficial to the subgroup of people with mild to moderate depression who seek information written by mental health professionals about addressing depression, or who think that they might be able to address their depression if they knew how. A subgroup of people with more severe depressions may also profit from this evidence-based approach.
- Educating friends and relations about your depression can help them understand the complexity of this disability. Too often glib advice for overcoming depression such as “Pull yourself up by the boot straps,” falls flat. The slogan, “pull yourself up by the bootstraps” is of value only where there are science-based behaviors that you can link to that advice, and where you can implement the prescribed antidepressant actions. This can be found within your work with a CBT therapist or while using a CBT workbook.
It is a fact that depression is highly addressable, even for those who believe that they have no hope. If you find yourself cloaked by a damp blanket of depressive misery, act now to beat the holiday Grinch.
The fact that you take action to address and arrest depression, provides a compelling argument that you are not helpless and that you have voted on hope over despair. That powerful decision to act progressively to master depression is one that you are likely to find rewarding at any time of the year. However, if within a reasonable time you find yourself threading water, risk a valued job or relationship, or have recurrent suicidal thoughts, by all means, seek professional help.