December 19, 2013

“Between Hallmark and heartache”: Vanderbilt psychiatrist offers tips for how to have a pretty good Christmas

Judith Akin, M.D.

During the holidays, the goal should be to set the course somewhere “between Hallmark and heartache,” a Vanderbilt psychiatrist says. In other words, don’t strive for the perfect (you won’t achieve it), and recognize and deal head-on with some of the stressors of the season.

Judith Akin, M.D., assistant clinical professor of Psychiatry at Vanderbilt University Medical Center, says that for most of us, holiday time does not reflect a Hallmark card image: a tastefully decorated house filled with happy people exchanging perfect gifts and enjoying a wonderful meal while a beautiful snowfall settles gently outside.

In fact, Akin says, for some people, the combination of holiday time and the winter solstice that comes about the same time can combine for a period of stress and unhappiness.

“This is a time of year where individuals can be more aware of sadness,” she says. “We can be stressed because we are away from our families; we can be stressed because we are WITH our families; we can be aware of money problems.”

And combined with that, this Saturday, Dec. 21, is the Winter Solstice, the shortest day (and longest night) of the year in the Northern Hemisphere, which Akin says contributes to the sadness and even clinical depression that many people experience this time of year.

“A lack of light may be an even bigger factor in stress and depression than the holidays,” she says. “Weather is bad, we stay inside, and a lot of us go to work in the dark and come home in the dark.”

While typical holiday stress or seasonal affective disorder comes and goes with the season, depression symptoms tend to be the same whatever the time of year. Some of these symptoms include people commenting that you seem different; a slip in occupational or academic performance; a feeling of being overwhelmed or overextended most days; changes in weight or sleep cycle; increase in alcohol consumption when alone; feeling helpless or more isolated; or a preoccupation with death and dying.

Since stress and sadness around this time of year can come in gradations, Akin offers tips for dealing with some of the common problems of the season.

 For Those Celebrating Alone:

  1.  Fix a special meal (or plan ahead and get some special takeout).
  2. Enjoy non-traditional holiday fun: go for a long walk, go to the movies, spend the day on an art or house project that you can enjoy.
  3. Let co-workers and friends know that you are alone; often an extra person at a holiday gathering can make it more fun for everybody.
  4. Check online for local agencies that need help and give part of your day to help others.
  5. Even if you can’t be there in person, connect with family and friends by phone, email or text and pass along love and good wishes.

 For Those Celebrating with Family:

  1. Don’t try to do too much—strive to keep expectations in balance.
  2. Don’t try to match some ideal of the “perfect” holiday. Look for happiness in what you are able to do and keep your expectations realistic.
  3. At gatherings, try to find common ground with those with whom you might disagree, and avoid conversation topics of obvious conflict.
  4. Don’t overspend on gifts or make gift-giving the centerpiece of the celebration. Be sensitive that some people may be facing financial challenges.

For Those Feeling Stressed or Who May Have Seasonal Affective Disorder (SAD):

  1. Avoid being a couch potato—inactivity and staying indoors can add to the problem.
  2. Avoid consuming too much alcohol or caffeine.
  3. Stay physically active—even if it’s cold, bundle up and go for a walk.
  4. Expose yourself to light. An artificial light source with full spectrum light of 10,000 lux works to relieve signs of depression or seasonal affective disorder in many people.
  5. Strive to eat in a healthy manner. Often a carbohydrate craving strikes during the darkest time of the year, and resisting it can help with feelings of sadness.
  6. Seek counseling to address stressors and help find solutions to problems.
  7. Have a regular physical exam to rule out physical causes such as anemia, thyroid problems, or a diminished vitamin D level.