RIVERSIDE, Calif. - The ideal holiday is a time filled with love and joy with friends and family, but for some people, holidays can bring up unresolved issues of loss and feelings of isolation that contribute to depression.
The problem can become worse when those feelings linger after the holidays, according to three mental health experts.
"If you're unhappy during the year and you can't set limits and take care of yourself, Christmas is going to present more challenges," said Ann Kramer, a licensed marriage and family therapist in private practice in Moreno Valley.
The expectations and ideals of how Christmas should be can be a source of sadness for those longing to have a perfect holiday season.
With so many demands on personal time and the hustle and bustle of shopping and baking, people tend to push their feelings aside and not deal with their unhappiness, according to those who work in the mental health field.
Lugena Wahlquist, mental health services manager with the Mental Health Department in Riverside County, Calif., said this is not unusual during the holidays.
"I do think people tend not to express things out loud to others at Christmas," said Wahlquist, whose department works with children and families in southwestern Riverside County.
Wahlquist said she sees depression starting within the first two weeks of a new year because people haven't had the time to deal with their emotions at Christmas.
Margo Alexander, a licensed clinical social worker with the County of Riverside's Mental Health Department, agrees.
"They will not even recognize the depression, even though it begins before the holiday," said Alexander.
Ann Kramer said childhood expectations can lead to depression because people want to re-create past Christmases and relive those comforting feelings.
Or people may want to avoid unpleasant experiences associated with the holidays, said Kramer.
There's also the need to please people that leads to unhappiness and burn out, which Kramer said is often mistaken for depression.
"They're trying to recapture something that is an illusion," said Kramer.
There are signs to watch for if depression is suspected, said Kramer, such as the amount of isolation in a person's life. The mental health expert said "red flags" might go up if a person is not talking to family and friends or staying involved in daily life.
Kramer said depression can manifest itself into an illness that can't be shaken or treated with medication.
Wahlquist said it's important to note that some people may already have pre-existing forms of depression that are heightened by the holidays. There's also a letdown that many people experience after the holidays.
Alexander said it's beneficial to be direct and ask if people are suicidal. Those feelings can peak around February, she said.
Identifying and talking about a problem is the first step in treating depression, say mental health experts. If a person has a good support system and family and friends to talk to, that can be a good start. Those suffering from depression also can talk to professional counselors, if that feels more comfortable.
Simply talking it out can often bring forth issues that have been buried, said Alexander.
"Once you start talking to people and asking the right questions, issues will generally come to the surface," she said.
- Eating and sleep pattern disturbances.
- Underlying feeling of "blues."
- Loss of energy.
- Lack of strong peer group or support system.
- Lack of contact or no contact with family.
- Recognize issues of unresolved loss.
- Make future holidays simple.
- Be realistic about what you can and cannot do during the holidays.
- Go to celebrations but don't feel obligated to stay all night.
- Focus on the people close to you.
- Visit a convalescent home or hospital.