Christmas Depression: Tips to Cope with the Holiday Blues

Sometimes Christmas Depression is Just SAD
Throughout the Western world, there is no time of year more intensely associated with depression than Christmas. Suicide rates peak in December, and monthly incidents of crime and violence are highest at this time of year as well. Although Christmastime depression certainly can be associated with personal losses, a less frequently considered source of the condition is seasonal affective disorder, also known as SAD.

SAD, a biologically based condition that is worst around the winter solstice. Seasonal affective disorder is a source of depression that gets worse and worse as days get shorter and shorter, but then goes away during the spring and summer. More common in women than in men, SAD usually begins in late the teenage years and comes back every year throughout the rest of the lifespan. Many sufferers of SAD experience all or most of these symptoms:

• Carbohydrate cravings, especially at night
• Decreased ability to focus on tasks at hand after lunch
• Decreased interest in work or social activities
• Depression that starts in fall or winter
• Increased appetite, especially for “munchies,” with weight gain
• Increased sleep and excessive daytime sleepiness
• Lack of energy in general
• Slow, clumsy, sluggish, lethargic movement
• Tendency toward falls, cuts, and scrapes
• Withdrawal from social activities

Seasonal affective disorder is more than just cabin fever or the winter blahs. More than a matter of simple bad mood, it can be truly debilitating. It strikes people who live in countries where Christmas is an important holiday and people who live in countries where it is not. The condition is more common in locations north or south of the 45th parallel. This includes all of Canada and almost all of Europe and Russia, the northern part of the United States and the tip of South America.

How to Stop Feeling SAD at Christmas

Medical science does not have a good theory about the causes of seasonal affective disorder. Researchers have identified a part of the brain, the suprachiasmatic nucleus at the front of the hypothalamus, that acts as a kind of pacemaker to make sure that people are more active during the day and less active during the night. This inner pacemaker is not perfect. It tends to let you sleep longer and longer unless light falls on your retinas early in the morning to “reset” it. If you do not see the morning's first light, or if you live in an arctic region where the winter sun rises late in the morning or not at all, then you feel sleepier and sleepier for longer and longer each day. If you have to get up to go about your daily activities anyway, then your mind and body simply rebel. People who get SAD are unusually affected.

Although science does not explain why some people suffer SAD and others do not, doctors usually are successful in treating it. Antidepressant medication often is not necessary. Instead, a totally natural approach usually works best. Getting 20 minutes of sunlight, either outdoors or in a solarium, before 9 o'clock in the morning, seems to reset the brain to a normal schedule of feeling aroused and feeling drowsy.

It's important to get enough light. If you have to rely on artificial light to treat SAD, then the minimum intensity should be 1500 lux. The packaging of your lamp will disclose the number of lux the lamp produces. If you want to start feeling better in just two or three days, however, then you need at least 10,000 lux for 30 minutes each morning. After your brain has reset to a normal rhythm, then 1500 lux every morning will keep you feeling alert during the day and ready to get rest at night.

The medication that works best for SAD is agomelatine. Over the counter melatonin, however, can also help restore normal sleep. The most important thing to remember about melatonin is that you should only take it at night, about an hour before your bedtime. Melatonin taken during the day induces sleepiness when you are already feeling an energy slump.

Christmas SADness and Social Withdrawal

Just because you suffer SAD, of course, does not mean you cannot also suffer sadness from life events. Losses through physical separation, divorce, arguments, and death are acutely felt at Christmastime. For people who experience both the depression caused by life events and seasonal affective disorder, a treatment known as interpersonal social rhythm therapy, or ISRT, was invented.

The key idea of ISRT is that social activity will do the most good for treating depression if social activities can be scheduled at nearly the same time of night or day throughout the winter season. If you ordinarily see your friends over coffee in the morning, then it is a good idea to continue to see them in the morning. If you ordinarily see your friends and family after work, then it is important to continue seeing them at the same time of day or night. No more than about 45 minutes variation is advised. Sticking to a schedule of meal times, sleep times, and social engagement makes it easier to deal with the underlying brain-based problem. Reducing stress also helps prevent the holiday arguments and breakups that can cause so much grief in the next year.

Avoid the most common cure for SADness. Most people who have SAD, however, don't get treatment with bright light or by scheduling social activities. Most people who have this condition treat themselves with sugar.

There actually is a biological reason for having cravings for sweets and high-carbohydrate snacks when you are depressed. The brain makes the mood-elevating hormone serotonin from the amino acid tryptophan. This amino acid flows into the brain across the blood-brain barrier far more easily when blood sugar levels are high. The more sugar you eat, assuming you are getting adequate protein (and most people do), the more dopamine is available to your brain. The pounds you pack around the waist as a result of this process, however, are likely just to add to your depression!

If you feel a urge to suicide during the holidays or at any other time of year, do not hesitate to call a counselor. There is nothing about Christmas that is worth the whole of your life. And if you feel tired, sad, and lacking energy, remember that the problem may be SAD. Get bright light, stick to a schedule, and remember that light and regular lifestyle will make you much happier than eating too many holiday sweets.