Christmas is the most wonderful time of the year. Peppy Christmas songs play constantly on the radio. The news offers us stories of ‘good will and good cheer.’ People spend their time buying gifts for other people, doing little things ‘just because,’ and in general trying to make the people around them happier. It’s a season full of merriment, mirth-making, and happy holidays. And it’s one of the lowest points of the year for people who struggle with depression.
We’ve heard that the Christmas season sees a huge surge in suicides (though that isn’t actually true), and it fits our picture. We want to think that depression is for people who are ‘losers’ or who are ‘down on their luck’: people with no family to go to at Christmas, or people with no job who have lost all their money and can’t afford to buy presents at Christmas. But in reality, people feel depressed at Christmas while surrounded by family, awash in a sea of gifts and feasting, living out scenes of ‘perfect’ Christmas cheer. Depression during the holiday season isn’t just for people left out of the holiday festivities — all too often it rears its ugly head right in the middle of the party.
I know this because I struggle with depression. Have for a long time. And I can virtually guarantee that, at least once during the holiday season, I’ll have a depressive episode. I’ll begin to feel lonely and isolated (usually this happens during a party or family gathering). I’ll have a hard time staying engaged in conversations. I’ll have an overwhelming desire to leave where everyone is and find a quiet place to go and be alone — but if I do, I won’t feel any better there. Then I’ll just feel weird for being unhappy when everyone around me is happy and everything is in place that should make me happy.
It is the irrationality of depression that makes it so hard for people who haven’t lived with depression to understand. It simply doesn’t make sense. The vast majority of the time, there is no good reason to be depressed. Depression isn’t understandable. It doesn’t come when I’m in a bad place in my life — it is more likely that I’ll get to a bad place in my life and things will go poorly because (or after) depression has come.
But, while I can’t say I’ve noticed definitive causes for my depression, there are certainly things that can trigger a depressive episode. None of these are determinative, but a few things can be contributing factors:
Alcohol consumption — Alcohol is a depressant. It not only counteracts the ability of anti-depressant medications to do their job, but it can also encourage depression itself. This isn’t to say the people susceptible to depression can’t have a drink now and then, but the more alcohol they drink, the less effective their medication is — there is an increased likelihood that they will have a depressive episode.
Stress — is stress. There are both chemical and psychological reasons why stress is a common trigger for many people with depression. Being confronted with stressful situations can decrease people’s feelings of self-worth, as they come to blame themselves either for causing the stress or for their inability to deal with it well. Stress can also lead to some other trigger behaviors, including disrupted sleep, increased alcohol consumption, and changes in diet.
Altered sleep patterns or less sleep — while we may not fully understand the reasons why, there is a well-documented connection between lack of sleep and depression. Staying out late one night will likely not lead to a depressive episode in susceptible people, but a notable change in sleep pattern or a sustained period of less-than-normal sleep can certainly be a trigger.
Too many choices — for some people, being confronted with too many choices can be overwhelming. If someone is unable to make the ‘good enough’ choice, but is driven to make the ‘perfect’ choice, then being confronted with a vast array of choices can lead to higher stress levels, increasing feelings of worthlessness (“Why can’t I even make a simple decision?!”), and in some cases, a depressive episode.
Change in Diet — there seems to be some research that suggests that eating foods that are deficient in vitamins and minerals and/or eating foods high in fat and sugar can lead to chemical changes in the brain that can affect mood and, in some cases, contribute to depression. Conversely, eating nutrient-rich foods, foods high in anti-oxidants, and foods high in Omega-3 fatty acids can sometimes help people struggling with depression.
Reverting to old patterns/relationships from previous bouts of depression — You grew up with your family and lived with them for a long time, acting in particular ways to make things work, and it is easy to slide back into those old habits of acting when you visit with them again. This need not be problematic — but if your childhood or adolescent years were marked by a struggle with depression, then sliding back into those patterns is likely to put you up against a depressive episode.
Many people struggling with depression do their best to avoid these (and other) triggers, but that can be very hard to do during the holiday season. Avoiding alcohol and eating healthy foods is difficult when there are work parties, family parties, and neighborhood parties to go to and a lot of travelling to do. Add in some of the other elements of the Christmas season — family visiting, the need to select presents for a bunch of different people from an almost endless array of possibilities, sleeping in different beds as you travel or stay with parents — and it’s clear that the holiday season seems almost tailor-made to trigger depression in those susceptible to it.
Others have offered some tips to help you survive the holidays if you struggle with mental health. For those who know someone who may be struggling with depression during the holidays (which is more of us than we might think), I encourage you to read that list and try to be compassionate.
Sometimes what may look to you like someone not pulling their weight in planning for the family event could be someone trying to minimize depressive triggers by reducing their stress or the number of choices they have to make. Someone leaving early from an event may not be doing so because they are rude or not having fun, but merely because they know they need to get extra sleep to avoid a depressive episode during this busy season. If a family member is reluctant to come over or doesn’t want to stay as long as others at the big holiday get-together, it could be that being around family causes them to revert back to earlier times and patterns in life that are, for them, tied closely to their depression. It doesn’t mean they don’t love you; they almost certainly do and probably feel terrible that their illness won’t allow them to spend as much time with you — there’s no need to make that worse through guilt trips or social pressure.
Depression is a hard thing to understand and an even harder thing to explain. But you don’t have to ‘get it’ to help your loved ones this holiday season. Don’t be afraid to talk about it — but also don’t force the issue if people aren’t comfortable talking about it with you or talking about it in that setting. Don’t scold them if they aren’t avoiding the triggers the way you think they should, and don’t second-guess all their choices. Give them space to do what they need to do to navigate the holidays, and let them know that you love and support them. Don’t ask them to fake being happy — love them for who they are and how they are, right now. That is the best gift you can give them this Christmas.