Key takeaways

88% of adults experience stress during the holiday season, with factors including the pressure for perfection, financial concerns, and strained family relationships exacerbating anxiety and depression.
Common symptoms of holiday depression include persistent sadness, changes in sleep and appetite, irritability, and thoughts of suicide, with professional help advised for severe or prolonged symptoms.
Strategies to mitigate holiday depression include letting go of perfectionism, adjusting expectations, maintaining a healthy routine, connecting with others, limiting social media use, and practicing gratitude.
Seeking professional help is crucial for individuals experiencing severe depression or suicidal thoughts, with therapy and medication being effective treatments for improving mental health during the holidays.

‘Tis the season to be jolly, but in reality, 88% of adults feel stressed during the “most wonderful” time of the year, according to a 2018 survey. Additionally, 64% of people with mental illness reported that holidays make their symptoms worse. So, what causes holiday stress—or even holiday depression?

“One of the most difficult things about the holidays is the idea that we should have a ‘perfect holiday,’” says Sheela Raja, Ph.D., a licensed clinical psychologist and associate professor at the University of Illinois at Chicago. “Many people worry that they don’t have enough money to spend on gifts, that they may not be at fancy parties or that their family relationships may be strained. If you already struggle with anxiety or depression, you might feel like everyone else is having a great time and there’s something wrong or defective with you because you’re feeling stressed.” Or, you may have had to cancel visits with family and friends because of COVID-19, and that has you down in the dumps.

Gail Saltz, MD, clinical associate professor of Psychiatry at the New York Presbyterian Hospital, Weill-Cornell Medical College, agrees and adds that some people may feel sad at this time of year because of lost loved ones (which often is more felt during the holiday season) or a biological issue that happens with the change of seasons. “There’s the simple fact that it’s winter and the days are shorter because of less sunlight which affects many people’s moods,” she continues, referring to the condition seasonal affective disorder (SAD), a type of depression that usually begins in the late fall and lifts during the spring.

Common signs of holiday depression

A bit of the blues at the holidays may be normal, but if you experience depression, you should seek help. While symptoms of depression vary from person to person, some of the typical indicators include:

Feeling sad, lonely, and hopeless most of the day
Changes in sleep patterns (having difficulty falling asleep, staying asleep, or sleeping too much)
Changes in appetite (eating too much and craving carbohydrates or loss of appetite)
Feeling restless, angry, guilty, or irritable)
Difficulty concentrating
Loss of interest in activities that usually give you pleasure
Fatigue (loss of energy) despite getting enough sleep
Thoughts of not wanting to be alive

This is not a complete list of symptoms. If you think you or a loved one might be depressed, speak with your healthcare provider. If you have thoughts of suicide, the National Suicide Prevention Lifeline is available 24/7 at 988. You can also call 911 for help.

6 ways to ward off holiday blues

Both Dr. Raja and Dr. Saltz offer six lifestyle strategies that may help navigate sadness and prevent stress during the holiday season.

1. Let go of perfectionism.

Dr. Raja shares the story of a friend who baked a cake that didn’t rise, so she decided to serve the cake as pudding instead at her holiday gathering—and it turned out to be a hit. “Her attitude was everything,” she explains. “Try to remind yourself that the best memories have nothing to do with perfection—and everything to do with the people around you.”

2. Change your expectations.

This involves realigning your thoughts, suggests Dr. Saltz. “The month of December does not equal automatic happiness, so there’s no need to expect more of yourself,” she explains. “Give yourself permission to have these feelings.” You may have always had a big holiday dinner with family. If that’s not possible this year because of COVID-19, it’s okay to mourn the change in tradition.

3. Stick to a healthy routine.

“It’s important to do things that help improve mood, such as exercising for 30 to 40 minutes, three to four times a week, along with maintaining a regular sleep schedule,” says Dr. Saltz. Also, keep alcohol intake to a minimum since this beverage is classified as a depressant.

4. Connect with others.

“If loneliness is the problem, most people’s immediate response is to hunker down even more, but actually, the opposite is helpful,” states Dr. Saltz. She suggests that you make an effort to interact with others, whether that means heading to your local coffee shop to strike up a conversation with a friendly stranger or traveling to visit a friend who lives at a distance. If that’s not possible, organize a Zoom hangout with your loved ones.

Both she and Dr. Raja suggest volunteering during the holiday season, as well. “Helping others who are in need helps us gain perspective, as well as helps us feel we have something positive to contribute to the world, which can be so beneficial when combating feelings of depression and loneliness,” says Dr. Raja.

5. Limit your time on social media.

Since the majority of people on Facebook and Instagram tend to post their happiest moments, scrolling through numerous party and vacation photos may only exacerbate your sadness. “And if you have a mental health condition, you may be even more likely to think everyone else has a ‘perfect’ life and you are the only one struggling,” states Dr. Raja.

6. Practice gratitude.

Each day, find at least one thing in life you’re grateful for and choose to either write in a journal or say it out loud to yourself. “It can be something small, for example, ‘I love that someone at the grocery store let me go ahead in the line today,’” says Dr. Raja.

When to seek professional help for holiday depression

“If you’re having thoughts of suicide or if your depression is severely impeding your ability to function, see a mental health professional immediately,” urges Dr. Saltz. If you are thinking of ending your life, you should call 911.

If you’re having trouble eating, sleeping, or going to work or you’re losing interest in life and those symptoms last more than one to two weeks, you should reach out for help.

Consider asking your primary care physician for a referral to a psychologist or psychiatrist. A mental health specialist is qualified to assess your symptoms in order to clarify whether you’re suffering from the blues versus depression, as well as if your condition warrants therapy and medication, continues Dr. Saltz. “The presentation of the depression will often dictate which medication is chosen since the meds slightly vary—but I would not do medication without therapy,” she says.

A mental health provider would also take into account your medical history and your family’s mental health history before prescribing a treatment. There are many effective medications to treat depression—during the holidays and year round—such as: selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and atypical agents.

The right treatment can be very effective at lifting holiday depression and improving your ability to function at home and at work. Work with your doctor to find the combination of therapy and medication that works for you. With these steps, you’ll say goodbye to excess stress, and can get back to enjoying all the festivities the season brings.