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Is It the Holiday Blues or Seasonal Depression?

... and expert advice on what to do once you know what you face.

Photo purchased from iStockphoto, used with permission.
Source: Photo purchased from iStockphoto, used with permission.

We anticipate it as a time of joy and good cheer, but the holiday season also offers plenty of reasons to feel overwhelmed and discouraged.

For one thing, there’s the mad drive to live up to expectations—the decorating, the holiday meals, the card writing, the budget-busting gift buying.

And then there are the get-togethers with relatives, which provide plenty of opportunity for old conflicts to resurface and disappointments to be aired.

It’s a recipe for the holiday blues. But instead of assuming it’s your mother-in-law’s critiques and the unaddressed stack of Christmas cards that are bringing you down, consider whether your low mood has another source—seasonal depression.

‘Tis the Season?

Seasonal depression, also called seasonal affective disorder (SAD), is a mood disorder which may accompany the shorter daylight hours that arrive just as the holiday season gets underway. SAD is commonly marked by a sense of apathy and fatigue, excessive sleeping, problems concentrating, and food cravings, especially for sweets and carbohydrates—and it can reach the level of major depression. For most, SAD fades in early spring, when the days get longer and sun exposure increases.

That timing can make it easy to confuse SAD with a bout of the "holiday blues," but there are important differences. And most crucially, each may respond to different treatment approaches, meaning that misunderstanding what you’re experiencing could potentially prolong your distress.

Holiday blues, for example, tend to come with feelings of anxiety and sadness. SAD, on the other hand, despite its acronym, is more about feelings of emotional indifference and lethargy than sadness. There’s often rumination in holiday blues, as well, often triggered by a specific issue, such as worry about finances or the disheartening contrast between holidays past and present. As the New Year approaches, the blues can deepen with the internal tallying of missed opportunities and unreached goals.

Effective treatment for the holiday blues can vary with the symptoms. Therapy can help you come to terms with a dysfunctional family relationship or learn ways to cope with anxiety. In some cases, support groups can be a good option—grief groups to help with loss, Debtors Anonymous to help with compulsive spending, or support groups designed for children of alcoholics, to name only a few.

Dark Days, Dark Mood

What’s going on with SAD? Its mechanisms, and the reasons why only some people are affected, are not perfectly understood, but researchers believe it’s due to a change in brain chemistry and biological rhythms that can emerge when we are exposed to shorter days—and less sunlight. That means it’s a greater risk for populations where winters are dark and cold, but anyone can be affected.

If you find that shorter daylight hours tend to send you into a slump, you may be affected. The good news is that some simple actions have the power to help, especially if you act before symptoms progress.

The most obvious is simply to prioritize time in the sun. This is easier said than done if your climate tends toward the gloomy, of course, but even the light from overcast skies is better than none. Try walking in the mornings, when light is at its strongest. This also has the benefit of increasing your physical activity, which may well boost your mood, although the link between SAD and exercise has not been adequately studied.

Light therapy boxes that mimic sunlight can also be purchased in retail stores and online. Look for those specifically designed to treat SAD. For best results, plan to spend at least a couple of hours a day in front of it, preferably in the morning.

(By the way, don’t just switch on a few extra interior lights and expect that to give you the illumination you need. Regular interior lighting, which ranges from about 300 to 500 lux, simply can’t approach the brightness of the sun, which usually falls between 2,000 to 10,000 lux.)

Talking with a therapist can also offer powerful help. A recent study by University of Vermont researchers found that a type of cognitive behavioral therapy (CBT) tailored toward those with SAD can be even more effective than light therapy, although this may be in part because light therapy can be tough to stick with day after day. This type of CBT teaches recipients ways to challenge negative thoughts about the gloomy fall and winter months and helps them learn strategies for dealing with low mood rather than defaulting to behaviors that can make it worse, such as retreating socially. Such skills can help prevent a future return of SAD. If the fall and winter months have been a problem for you in the past, it’s wise to connect with a psychiatrist with experience treating SAD. Such a professional can assess your issues, help determine if SAD is indeed what’s troubling you, and guide you through treatment. He or she may also recommend antidepressants, which some studies have shown can have a preventative effect, especially if you’ve been hit hard by symptoms in the past.

No matter the ultimate diagnosis, if you’re feeling down this holiday season, don’t ignore your pain. By addressing the issues, you’re much more likely to keep symptoms from spiraling out of control—and that means a much greater chance that the happy holidays we’ve been primed to expect will live up to their promise.

David Sack, M.D., is board certified in addiction medicine and addiction psychiatry. As CMO of Elements Behavioral Health, he oversees a number of depression treatment programs including The Ranch in Tennessee, Malibu Vista women’s mental health center in California, and Lucida Treatment Center in Florida.

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