Steamboat Springs It is ironic the holiday season full of joy and celebration can lead to sadness and even depression.
But the serene images of happy family gatherings, the enjoyment of traditional holiday activities and joyous holiday parties do not often mesh with the toll that busy schedules and excessive eating and drinking have on the body and mind.
"I would say it is more common than most people think," said Carol Gordon, a licensed clinic social worker and grief counselor, about holiday depression.
"It is about people's expectations of a glorious, wonderful time," she said. "For some people, they expect such an incredible, wonderful warm feeling. But what happens with all the stress is you don't feel as well or you become emotionally burnt out."
Statistics from the National Mental Health Association show depression peaks during the holidays, affecting more than 17 million Americans. And a study by Pacific Health Laboratories found that 34 percent of men and 44 percent of women in the United States reported feeling "blue" around the holidays.
Holiday depression can come from stress, fatigue, financial worries and family reunions. People can also form other negative responses to the holidays by drinking too much, overeating and getting headaches.
The combinations of too many carbohydrates and alcohol going into the body, with a busy schedule leading to less sleep and exercise, can lead to irritability and sadness.
But depression can also occur for those who are single, do not have a family or are far away from their family. And the holidays can add stress for those involved in family feuds.
"The holiday attention toward family traditions and culture revolves around the happy family, and for a lot of people, that is not a reality," Margy Bookman said.
Bookman, a certified psychotherapist nurse practitioner, said for those who do not have or cannot be with their families, stress and feelings of loneliness and abandonment can occur.
"Probably, we should not have the social norm that you should be with your family," she said. "It places stress on those who aren't."
And Gordon said the holiday season's added focus on materialism increases the level of strain. The need to make the holidays perfect and the money it takes to do that factors into the holiday blues.
"For some people in the low-income (bracket), they can't help but compare what their Christmas is like to someone with more money. And it is particularly hard on children," Gordon said.
The holidays can also be especially hard for those who have lost a loved one within the year or have gone through a divorce, which Gordon calls a death of a relationship.
Gordon said the person who died is greatly missed during a time of year filled with family traditions. The survivors are often filled with guilt about having fun and enjoying the holidays when their loved one has died. Or those grieving compare their feelings to the general festive atmosphere of the holidays.
For those grieving, Gordon said even traditional holiday tasks such as shopping, sending holiday cards and attending holiday events for the first time alone can be difficult.
"The first time you sign your name alone on a card or go out shopping and realize, 'Oh my god, I can't buy a gift for my husband,' it feels like some one is stabbing you," Gordon said.
One of the best steps in reducing grief over the holidays is making specific plans. With grief, people feel out of control, Gordon said, and while writing down plans doesn't ease the sadness, it does give some sense of control.
But the most helpful suggestion, Gordon said, is to do the one thing everyone does not want to do: mention the person's name who has died. By not discussing the loss, it is like having a giant elephant in the room with everyone walking around it and no one talking about it.
"People do not want to do that because they are afraid they will cause the person to think about the deceased. But they are already thinking about it," Gordon said.
To remember the person and to open up dialogue, Gordon suggests creating a special event, like having a family open symbolic gifts to remember what was important to that person. And Gordon said people should not shy away from tears, which have the biological purpose of release, expressing the emotions of sadness and despair and even lowering blood pressure.
Gordon advises similar steps for those going through a divorce, which she said has the same grieving cycle as someone who died. She said parents should talk to their children about how this holiday season is different because of the divorce and how they are feeling.
"It is like the old wives' tale belief if you don't talk about something it just goes away. But when it comes to grief or anything, it is not true," Gordon said. "It sits and waits for you to pay attention to it. And it certainly can build and create a lot of stress."
For those going through grief during the holidays, Gordon is offering weekly workshops.
Bookman said she does not typically prescribe medicine just for the holiday season. Medication is for more long-term, clinical treatment.
For those depressed during the holiday season, she said, it helps to have people to talk to and to have a healthy lifestyle. But if the depression is having a significant impact on someone's life, it is time to seek help.
"Someone should get help when it starts to really interfere with their life, with sleeping, appetite, work, if they are feeling suicidal," Bookman said.
Although depression might increase during the holidays, studies show that suicides do not. A study published by the American Foundation for Suicide Prevention shows November and December have the lowest number of suicides per day and May and June have the highest.
Bookman also said depression can come after the holidays when things slow down. And for those who are already seeing a therapist or using medication, Bookman said the holiday season is not the time to make major changes.