Meagan really wanted this Christmas to be “extra special” — not like last year, when the family dinner turned nasty and Uncle Fred left in a huff. But as Christmas approached, the shopping chores multiplied, and the savings account dwindled, Meagan became increasingly anxious and dejected. Paul, her husband, wasn’t of much help — he was preoccupied with his job search, after having been laid off two months ago. Meagan was left to deal with three school-age kids and a part-time “temp” job as a secretary. And all this, at a time Meagan strongly associated with her late mother, who always used to help with the holiday cooking — and who had passed away at about this time last year.
In the past few days, Meagan had found it increasingly hard to fall asleep, and noticed that her appetite was poor. From time to time, she found herself weeping or sighing, but not knowing what to do. She wondered if “maybe having a few drinks” might do her some good.
Meagan (a composite character) has a number of risk factors for feeling down or depressed. First, women have rates of serious depression about twice those of men, and are also at higher risk for a particular type of major depression called Seasonal Affective Disorder (SAD). In addition, the combined stresses of holiday chores, child care, and financial woes put Megan at risk for what is popularly known as “the holiday blues.” So does Meagan’s “anniversary reaction” over the death of her mother. But what do we really know about the “holiday blues,” beyond hundreds of anecdotes and Internet postings? How do the “blues” differ from SAD and other forms of major depression? And is the commonly-held notion that suicide rates soar during the Christmas and winter holiday season really valid? Some recent research sheds light on these questions, while also highlighting many “grey areas” in our knowledge.
Let’s deal with the “Christmas suicide” story first. From all the data we have gathered in the U.S. and parts of Europe, we can say confidently that this is a myth. In fact, we have evidence going back to the 19th century that suicide rates generally decline in the late fall and winter months, and spike upward in late spring and summer. The precise reasons for this pattern are not known, but the finding is consistent across many studies. In fact, data from Zurich, Switzerland, show that suicide rates begin to fall as early as late November, and remain lower until just after New Year’s Eve. That’s the good news, and ought to allay fears that Christmas, Chanukkah, Kwanzaa or other winter celebrations are times of high suicide risk. The not-so-good news, however, is that suicide rates appear to spike upward after New Year’s Eve — largely among men. Rates for women seem to return to baseline, without a major spike.
There are two main hypotheses to explain these patterns. The “broken promises” hypothesis holds that, during the holiday season, people have very high expectations. Like Meagan, many view the holidays as a time to put things right, experience the joy of family and friends, and perhaps to experience some kind of spiritual renewal. Unfortunately, many are disappointed when these hopes are dashed — and some who become very despondent may take their lives. In contrast, the “withdrawn support” hypothesis begins with the observation that the winter holidays are usually a time of increased contact with family and friends. Social contact and support are known to protect against the risk of suicide. But after New Year’s Day, social supports usually diminish rapidly. This is what I call the “picking up the wrapping paper phase,” and it may be the time some very vulnerable individuals decide to take their own lives. Why does the post-holiday increase in suicides affect men more than women, at least in Switzerland? It may be partly because women are better than men at maintaining post-holiday social support networks, but this remains speculative.
With all the annual hoopla over the “holiday blues,” it is surprising that so little solid research has been done on it. There seems to be no specific definition of the term, and — so far as I can tell — there are no well-designed epidemiological studies of the phenomenon in the U.S. That said, Dr. Jennifer Wider reports that nearly two-thirds of women surveyed by the National Women’s Health Research Center reported feeling depressed during the previous year’s winter holidays. I’m not aware of comparable data for men. However, Dr. Wider observes that often, during the holidays, the burdens of family caretaking fall mainly on the shoulders of women. Increased alcohol use during the holidays, combined with family stressors, may set many women up for the holiday blues. Of course, men are hardly immune to this condition, and are at higher risk for completed suicide.
Psychologist Dr. Herbert Rappaport believes that those he calls “fixers” — individuals intent on “making everything right” during the holidays — are especially prone to grief reactions after Christmas and Chanukkah. Fortunately, the “holiday blues” are usually short-lived, lasting a few days or perhaps a week or two in most cases. This differs from SAD, which tends to last weeks or months, and reappears winter after winter, regardless of social stressors. SAD, which affects perhaps 10 percent of the population, may be related to decreased daylight in the winter months, which in turn may reduce mood-boosting brain chemicals like serotonin. SAD is often characterized by excessive daytime sleep, substantial weight gain, inability to function, and persistent thoughts of suicide. Unlike the “blues,” SAD and other types of major depression require professional intervention.
Preventing the holiday blues involves four main strategies: keeping expectations realistic; delegating responsibilities; shoring up social supports; and avoiding excessive alcohol consumption. More detailed advice is found in several of the articles listed below. Finally, another good strategy, according to Dr. Hinda Dubin of the University of Maryland Medical Center, is to find ways of helping those less fortunate than oneself. Taking the focus off your own problems and aiding somebody truly in need may be the best gift you’ll ever get during the holiday season!
For more information on coping with the “holiday blues,” see the following websites:
- Beating the Holiday Blues
- Managing the holiday blues
- Beating the Holiday Blues
- Nine Ways to Beat the Bah Humbugs
- Wrung-Out by Ringing-In the Holidays: Dealing with Post-Holiday Blues