Blue Christmas: When depression strikes over the holidays

Some researchers and health professionals believe that depression and suicide rates go up around the festive season, though others believe that figures are unrelated to the holiday season.

In Malta, statistics relating to depression do not seem to go up over the Christmas period. However, whilst official figures of admissions to Mater Dei Hospital and Gozo General Hospital for patients treated for depression do not increase over this period, cases of intentional self-harm increased significantly in 2008 and 2009, more than doubling any other month for the two years. This signifies a cry for help over the Christmas period where people may be feeling alienated.

Agenzija Appogg answered 457 calls related to depression in 2009, 27 of which were made in December and though there were sporadic increases/decreases throughout the year no association was made to time of year.

Psychiatrist Mark Xuereb says that there is culture of under-reporting with regards to suicide, self-harm and abuse and that our figures could be concealing “hidden monsters.”

Psychotherapist Dr Anna Grech also says that Christmas is one time of the year where those who already suffer from some form of depression may be more inclined to relapse into a depressive episode or exhibit more symptoms associated with depression.

“It is the time of the year that can evoke a lot of sadness, negative thoughts and emotional stress to many other people who are not as such clinically depressed. Research shows that over the Christmas period the rates of help line calls and suicide attempts does increase compared to other times of the year, with people suffering from depression displaying more symptoms at this time of year. ”  

Christmasis portrayed as a period of peace, joy and making merry, however for some people, feelings of loss, betrayal, rejection and failure, when set against the backdrop of Christmas joy and festivities becomes more intense and cause greater suffering to the individual. For some, Christmas and the holiday season is not a time of joy and cheer but of sadness, loneliness, anxiety and self-evaluation.

“Those with few friends or family members, or living far way from loved ones may feel even more alone and isolated during this time of the year. On the other hand, those with a large circle of family and friends may feel stressed or overwhelmed by having too much to do or too many expectations to meet.” 

However Dr Grech says that not all holiday depression has to do with loss or failure, or anything obvious. Some people generally feel more depressed around the holidays and because they feel like they should not be depressed as Christmas is meant to be a happy time they are more reluctant to seek help. A sense of isolation can be felt much more acutely when everybody else appears to be celebrating and having a good time.

The pressure to provide food and gifts combined with work or family commitments may leave a person feeling burnt out and depressed.

However for people suffering ‘holiday blues’ symptoms tend to clear up once the holiday season is over, though people who have a more chronic condition or a history of depressive episodes can experience symptoms for a longer period.

Dr Grech advises people who are suffering from depression at this time of year to acknowledge their feelings, as avoidance can lead to further pain and a delay in healing time.

“A key factor to keeping feelings of depression at bay during Christmas is to have realistic expectations of oneself and others. Also, it is important to try reach out to those people one feels comfortable with and try to accept help, even professionally if necessary.”

Diet is also of major concern among depression sufferers as food that is high in sugar and carbohydrates often makes depression worse. Excess amounts of alcohol will also contribute to depression symptoms as alcohol acts as a depressant.

Keeping active will also keep depression at bay. Even something as simple as a brisk walk is known to have had antidepressant effects with mild to moderate depression.

For friends and family of depression sufferers there are a number of things that can be done to help. Some people feel better when they have a physical task to do or are kept occupied or distracted with something to do, this way they don’t have to engage in small talk or pretend to be happy and at the same time feel useful as opposed to helpless and alienated.

Try and keep things calm and simple for the person especially if the person feels overwhelmed or more alienated when there are too many people around.

Agenzija Appogg provide emotional support and crisis intervention 24 hours a day 365 days a year by professionally-trained volunteers, under the ongoing supervision and guidance of professional staff who provide immediate assistance on Supportline 179.

“Depression is not something people can easily overcome or ignore, which makes helping a loved one deal with depression difficult. It’s even more difficult over the holiday season when everyone is ‘expected’ to feel happy. The best way to cope is to try and find a balance between helping your loved one but at the same time not shouldering too much responsibility yourself.”