Introduction

The festive season is a time of celebration, but for many Australians the festivities also mean extra pressures, like buying gifts, attending many social gatherings, staying away from home and/or entertaining family and friends. Coupled with great (and often unmet) expectations of what the festive season will bring, these pressure can build up and cause stress, which if ignored may lead to mental health disorders, particularly depression. Holiday periods have been associated with higher levels of depression, and one study found that suicide rates increased on the days following holidays. Another reported a 40% increase in suicides in the days following Christmas. Stress and depression not only have the potential to ruin the festivities, they also have considerable negative health effects which may persist if ignored.

It’s easier to avoid stress and associated depression than it is to cope with these conditions when they occur. If you are feeling stressed out about Christmas, or have experienced mental health problems like stress and depression in the past, make sure you are familiar with common sources of stress and depression in the festive season so that you can avoid them. Arm yourself with strategies which can help you cope if the demands of the festive season become too great.

What is depression?

Depression is the most common mental health condition seen by Australian general practitioners and amongst the leading causes of illness-related disability in the world. It is characterised by a persistently depressed mood, low self-esteem, self-criticism and lack of pleasure. People who are depressed usually feel more vulnerable and guilty than usual. They may be self-critical and distance themselves from other people. Depression also commonly produces feelings of hopelessness or helplessness and may leave affected individuals with difficulty sleeping and/or feeling fatigued.

Historically, depression has been an under-recognised condition which has received little research attention, despite being one of the leading causes of illness-related disability However, since the introduction of effective treatments (such as medicines called selective serotonin reuptake inhibitors, or SSRIs) and the development of strong evidence regarding the high level of disability associated with the condition, depression is receiving increasing attention in clinical practice.

For more information about the causes of and treatments for depression, see Clinical Depression.

What is stress?

Stress is a psychiatric condition characterised by the individual feeling intense emotional pressure with which they are unable to cope. Everyday pressures such as work, relationships and finances, with which one individual copes, or even finds motivation from, can produce stress in some people. They may find themselves unable to manage day-to-day life and that stress about one problem affects many or all aspects of their lives. They may suffer insomnia, loss of appetite and difficulty concentrating.
Stress also causes physiological changes, in particular increases in heart rate and blood pressure. In the long term it increases the risk of cardiovascular problems and other chronic health conditions. It can also have a considerable negative impact on a person’s quality of life, and causes difficulties in intimate and professional relationships. Stress is a difficult condition to prevent, however there are many strategies that can help you cope with stress.

For more information about what causes stress and how it can be managed, see Stress (Anxiety).

Who is affected by stress and depression

In Australia 5.8% of the population experienced at least one episode of depression in 1997. Men were more likely to be affected than women (7.4% vs. 4.2%). There is an increased risk of depression for some individuals in the festive season.

Stress, a condition which can lead to depression if ignored, arises in approximately 1 in 5 Australians as a result of festive season activities. A similar proportion of Australians experience stress due to health problems or relationship problems.

Causes of stress and depression at Christmas

The festive season is a busy time when normal routines are often interrupted. There are many behaviours and situations which may cause stress and/or depression at this time of year.

Poor nutrition

The festive season is a period of over indulgence and the combination of too much food and generally poor nutrition can have a negative impact on an individual’s mood.

Excessive alcohol consumption

Excessive alcohol consumption is common in Australia, particularly in the festive season. At this time some people, particularly those who work in stressful occupations like nursing, may use alcohol not only as a celebratory mood enhancer, but also as a means of coping with the additional pressures the festive season entails. While alcohol temporarily produces positive feelings and relaxation, when it’s intoxicating effects wear off it can contribute to stress and depression. Use of illicit drugs is thought to contribute to depression, and some evidence suggests that illicit drug use increases in the festive period.

The festive season is also a time of considerable expense, and the financial strain associated with buying gifts and food and travelling to visit loved ones, can contribute to stress, anxiety and depression. The materialistic nature of society is thought to contribute to depression in general, and in the festive season there is considerable pressure to buy luxuries, which causes financial strain for many.

Family conflict

Festive family gatherings are, at least according to expectations, a time for sharing love and joy. In reality they often mean extra work and can be a time of conflict. Conflict with family members can cause stress and contribute to depression.

Juggling work and festivities

For many individuals work is a necessary part of the festive season and managing work, festive season shopping, celebrating and entertaining can contribute to stress for many. Patients may find it difficult to get enough sleep in this busy period, which can have a negative impact on their moods.

For more information about the psychology of sleep and how you can promote better sleeping patterns, see Sleep.

Isolation

The festive season is traditionally a time for getting together with loved ones and the expectation of being part of a loving social network can make coping with isolation more difficult.

Tips for coping with stress and depression in the festive season

In the busy and often stressful festive season, it’s important to be aware of strategies that can help you reduce the likelihood of stress or depression.

Eat well, exercise and relax every day, and enjoy alcohol in moderation

A healthy body is the foundation of a healthy mind, and maintaining good nutrition and performing plenty of physical activity can have a positive impact on festive season mood.

Eating

Despite the culinary temptations the festive season brings, it is important to maintain a healthy diet, including plenty of fresh fruits and vegetables. Buying healthy festive snacks and minimising sweet, fatty and salty treats is one measure you can take to ensure your festive season diet remains healthy and balanced.

Alcohol should be consumed in moderation. The festive season is a time when many Australians consume too much alcohol, and some people may even use alcohol to reduce their stress levels. However, alcohol is a depressant which in the medium to long term has a negative impact on moods and can also contribute to lack of sleep. Alcohol intoxication can fuel conflicts and also lead to risk-taking and other unwanted behaviours which may ultimately contribute to, rather than relieve, depression and stress in the festive season.

The festive season is a busy time when routines are disrupted, and many people ignore their normal exercise routines or struggle to find time for daily physical activity. To ensure you get enough holiday exercise, plan to go for a walk every day, for at least 30 minutes, and find other opportunities for fun, festive physical activities. Brisk walking will burn more energy than slow walking. Fun holiday activities like roller skating, beach volley ball and bushwalking are all great ways to exercise and have fun with family and friends.

It’s also important to get enough rest and put aside some time for holiday relaxation and enjoyment. A massage is a pleasurable and relaxing treat which can help you avoid festive stress. However, simply setting aside 15 minutes a day of personal time to take a break and clear the mind is also a wonderful way to beat stress. It doesn’t matter what the 15 minutes involves. Whether it’s a relaxing walk, listening to music or sitting and staring at the stars, personal time can help you cope with the added demands of the festive season.A good night’s sleep is also an important stress-busting technique. Set aside enough time to sleep properly in the festive season.

The festive season is unlikely to be perfect or stress-free. Coping with the stress of festivities can be easier if you approach them with realistic expectations. Expectations may relate to festive season activities, from gatherings with loved ones to shopping for perfect Christmas gifts. Use you past experiences to inform your expectations of this festive season. Consider which aspects of the festive season are likely to be easier and which will be more challenging to cope with. Negative feelings such as grief or conflict do not disappear at the beginning of the festive season and acknowledging them, and taking time out to talk or cry is an important coping mechanism.

For example, if you have recently left an intimate relationship you may identify coping with feelings of loneliness and the absence of the ex-partner as expected challenges. Similarly, if family conflict is an annual tradition at your Christmas gatherings, you should approach family gatherings knowing that this conflict may be a source of tension. Considering and acknowledging situations which may present challenges in the festive season is less likely to cause disappointment than entering the season with unrealistically high expectations which go unmet. It also allows you to prepare, for example by consciously setting aside differences which cause conflict and deciding to leave them for another day, rather than lay them on the table at the family festive gathering.

However, even if the festive season has been perfect in the past, it may not necessarily be so in the future. Families and the traditions and rituals they practice change over time. You should be prepared for changes. For example, if children have grown up and left home, they may not be able to attend the family Christmas celebration. Finding other ways to be in contact, for example telephoning or emailing, can help reduce the stress and sadness this change could potentially cause. Trying something new can also be a positive way to avoid stress and grief associated with change. Why not take Christmas lunch outdoors and barbecue rather than baking indoors? Or celebrate the New Year camping under the stars, rather than under the influence of alcohol?

Make a realistic budget and stick to it

With so much pressure to spend money in the festive season it is little wonder that many Australians feel the financial pinch at this time of year. Ideally you will have put aside money throughout the year to help you cope with the added expense of Christmas, but regardless of your savings status, you will benefit from careful festive financial planning. Setting limits is important. Make a list of people you want to buy presents for and allocate price limits. Stick to them. Leave your credit card at home when you do your Christmas shopping to avoid over-spending and creating financial stress for the New Year.

Setting a limit for the food budget is also important. Making gifts or suggesting that the entire family sets Christmas gift limits may also help. Donating money to a good cause, in lieu of buying Christmas gifts is another option. Bear in mind (and remind your loved ones as necessary) that money cannot buy festive season happiness.

The festive season is a time when many fun and unusual activities can be undertaken for free. Make the most of the free entertainment. A night time walk to see the Christmas lights in the neighbourhood or to sing carols by candlelight is a cheap and enjoyable way for the entire family to pass a festive evening.

Develop strategies for coping with stress and depression

Once you have identified the potential challenges which will arise in the festive season, it is important that you develop strategies for coping with them. Simple measures, like taking a ‘cool down’ walk when conflict arises at the family gathering, or avoiding certain situations (e.g. being alone with someone who causes you stress) can help.

If you have lost a loved one in the festive season, whether it is to death, divorce or other circumstances, you are likely to experience feelings of grief and loneliness. These are normal and difficult to avoid, but talking openly can be helpful. Consciously remembering the loved one, for example with a memorial service for a loved one who has passed away, may also help. If there’s someone you’ll be missing this Christmas, making a new friend or getting in touch with an old friend you haven’t seen for a while, may ease the loneliness and sadness.

Planning

Planning ahead can also help you avoid stress. For example, you could set aside days for shopping, visiting and other festive activities. Preparing menus and shopping in advance can also help. Ensuring friends and family are on hand to help with festive season preparations can help ensure the work is shared around and one person doesn’t end up with a huge, stressful burden that negatively impacts on their festive season. For example, you could arrange for some guests to arrive early to help with preparation, or for all guests to bring a plate of food to distribute the work around.

Being prepared to say ‘no’ when juggling the demands of the festive season becomes too intense is also an important part of planning. It is often not possible to attend every celebration or visit every loved one in the short and busy festive period.

If you are a divorced parent, you may need to plan in advance to ensure that custody arrangements for Christmas day don’t contribute to stress which can affect you and your children. Be flexible and make plans with the children’s best interests in mind.

Be with other people

Isolation can be even more difficult to cope with in the festive season due to society’s expectations of social festive season gatherings. If you are feeling isolated it may help to make plans to be with other people in the festive season, and particularly on Christmas day. Volunteering with a charity service is an excellent way to avoid negative feelings by to getting out and amongst other people. Helping other people can often foster positive feelings and open new social networks. It may also be helpful to prepare a list of people you can contact throughout the day if you are feeling lonely or isolated. It should include loved ones, but also professional support such as telephone lines which can be called if you have difficulty coping.

Recognise the symptoms of stress and depression and seek help if they occur

There are many strategies which can assist you to cope with stress and a wide range of possible treatments for depression. But unless you recognise the symptoms and seek help and support, you may miss out on much needed assistance. Stress occurs when you feel unable to cope emotionally. If not adequately managed, it can lead to depression, common symptoms of which include feeling sad or tired, not enjoying life or feeling unmotivated. Less common symptoms include reduced libido, concentration difficulties, insomnia, and mood changes.

Seek help from friends, family or a health professional if they experience these symptoms. Help your friends and family by watching out for these symptoms and helping loved one seek assistance if needed.

Support those around you and ask for support when needed

Individuals with stress and depression require support, both from health professionals and loved ones. In the festive season, when regular routines are often interrupted, you may have difficulty accessing your normal professional supports or require more support from friends and loved ones. This can add to relationship tension, as it places pressure on you and your loved ones to cope with stress.

However, don’t be afraid to seek support from loved ones if you are feeling stressed or depressed. If you are experiencing stress, depression or another mental health problem, try to be close to other people and avoid being alone.

If you have a loved one experiencing stress or depression, offer support when and where you can. Talking about the person’s feelings and experiences may be enough; however for those who require more support, it may be necessary to seek professional help. It’s important to reserve judgment; telling a depressed friend you’ve noticed a change in their behaviour and offering support is probably the best place to begin. Encouraging them to eat well, be social and get out for physical activity and to see friends can also help. Try not to leave friends or family members who seem depressed alone. If you think a loved one requires professional assistance ask that person if you can help organise a doctor’s appointment, or obtain information about depression on their behalf.

Look ahead to a bright future

Whatever events arise and cause stress in the festive season, remember that it is just one short period. Planning for the New Year and having expectations of a bright future can also help combat negative emotions in the festive season.

References

Beyond Blue. Watch for signs of depression during the festive season. 2005. [cited 5 December 2011]. Available from: [URL Link]