The pandemic has created a great deal of anxiety since it reared its ugly head this year. But as the holidays approach, a new level of stress has emerged for some people. With spiking numbers of COVID 19 cases, the CDC recommends we not gather in large groups indoors to celebrate the holidays. Normally the stress this time of year springs from too little sleep, shopping in crowded stores for the perfect gift, too much food and drink, or just an overload of visiting.
There is No Normal This Year
The difference is, nothing is really normal this year, and the fact we can't have the large family get-togethers we're used to is topping off a pretty rough year. Psychiatrist Dr. Jenys Allende, Executive Director for Mental Health and Staffing at Legacy Treatment Services shared statistics about how stress can impact the holidays. She indicates that on any normal holiday, about 64 percent of people experience moderate or high stress, an equal number say they were mildly affected by holiday blues and 24% of the people are very affected by the holiday blues.
Those Holiday Blues
"Holiday stress or blues are extremely common and are not unreasonable feelings. This year with the added uncertainty about rising COVID 19 numbers and holiday gathering restrictions, it will be even more widespread to have these feelings," said Dr. Allende. "Holiday blues are transient feelings of sadness, irritability or anxiety during the holiday season. While most people with holiday blues will recover from these feelings, some can go on to develop a major depressive episode or an anxiety disorder."
What to Look For
Holidays can be very difficult for some to navigate if they are already having a rough time. Dr. Allende says we should look for obvious changes the personalities of people we care about who are particularly lonely or at risk this holiday season.
Reach out and show support if you notice they are:
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More withdrawn than usual.
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More irritable or impulsive than normal.
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Not sleeping or are over-sleeping.
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Drinking more than normal.
Should you notice any of the above signs, Dr. Allende suggests the following steps:
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Talk with your loved one in a quiet location.
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Listen without giving advice and empathize with them.
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Offer support and let them know you are here to help.
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If your loved one is not actively suicidal, suggest they see their primary care physician. If they are suicidal, call your local crisis center. For the Screening and Crisis Intervention Program (SCIP) in Burlington County, operated by Legacy Treatment Services, you may call 609-835-6180.
When to Seek Counseling
Dr. Allende said it is completely reasonable to feel sad, disappointed or any combination of emotions. "Having complex feelings during this season should be normalized. However, depression is an illness and it is never "normal." Just as having the flu is not normal."
She continued saying that, "the distinction between sadness and depression is the intensity and the duration of these feelings. Sadness and other emotions tend to be transient. People do not experience them a majority of the time and generally these emotions do not affect their ability to live their life. The emotions tend to last less than two weeks.
"However, depression is an illness where you have sadness, irritability or apathy greater than 50% of the time over at least a two week period. It tends to be accompanied by at least four symptoms including problems with sleep, appetite, not enjoying activities you normally enjoy, decreased concentration or memory issues, feeling slowed down or having decreased energy, and feelings of guilt, hopelessness or worthlessness. Suicidal thoughts are never normal and people should always seek the attention of a medical professional if these thoughts occur."
The Pandemic Changed Everyone's Plans
Dr. Allende used her own family as an example of celebrating the Thanksgiving holiday very differently this year. "My family is spread out with my parents in Miami and my brother spending time in the Dominican Republic. Last year we had a wonderful Thanksgiving at my family's home in the Dominican Republic. This year due to COVID 19 none of us can travel and it breaks my heart that my parents ate Thanksgiving dinner alone. I felt a sense of loss and anxiety at not being able to have our family together for Thanksgiving," said Dr. Allende.
Go Virtual
This year, it was a virtual Thanksgiving for Allende's family, who relied on Zoom to bring them together. They also made other changes this year with the menu. Her brother had fried chicken for dinner and she sent her parents a full Thanksgiving dinner they were able to pick up at their nearby Whole Foods. But Dr. Allende acknowledged that while her family may be far away and travel is not in the cards this year, it is even harder for families who live in close proximity to one another.
Referencing the recommendations in some states that families celebrate only with their immediate household members, Dr. Allende said, "Many people struggle with having varying risk tolerance when it comes to COVID 19. Assess your own risk tolerance and how you wish to follow the guidelines. Try not to give in to pressure to compromise the guidelines you want to follow."
Plan Ahead
The holiday dinner is a big part of the celebration and there is no need to abandon the dinner because there are fewer people around the table. Scale back the dinner, or Dr. Allende suggested to think of this year as a time to experiment. If a big turkey is too much, get a turkey breast, try a ham or if even beef Wellington for the main course. In her house, they switched up the meal preparations and everyone in her house made a dish this year. She likes stuffing so she made a smaller version of the stuffing she makes every year. Her daughter made mini pepper pizzas for an appetizer. So while they were unable to be with their larger family, it was still be a special time to celebrate together around the table.
Dr. Allende said, "My most resounding piece of advice is plan ahead. Have a plan for moments that you know may be difficult for you. If you anticipate feeling lonely or will be missing your family, finding a way to involve them at this unprecedented time is important." She suggested going virtual this year and reserving a Zoom time in advance so there are no last minute glitches.
The American Psychological Association has created a checklist to help people cope with the holidays. Dr. Allende suggests reviewing the list and taking a realistic approach to the holidays.
Coping with Holiday Stress Worksheet: Creating My Own Plan for a Happy and Healthy Holiday Season:
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Let go of unrealistic expectations: You can't recreate the past and you can't have perfect holidays.
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Acknowledge and express your feelings honestly: Give yourself permission to feel a sense of loss because of illness, divorce, death, separation, anxiety, dread, pandemic or other pressures.
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If you tend to isolate, try to keep busy instead: Be proactive, not reactive. Get out, go for a walk or even window shop.
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Don't expect issues with others to disappear just because it is the holiday season.
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If you are struggling with loneliness or are facing the loss of a loved one with whom you have shared the holiday then go to a place where you can find support. Volunteer – helping others can take the focus off of your pain.
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Prepare for extra intensity. Eliminate stressful or unnecessary activities and devote at least some time to relaxation and rejuvenation.
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Re-evaluate your holiday traditions and whether they are too stressful.
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Beware of over-indulgence.
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Remind yourself of the true meaning of the holiday.