Depression - whether it is clinical or brought on by a bereavement, divorce or work - is often at its worst for some people during the holiday season.
There is such an emphasis placed on 'perfection' at this time of year that it can make people feel terrible if they aren't living up to that ideal.
HuffPost UK Lifestyle asked the experts for their take on how to handle depression at this time of year.
Dr Paul Zollinger-Read, chief medical officer at Bupa said: "Everyone can have off days, or feel blue for a short time, but for most people this usually passes relatively quickly. However, being depressed is a medical condition and you can experience intense emotions of anxiety, hopelessness, negativity and helplessness that simply won’t go away.
“Unfortunately, although the festive season is often one associated with joy, it can also be a stressful, lonely or sad time for many people. For those affected by depression, Christmas can actually be the worst time of year and something many of us need to be more aware of."
Why is it the worst time of year though? For a lot of people, it's a combination of financial pressures and work stress. Karin Sieger, psychotherapist and HuffPost UK blogger said:
"We all face a combination of different challenges including: financial, because of the extra expense; physical, because less sunlight means low Vitamin D and serotonin levels, which affect our mood and sleep. Social, because we may have no family or friends to spend time with, or we may have gatherings with relatives where disagreements and difficult character styles are ready to erupt; and emotional, because in the midst of the seasonal hustle and bustle we may feel isolated and lonely, or we may feel stressed, anxious and vulnerable."
Dr Zollinger-Read adds: "For employees, meeting deadlines and the pressure to wrap up at work before Christmas can also cause stress, anxiety and depression."
So what can you do about it? Dr Sheri Jacobson, clinical director at Harley Therapy says: "The loneliness can be overwhelming, or we feel an outcast. Don't be too proud to accept invites if it makes you feel good- and if it doesn't, if it honestly makes you feel worse to spend Christmas with someone else's family, then don't let guilt make you feel you must say yes. It's not at all selfish to prioritise yourself during this delicate time, it's wise."
Also, if you aren't in a position to go out, do embrace the positives. "You can sleep in, hit the boxing day sales, and eat all the mince pies you want with nobody complaining. And indulge yourself a little if it helps. Buy yourself a gift. It's a great time to celebrate you."
Story continues below the slideshow:
If you are able to, make an appointment with your GP ahead of time. However, there several things you can do to help deal with depression at Christmas.
- Make sure you exercise regularly and stay as physically active as possible. Even if it’s cold outside, try to do an indoor activity or simply wrap up well and enjoy the great outdoors.
- Some relaxation techniques, such as deep breathing or meditation, may also help ease your symptoms. Make time over the festive period to relax and unwind, however busy you may be.
- Space out your shopping and other preparations and start in advance, which helps avoid spending too much money.
- If you are worried about potential arguments with family members or friends, try and have a word with them about your concerns in advance. If this is not possible, try and have an 'ally' on the day, who can support you, and be on your side. Have a think about how you can diffuse or literally walk away from difficult situations, by giving yourself time out.
- If you are visiting others, have a think whether your stay can be kept short.
One of the most frustrating things with depression is that it can't be controlled - in terms of onset and severity. But one thing that can be controlled and is guaranteed to make things worse is alcohol.
"It can be tempting to use alcohol to cover up how you are feeling or ease feelings of stress and anxiety, says Dr Zollinger-Read, "but alcohol will only make you feel worse in the long run. Christmas is a time of year where people often drink more than recommended.
"Remember that alcohol is a depressant and can enhance the symptoms of depression. If you’re taking anti-depressants, then I would avoid alcohol altogether."
If your family don't know you have depression, as hard as it may be - now might be the time to talk to them about it. On the other hand, if you'd like to keep busy but don't want to hang out with the family, then there are plenty of support groups and volunteer work with the homeless around this time of year.
How To Do Exercise Mindfully
An extract from Richard Gilpin's book on depression: Mindfulness for Black Dogs and Blue Days
• Take a walk for the experience of walking. Perhaps around a park or any quiet, open space. Rather than needing to get somewhere, use this time as a break from having to ‘do’ anything.
• Walk naturally. The only diff erence to how you normally walk is that you are deliberately applying your mind to what you are doing as you are doing it.
• Adjust your pace to suit your state of mind. Walk faster if drowsy or if there is a lot of thinking. Walk slower if you feel restless or irritable. Gaze softly ahead.
• As you take each step, tune into the sensations that accompany the motion of the body. Give particular attention to the contact between the soles of the feet and the ground. Use this contact point as a way of anchoring yourself in the present. Allow awareness to inhabit the body and senses.
• Notice each step. Notice the changing pattern of physical sensations in the legs and feet as they alternately receive the weight of the body. Relax. Let go of any concepts about walking. Let the body walk itself. Walking is automatic. It doesn’t require thought. It just happens. Let it just happen.
• Distractions will arise. The mind will get caught up in chains of thoughts, sounds or visual phenomena. This is normal. As soon as you realize the mind has wandered, gently and patiently escort the attention back to the sensations of contact between the feet and the ground.
• Don’t expect the mind to be still. Allow whatever arises in the mind to pass through. Stay with the experience of walking, the sensations of touch and movement.