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Depression and the Holidays with Kenneth Johnson, M.D., Psychiatrist, Columbia St. Mary’s

Depression and the Holidays
with Kenneth Johnson, M.D., Psychiatrist, Columbia St. Mary’s

Last Updated: Dec. 1, 2003

Depression is one of the highest causes of disability year-round, said Dr. Kenneth Johnson, a psychiatrist at Columbia St. Mary’s, with the latest reports showing that it costs the American economy between billion and billion a year due to lost productivity and medical costs.

It’s also one of the most common illnesses for adults of working age, and the biggest factor in suicide for college students.

Kenneth Johnson, M.D. Kenneth Johnson, M.D., Psychiatrist, Columbia St. Mary’s

“Wintertime in general is a little bit harder for people, but I think the bigger cause of holiday depression is unmet expectations.”
But, he said, you don’t have to have full-blown depression to experience the holiday blues. “It’s multifactorial. Wintertime in general is a little bit harder for people, but I think the bigger cause of holiday depression is unmet expectations,” Dr. Johnson said.

His solution?

“Decide for yourself what the holiday means for you and how you’re going to make it a good holiday.”

The first part of that means adjusting your expectations to match your current reality.

Expectations vs. reality
“There’s nothing magical about the holidays,” Dr. Johnson said. “If you don’t get along with your sister during the year, you’re not going to get along with her during the holidays.”

Understanding that before you arrive at the big family gathering can make a big difference in how you feel when you’re putting your coat on to go home.

Adult children of divorced parents and parents who share custody should plan up front how they’re going to divide their time this season. People should also take into account that the holidays may be a busy time at work.

“People who work in the retail and service industries can’t devote all their time to the holiday when they have other things going on in their life,” Dr. Johnson said, adding that for women, the holidays can be an additional and unpleasant reminder of their own childhoods.

“A lot of women who work now were raised by women who stayed at home, and although they’re working, they’re still trying to produce this old-fashioned Christmas, which is an enormous amount of work.”

The doctor’s prescription?

“Take a stand.”

One example is his stand on gift giving. Dr. Johnson buys presents for the children in his life, but added, “I do not enjoy giving gifts to adults at Christmas other than my spouse, parents and close family members.”

In the 1800s, Dr. Johnson said, there was no tradition of giving gifts to other adults or other families. Parents bought one gift apiece for each of their children, and that was all.

One gift you can give yourself, Dr. Johnson said, is the realization that you don’t have to live up to the lofty ideals portrayed by television specials and ads depicting an idealized vision of the season.

“If you’re a woman who can’t crank out cookies like your grandmother did,” he said, “you’re not a bad person. If you’re a dad who has a business and can’t devote as much time as you’d like to your family, you’re not a bad person.”

People who have significant mental illness should be especially mindful of taking their medication and keeping regularly scheduled appointments with their doctors during the season.

Light therapy
Those with a touch of the wintertime blues may want to try light therapy, Dr. Johnson said.

He recommends 10,000-lux units, and spending 30 to 60 minutes sitting under the lights first thing in the morning. “They’re great, and you don’t need a prescription for them,” Dr. Johnson said. A lot of his patients take that time to read the morning paper and sip a cup of coffee.

Signs of depression
If things don’t improve, Dr. Johnson offers this advice. “We all have bad days, and we’re all going to suffer with those – it’s just life,” he said.

“But if you have a period of more than two weeks where you have a depressed mood, crying spells, sleep problems, feelings of guilt and thoughts of death or suicide, you probably have a major depression and should seek medical care. You’re moving beyond the holiday blues.”

We Have Answers
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