Navigating holiday stress: How to recognize and support those struggling with depression

Signs of depression can manifest in numerous ways, psychiatrist says

Recognizing the signs of depression can be difficult, as it manifests in various ways, depending on the individual. One common indicator is a noticeable shift in mood, such as persistent feelings of sadness, hopelessness or crying. (RDNE Stock project, RDNE Stock project via Pexels.)

While the holidays are a time many look forward to with joy and excitement, they can cause a range of emotions for others who might be struggling or going through something difficult. Recognizing the signs and symptoms of sadness, depression or a difficult situation can be key to helping someone through a tough time.

“It can be very difficult for many people, whether it’s just the demands of the holidays, being around people, hosting people, having gatherings, maybe going out of your comfort zone,” said Dr. Dan Glassman, an inpatient psychiatrist at Methodist Hospital | Specialty and Transplant. “At the same time, it can be reminders of difficult memories for a lot of people, whether it’s loss of a loved one, loss of relationships or just reflecting on the past about prior holidays that have been tough.”

Recognizing depression

Recognizing the signs of depression can be difficult, as it manifests in various ways, depending on the individual. One common indicator is a noticeable shift in mood, such as persistent feelings of sadness, hopelessness or crying. However, depression isn’t always obvious; some may lose interest in activities they once enjoyed or start isolating themselves from others.

“This can come in the form of not enjoying your hobbies like you used to, or just isolating yourself from people,” said Glassman, who’s also the outpatient medical director for Methodist Hospital | Specialty and Transplant’s partial hospitalization program. “Some of the more common ones you’d see are sleep changes -- too much sleep or too little sleep. They can’t fall asleep or perhaps awaken throughout the night or wake up too early, can’t get back to bed.”

Others might sleep excessively and feel so drained that getting out of bed feels like an insurmountable task.

Beyond mood and sleep, depression often impacts other areas of daily life. Concentration can suffer, with the mind feeling slow and distracted, leading to difficulty remembering details or finding the right words. This cognitive fog can feel like memory loss or early signs of dementia, but it is a result of depression’s toll on mental clarity.

Another common symptom is changes in appetite. Some individuals may eat much less due to a lack of interest in food, while others might overeat for emotional relief. These changes can be particularly noticeable during the holidays, when food is abundant.

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It’s important to note that, while these symptoms can occur occasionally, they become concerning when they interfere with daily life.

“If it’s at the point where you feel paralyzed, you can’t do anything, you can’t engage any coping skills, perhaps work is suffering, relationships are suffering -- those are times to reach out,” Glassman said.

If someone is struggling with hopelessness or thoughts of self-harm or suicide, it’s essential to intervene immediately and seek professional assistance. In cases where suicide is a concern, it’s crucial to act quickly to ensure safety. This might involve calling 911, reaching out to a suicide crisis line (988), or taking the person to the nearest emergency room or psychiatric hospital.

Warning signs like giving away possessions, sudden mood changes or a sense of hopelessness should not be ignored, and it’s important to stay engaged, offering support while encouraging professional help.

Coping with depression

Coping with depression involves lifestyle changes and self-care practices that promote emotional and physical well-being. Glassman noted four that are of particular importance:

  1. Regular physical activity

One of the most effective ways to manage feelings of sadness or depression is by incorporating regular activity into your daily routine. Physical activity releases endorphins, natural mood lifters, and provides a sense of accomplishment, which can be particularly beneficial when depression causes a lack of motivation.

“This should be something you can incorporate into your lifestyle, and it shouldn’t feel like a chore,” Glassman said. “It’s something that should be sustainable. For some people, that might be dancing, gardening or yoga. You could sign up for a class that’s strength training or more cardiovascular. Getting a good amount of activity can be so beneficial.”

  1. Nutrition

Another important aspect of coping with depression is paying attention to nutrition. Rather than dieting, consider the impact food has on brain function. Nutrient-rich foods, such as those rich in omega-3 fatty acids, vitamins and minerals, can boost cognitive function and help manage mood.

[Related: Small changes, big impact: Simple dietary shifts that can lower your cancer risk]

  1. Good sleep hygiene

Glassman stressed the importance of good sleep hygiene.

“Try to go to bed at the same time each night and get up at the same time. This can be more difficult during the holidays but try to keep it roughly the same so you keep that sleep-wake cycle intact. Try to limit the bed for sleep; don’t do work in the bed. And try to limit screen time. Blue light can decrease your melatonin output, which can make it more difficult to sleep.”

  1. Limit caffeine and alcohol intake

Glassman advised cutting off caffeine at least eight hours before you want to fall asleep.

With alcohol, while it may help you fall asleep, it disrupts sleep quality and increases the likelihood of nighttime awakenings.

Holiday impact on depression

When it comes to navigating the holidays, it’s important to recognize that everyone’s needs and preferences are different, especially when it comes to socializing. Large gatherings or family events can be energizing and enjoyable, but for others, these situations can be overwhelming and exhausting.

“It’s important to set those boundaries, both with your families and friends, but also yourself,” Glassman said.

Extroverted individuals may thrive in social environments, while introverted individuals may find too much social interaction draining. Either way, it’s okay to step away when feeling overwhelmed.

“If you’re getting exhausted, it’s OK to step away and have some of your own time.”

Supporting a loved one who is struggling during the holidays -- especially if it’s their first holiday after a loss -- can be challenging but showing that you are there for them is crucial.

“Let them know you’re there for them -- little signs like checking in and saying, ‘Hey, thinking of you,’” Glassman said. “But also let them take command of how much communication they want. Some people might just need some quiet time to reflect.”

While the holiday season might be filled with gatherings, the period after the holidays can be particularly difficult for those who are grieving.

“A lot of people struggle more at this point because they’ve lost that community and engagement.”

Continue to check in on them, acknowledging that their emotional journey may continue after the festivities are over.

Treatment for depression

If someone is considering either medication or psychotherapy, Glassman said each have their own unique benefits.

“Though it is difficult to compare medications versus therapy, in terms of effectiveness, the best predictor of success is treating the patient with what they prefer.”

He sees medications as a tool to get a patient where they want to go.

“Sometimes people may be so down or anxious that it is hard for them to engage in coping mechanisms, to adopt a healthy lifestyle, or to participate in therapy. This is where the medication can help pull you out of the funk.”

He said therapy plays an important role in addressing what the cause of someone’s symptoms are and what to do about it. While it can be difficult at first and take some time, the investment is worth it.

“As you gain more insight into yourself and learn how to tackle tough feelings and situations, you may no longer need treatment (meds or therapy). If you do require longer treatment, that is OK, too. The most commonly prescribed medications can be taken long-term, safely, and it is often helpful to have therapy available as life presents its new challenges.”

Stigmas and mental health

Glassman said he still sees a stigma surrounding mental health, especially among older men who may feel admitting struggle is a sign of weakness. While societal attitudes are improving, the belief that men should “tough it out” remains a barrier to seeking care.

Depression in older men often manifests through irritability, anger or physical complaints like aches and pains, which can be mistaken for something physical rather than a mental health issue.

However, Glassman emphasized that seeking help is not a sign of weakness, but an act of strength.

“It takes courage to reach out, to admit you’re struggling. Oftentimes the hardest part is just getting started and reaching out.”

How Methodist can help

Methodist Hospital | Specialty and Transplant provides a range of services to support people struggling with depression.

For urgent support, the inpatient psychiatric unit offers a safe and structured environment, where individuals can stay overnight and receive around-the-clock care.

“You’ll meet with psychiatrists, nurse practitioners, therapists, counselors, the nurses themselves, and there are different activities and group therapies,” Glassman said. “The idea is to have a wraparound service. Ensure your safety but also get the momentum going in the right direction.”

For ongoing support after inpatient care, Methodist offers a partial hospitalization program and an intensive outpatient program. The program runs Monday through Friday from 8 a.m. to 4 p.m., serving as a “halfway point” between inpatient care and outpatient follow-up, with intensive therapy and medication management. It offers a more flexible option with group therapy three days a week.

After completing these programs, patients typically follow up with outpatient therapists and psychiatrists.

Methodist is actively developing a more robust long-term follow-up program for continued care.

To access any service at Methodist Hospital | Specialty and Transplant, call 210-575-0500.

To learn more about services offered, click or tap here.