As a pandemic continues through another holiday season, will you be rethinking plans? Canceling? If you gather with families or friends, will you wear masks? Will you insist on social distancing?

And – possibly most stress-inducing – will your family members agree with your idea of what a safe holiday should look like? Or will your decisions lead to family fights or tension?

Importantly, what will this stress and tension do to your mental health?

The holiday season, during normal times, can be filled with stress. According to Harvard Medical School’s On the Brain newsletter, a 2015 survey conducted by Healthline cites that “62 percent of respondents described their stress level as ‘very or somewhat’ elevated during the holidays, while only 10 percent reported no stress during the season.”

Add to the stressful holiday equation a global pandemic and opposing beliefs about what safety precautions are necessary, and stress levels are likely to rise.

This could lead to an increase in depression and anxiety.

How Holiday Stress Can Lead to Depression

According to On the Brain, the “shifting set” is how we manage a set of mental skills (like managing time, being present, planning, organizing, and remembering details). People have to have the cognitive flexibility to adapt quickly to new circumstances.

Ellen Braaten, PhD, a Harvard Medical School associate professor of psychology at Massachusetts General Hospital and associate director of its Clay Center for Young Healthy Minds, noted in the On the Brain newsletter that the “tough part is that shifting set, which can be hard for us at any point in the year, is particularly pervasive at the holidays.”

Since the number of responsibilities and activities increase during the holidays, our brain can get overwhelmed.

“Over time, a high level of demand can decrease memory, halt production of new brain cells, and cause existing brain cells to die,” according to On the Brain newsletter. “Fortunately, holiday stress is a special kind of stress: an acute reaction to an immediate threat.”

“Once the holidays are over, we have ways of relaxing,” Dr. Braaten says. “The stress of the season goes away.”

Holiday Stress in a Pandemic

The global pandemic adds a considerable load to the already elevated level of responsibilities that arise during holiday season. Issues related to travel safety, family members’ health risk profiles, and precautions (or lack thereof) taken by family members can increase stress levels to greater than in the past.

“Stress has direct effects on mood. Early initial symptoms of lowered mood can include irritability, sleep disruption, and cognitive changes, such as impaired concentration,” Alice Boyes, Ph.D. writes in an article entitled “Why Stress Turns Into Depression” published in Psychology Today. “However, the indirect effects of stress are often what causes depression to take hold.”

According to Dr. Boyes, some examples could include:

1. Skipping healthy coping strategies
2. Creating bigger problems by being in a low or bad mood (e.g., being “stressed out” leads to blowing up at someone, resulting in a fight)
3. Disrupting relationships, as the stressed-out person isn’t as emotionally available
4. Engaging in unhealthy behaviors to cope (e.g., abusing alcohol)
5. Disrupting routines which help the ability to function

While it is possible that the stress of altering holiday plans in light of COVID-19 can lead to depression, it is also possible to manage some of those symptoms by planning for the changes ahead of time.

“In psychotherapy, we talk about ‘coping ahead,’” states Adriane Bennett, Ph.D. in a Cleveland Clinic’s Health Essentials newsletter. “If a big event is coming up, don’t wait until it happens. Start planning and coping now, which is especially good [in the case of the holidays in age of COVID-19] because of all the uncertainty.”

Should You Have A Virtual Holiday Celebration?

Dr. Bennett advises assessing risk factors to determine what your upcoming holiday celebrations will look like. Things to weigh include comfort with traveling, individual health profiles, varying degrees of pre-holiday precautions taken by your loved ones, and reasons for participating.

“The more people an individual interacts with at a gathering and the longer that interaction lasts, the higher the potential risk of becoming infected with COVID-19 and COVID-19 spreading,” writes the Center for Disease Control & Prevention (CDC) in its Considerations for Events & Gatherings statement.

Additionally, the CDC asserts that the lowest risk of spreading COVID-19 during the holidays would be through virtual-only gatherings. The highest risk is “large in-person gatherings where it is difficult for individuals to remain spaced at least 6 feet apart and attendees travel from outside the local area.”

If you decide to rethink the configuration of the celebration, Dr. Bennett insists it is still possible to create something positive.

“When you’re thinking about holiday rituals and adapting to new or different circumstances, ask yourself, again, if it’s something meaningful to you or something that feels like an obligation,” Dr. Bennett says. “If it’s meaningful, think about how you can still recreate a version of that.”

Managing Your Depression During the Holiday Season

The Mayo Clinic offers some practical tips to minimize holiday stress and depression, including:

1. Don’t force your feelings. “You can’t force yourself to be happy just because it’s the holiday season.”
2. Lean on a loved one. Seek others for support and companionship if you are feeling low.
3. Set realistic expectations. Things change including relationships, traditions and rituals.
4. Set grievances and differences aside. Accept family and friends “as they are” and try to be understanding, as others may be stressed too.
5. Maintain a budget. Create a budget for how much you can spend and make sure to stick to it.
6. Planning to minimize stress. Things come up, but if you set a schedule for your “to do” list, it can help reduce your stress level as you check things off your list.
7. Say no. If saying yes to a request fills you with resentment or overwhelms you, consider saying no.
8. Keep up healthy coping strategies. Stress and guilt compound when you don’t take care of yourself.
9. Take time for yourself. We all need time to ourselves and to unwind, especially when we are feeling stressed or depressed.
10. Don’t be afraid to seek professional help. Talk to a mental health professional if you feel unable to manage your symptoms on your own.

For more about depression and the holidays, read:
• https://genesight.com/blog/patient/the-most-wonderful-time-of-the-year/
• https://genesight.com/blog/patient/understanding-depression-and-anxiety/
• https://genesight.com/blog/patient/how-to-be-mentally-healthy-have-fun-this-halloween/