Depression at Christmas common in both men and women

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The Christmas season usually conjures up images of family gatherings, presents and joyous festivities.

But for many people, much like Santa arrives every year, so does their depression and Christmas becomes anything but the happiest time of year.

Many people still think experiencing Christmas "depression" is just a word used to describe being over-stressed or unhappy during the holidays. However, there is a difference between getting the blues and clinical depression, said Karen Liberman, executive director of the Mood Disorders Association of Ontario.

The confusion arises, she said, because many of the symptoms are the same, but the circumstances surrounding depression is different for everyone. It could be a seasonal depression, it can happen for the first time, or it can happen to a regular depression sufferer.

However, just because you have clinical depression does not mean you will suffer a bout of it at Christmas time.

"People can already be clinically depressed and their depression is not worse this time of year," she said.

Liberman said the reason why many experience Christmas, or holiday depression, is because Christmas creates what she calls the "hype of expectations," the perception that everyone else is happy, has loving family and friends and has the time and money not only to host a great party, but cook and bake everything from scratch.

"Generally, the Hallmark cards and the Christmas carols, the 'everybody seems to have it together and I don't,' so that dissonance between what you see on the television with the happy family eating turkey and 'I haven't been able to do that for 20 years,' you wonder, 'what am doing wrong?'"

Besides trying to live up to the ideal and the expectations of the season, Liberman said the stressors can come from anywhere, from financial strain to no social invitations or too many obligations, to personal lives that don't live up to the jolly ideal.

For Toronto resident Elizabeth Peers, her depression always gets worse around the holidays.

It can be because her expectations are heightened and she feels she doesn't have the happy ideal or because she's not in a relationship.

"At the times when I didn't have anyone it seemed more prevalent because it's the holidays that you usually share with your husband and your kids, and Christmas highlighted that I didn't have that in my life because I was single," Peers said.

Liberman said relationships, or rather, how happy or satisfied you are within them, can be a contributing factor. However, she said, it's all about the perception because even if you are married, the marriage could be in an unhappy state or perhaps you still don't have the supportive family and friends.

"So I don't think you can say it's a condition of singlehood, it's all about the perception and all about the dissonance between the media-driven, socially-accepted expectation that it's all going to be goodness and light...," she said.

"The reality for a lot of people is that it's not that and for some people the fact that it isn't, that is very painful."

Peers said the fact her reality wasn't idyllic most Christmas seasons - she was affected quite deeply. Her perception was everyone else was happy and cheerful and running off to parties, except her.

Adding salt to the wound, Peers said she felt she couldn't escape the feelings of loneliness and sadness because the reminders were everywhere. Soon after Halloween, the signs of Christmas were everywhere.

"It just heightens the fact that you are alone because you feel like you're the odd person out not having this wonderful time rushing off to shop or go to parties or taking the children to see Santa," Peers said.

Liberman said with all the happy images of the Christmas season, it's so easy to compare yourself to them and feel inadequate. But the stress of the season is also a contributing factor that can trigger depression in those who are vulnerable.

Also, Liberman said every person who suffers from depression suffers different symptoms - men and women.

"There are about 20 possible symptoms of depression, and sometimes, some of those symptoms come out more in women than they do in men," she said. "For example, a lot more women cry, a lot more men get angry."

Besides crying, women feel emotions like guilt, self-hatred, doubt and men tend to withdraw from people and don't want to seek help and self-medicate. Both suffer from appetite issues and sleep issues, either doing one or the other too much or too little.

Peers says when her holiday depression would hit, she would hide out, avoid socializing, she would sleep and eat too much or too little depending on how severe her bout was.

However, in the past 10 years, Peers has been able to manage her depression by changing her perspective on things. While she still fights off the twinges of depression, she said she has become more mature and has tailored her expectations to meet her own individual happiness and needs, no longer comparing her reality to others or the "ideal."

"I used to dwell on what I perceived was happiness and merriment that everyone was happy and rushing off to parties and here I was not doing those things," she said.

Now, every Christmas, Peers said she does what makes her happy and it helps her cope during what used to be a very difficult season. For example last year, on Christmas Day, she didn't want to be around so she jumped on a plane to London, England.

Liberman said, it's healthy to create your own normal and suggests doing whatever it takes to make yourself happy instead of trying to live up to the images you see. But she also urges if you do have symptoms of depression, seek help and go to your doctor.