Managing the Holiday Blues

Our Psychiatrists Answer Your Questions

In 2020, an estimated 14.8 million adults in the U.S. had at least one major depressive episode.

This represents approximately 6 % of the U.S. adult population. In fact, this number is even higher than reported, as some individuals may go undiagnosed or choose to not seek treatment.

And during the holidays, the feelings of depression and sadness can increase. You may have heard of Seasonal Affected Disorder or SAD. SAD most often begins and ends when the seasons change, according to the National Institute of Mental Health (NIH). Many people feel “winter blues” because the days get shorter in the fall and winter months, and we lack a higher amount of sunlight and vitamin D – even as Floridians we experience the effects of SAD, although not as much as those in colder climates.

At Lakeland Regional Health, we know that not every health concern or need is physical. At the Harrell Family Center for Behavioral Wellness, we have an expert team of psychiatrists and therapists who work closely with patients to create an individualized plan to care for their mental health, not only during the holidays but every day. We sat down with some of our providers to learn more about how depression affects people and about the advanced treatments that we offer here at Lakeland Regional Health.

Featured Physicians

Bishoy Kolta, MD

Psychiatrist

I felt I can help lots of patients suffering from different behavioral conditions like depression, anxiety, or OCD by helping to relieve the tension, pressure, and stigma associated with these conditions.”

Joseph Pullara, MD

Psychiatrist

“My biggest passion in mental health is psychedelic psychiatry, which focuses on reviving the rich history of clinical research on substances such as ketamine, psilocybin, LSD, and MDMA to treat a range of conditions."

Simon Chamakalyil

Psychiatrist

“I really enjoyed working with people from all walks of life, including all socioeconomic backgrounds and experiences. I like to employ positive psychiatry and psychology in my everyday work to improve overall patient care and outcomes.”

Madhurya Polavarapu, MD

Psychiatrist

“It has been very fulfilling to be part of the care team that helps to bring healing when adolescents and adults (including geriatric patients) are in crisis situations.”

What is depression?

This is a very difficult question to answer briefly, but depression is a common — yet potentially serious — mood disorder. There are many potential risk factors that contribute to the development of depression such as family history, brain chemistry, and life events. Sometimes depression can feel bigger during the holidays, especially if we are grieving the loss of a loved one.

Various recognized symptoms can include:

Persistent feelings of sadness, emptiness, or hopelessness
Loss of interest or pleasure in activities that were once enjoyable
Fatigue or lack of energy (even after rest)
Difficulty sleeping, including insomnia or excessive sleeping
Changes in appetite or weight
Difficulty concentrating or making decisions
Feelings of worthlessness, or shame
Feeling guilt
Thoughts of death or suicide, or suicide attempts
Persistent irritability, restlessness, agitation, or feeling run down

Depression in Adults

Are there different kinds of depression?

Yes. There are several different disorders which can present with symptoms that are consistent with depression, including:

Major Depressive Disorder (MDD): MDD is the most common type of depression. It involves 5 or more of the above symptoms. Diagnosis of MDD requires that symptoms last for at least two weeks.
Persistent Depressive Disorder (PDD): PDD is another form of depression that lasts for at least two years. People with PDD may experience symptoms similar to those of MDD at a lesser level of severity, but symptoms linger much longer.
Seasonal Affective Disorder (SAD): SAD is a type of depression that occurs during the winter months when there is less sunlight. Symptoms typically improve in the spring and summer. As mentioned before, the holiday months typically fall during the fall and winter and can increase our feelings of depression or sadness.
Postpartum (Peripartum) Depression (PPD): PPD is a type of depression that affects some women before or after they give birth. Symptoms can range from mild to severe and may also include feelings of sadness, anxiety, and exhaustion. Read more about PPD.
Bipolar Disorder: Bipolar disorder involves alternating periods of major depression and mania or hypomania (a less severe form of mania).
Psychotic Depression: This type of depression is characterized by severe depressive symptoms accompanied by psychotic symptoms, such as delusions, paranoia, or hallucinations.

Is depression common?

Yes. Nearly 15 million people have experienced at least one major depressive episode in 2020. Women are more likely to experience depression than men, with an estimated 10.5% of adult women experiencing a major depressive episode in the past year, compared to 6.2% of adult men. Depression can occur at any age, but it often first appears during adolescence or early adulthood, with the highest prevalence (17%) observed among adults aged 18–25 years old.

Can the holidays increase someone’s depression or sense of sadness?

A study by the National Alliance on Mental Illness (NAMI) shows that 64% of people with a mental health diagnosis like depression or anxiety report holidays make their conditions worse. It’s important for family and friends to watch out for their loved ones and if they detect increased signs of depression, anxiety, or mental distress to offer support and resources.

How can depression affect me or a loved one?

Depression can create hurdles in our daily life by affecting our mood, thoughts, behaviors, decision making, physical health, and ability to enjoy things we like. It can affect our relationship with others including our loved ones and how we perceive them. Depression affects our work productivity and can impact our ability to think clearly. Every individual experiences these challenges differently, so when we increase our awareness of depressive symptoms and treatments, we can grow empathy to support our loved ones experiencing them.

You may feel an increased sense of sadness during the holidays. Holidays can increase stress and feeling overwhelmed. Whether we are hosting family, missing a loved one, or feeling financial strain, the holidays blues are common and treatable.

How is depression treated?

Depression is usually treated with a combination of medications and psychotherapy. Some types of depression can be treatment resistant; in such cases, other alternatives should be considered. Our expert team will conduct a thorough evaluation to determine which treatment is suitable based on each patient’s needs. This may include a review of medical history, a physical exam, and a mental health evaluation.

Some forms of treatment are:

Therapy is always a great method for helping folks with depression ranging from mild to severe. There are various forms, including group therapy, cognitive behavioral therapy, family therapy, individual therapy, and more.
Medication options are available for those who therapy alone may not be sufficient.
Electroconvulsive Therapy (ECT) involves a brief electrical stimulation of the brain while the patient is under anesthesia. During treatment, the patient’s brain is stimulated with a brief controlled series of electrical pulses, causing an intentional seizure within the brain lasting approximately one minute. The patient is asleep for the procedure and awakens after 5–10 minutes. Evidence indicates that approximately 80% percent of patients with uncomplicated, but severe, major depression can have substantial improvement with ECT.
Transcranial Magnetic Stimulation (TMS) includes activating the right side of the brain, which is known to be responsible for depressive symptoms. By stimulating the right hemisphere, the brain produces a robust amount of neurotransmitters that help your mood. During treatment, magnetic electrodes are placed on the scalp to create a magnetic field on a specific area. It is a safe, effective, and painless procedure for treatment-resistant, severe depression. It is administered 4–5 times per week for a couple of weeks.
Intravenous (IV) ketamine is an agent to help with depression, particularly for treatment-resistant depression. It is effective for short-term and long-term relief. During treatment, ketamine will be administered through the IV line slowly over a period of 40 minutes to an hour. During this time, the patient may experience dissociation or other sensations. After the infusion is complete, the patient will be monitored to ensure that they are stable and safe to leave. Follow-up appointments are necessary to monitor their response to the treatment and to adjust the dosage or frequency of treatments as needed. This treatment is still being studied, but has been shown to be effective.

Is there hope for depression?

Of course! In addition to professional treatment, having supportive friends and family will be a great resource for someone going through depression. Your support system can help you with things like scheduling appointments, checking in on how these visits are going, and making sure you are taking your medications and attending your therapy sessions. Providing a positive outlook and being optimistic with their loved one who is being treated for depression can further help improve the chances of successful outcomes.

Depression is a common, but difficult disorder to endure. However, with proper diagnosis, treatment, and support, it is possible to thrive and enjoy life to the fullest. We are here to support all patients who are experiencing difficult hurdles. You are not alone.

If you are feeling the holiday blues this year, make sure to practice self-care and check-in with your primary care provider on ways to stay healthy mentally and physically.

Harrell Family Center for Behavioral Wellness

A place of hope, connection, recovery, and support-close to home. At Lakeland Regional Health, we know that not every need a person has is physical, and we understand the powerful connection of mind and body. If you are facing mental health challenges, we are here to care for you. Our incredible behavioral wellness team at Lakeland Regional Health will partner with you through each step.

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If you or a loved one are experiencing a mental health crisis, there are resources to help.

In the event of a life-threatening emergency, always call 911.

If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support:

Local 24/7 emotional support and Crisis Line at Peace River Center 800-627-5906 or send ‘Talk’ to 863-204-3443.
The 988 Lifeline network is available 24/7 across the US. You can call or Text 988 for help.
To reach National Suicide Prevention Lifeline call 1-800-273-8255.