Mental Health Check-In — Holiday Edition

Collage illustration by Emily Blevins

Even in normal circumstances the holidays can be stressful, but 2020 has clearly presented its own set of challenges. We asked MarinHealth’s Heather Carlberg, M.D., medical director of Behavioral Health, and Rebecca Maxwell, LCSW, director of Behavioral Health, for some advice on making the most of the holidays and how to help someone who needs emotional support.

Why do people feel more of a strain on their mental health during the holiday season?

Rebecca Maxwell: There are many reasons like busier schedules, social obligations, religious events, remembering loved ones who have passed, and there is less daylight, which for some directly impacts mood. People often use alcohol as a pick-me-up, but alcohol impairs judgment and rational thinking. Excessive alcohol use or binge drinking may contribute to increased feelings of depression. Because of the pandemic and shelter in place, this year will have more of the same stressors and added ones, too. People may still not be able to gather with their families, social support systems or congregations. Some may have lost people in their lives and grief may be prolonged and exacerbated by the holidays.

Heather Carlberg: The pandemic has turned our worlds upside down. For many, it slowed us down in ways we have not seen in years. Our expectations have shifted and we have all had to learn to sit with uncertainty. At the same time, we have been deprived of some of our coping strategies like hugs, travel, dinner with friends, shopping, etc. Additionally, we have had to manage stress around fires and unhealthy air. This can lead to habits of excess like too much food or alcohol or doom scrolling. The goal of these behaviors is to numb these uncomfortable, uncertain feelings, but sitting with uncertainty is a fundamental task of well-being.

What are the main differences between having the holiday blues and a mental health disorder?

RM: The major difference is the level of impact that it has upon the individual. It is normal for one to feel more sadness or experience stress during the holidays, but it is usually transient and without significant impact on the individual’s ability to function. It’s when these symptoms become pervasive, last for several weeks or more, and severely impact one’s life that it becomes a mental disorder.

Tips for coping with 2020 stressors during the holiday season?

RM: We can try to let go of what we cannot control, and that seems like a lot these days. But what we are able to control — good quality sleep, regular exercise and eating well-balanced meals — can help us navigate through these challenging times. Get outside as much as possible. Be mindful of your media intake. There is so much fear and misinformation being spread; only rely on trusted news sources and limit your daily exposure. Use technology to stay in touch with those you cannot connect with in person, and do this often. Meditate, take a bath, listen to music and make time to relax. Pay attention to your body, mind and spirit. Don’t ignore feelings or physical symptoms of anger, sadness or frustration.

HC: The science of behavioral psychology teaches us that circumstances are a small part of what makes us happy. Our choices around how we spend our time, how we spend our money and where we place our attention are responsible for a much larger percentage of our happiness. Make this holiday a time to use the lessons learned from 2020. Make it slower, be mindful of what you have and stay focused on what really matters.


Collage illustration by Emily Blevins

What advice can you give someone who is already dreading the holiday season because they will be spending it alone?

RM: Set your expectations and don’t compare your situation to others’. Be kind to yourself, and practice self-care. Reach out to others. Those around you may not know that you feel lonely, so speak up for yourself and ask for what you need. Volunteer — in person or virtually. Giving back helps one feel a sense of purpose and meaning and helps one connect with others. Join a support group or connect with a therapist.

What are some signs that kids might be depressed or suffering from another, and possibly newly developed, mental health disorder?

RM: Be on the lookout for the commonly known symptoms of depression such as feeling sad or depressed, decreased interest in things that they used to be interested in, becoming withdrawn or isolative, changes in sleep, appetite, weight, energy, expressions of worthlessness or hopelessness, thoughts of suicide or wanting to die. Children and teens do not necessarily display symptoms of depression like adults. Sometimes they may be more irritable or agitated and may lash out at their parents, siblings or peers. Teens can be impulsive, so listen when they say that they feel sad or even suicidal and offer support and seek help. Be on the lookout for intentional self-injurious behaviors such as cutting, burning, drug or alcohol use. If you notice any of these things, ask how your child is feeling. Be direct and let them know that help is available and they should never feel embarrassed or ashamed letting someone know how they are feeling.

If someone close to you seems to be suffering from a mental health issue and they are unaware of it, how can you help?

RM: Talk to them, let them know what you have noticed and offer support. Reach out to those who may be more isolated and lonely; let them know they are not alone. If you are concerned about their safety, offer to support them in making an appointment to speak to a mental health professional. 

Additional information and resources can be found at MarinHealth Behavioral Health, 415.925.8808; Marin County Behavioral Health and Recovery Services; Access and Assessment Line, 888.818.1115; Crisis Stabilization Unit, 415.473.6666; Mobile Crisis Response Team, 415.473.6392; National Suicide Prevention Lifeline, 800.273.8255.